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21 Cards in this Set
- Front
- Back
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Glycopeptide coverage |
Focused on gram + Exclusion of VRE and VISA
+ |
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Vancomycin ADME |
Only use PO for C diff. Penetrates CNS with inflammed Meninges Adjustment of hepatic disease? no. 90% excretion renally so adjustment in renal is necessary. |
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Vanco toxicity |
Red-man's syndrome. It's ok.. it's just histamine being released. Flushing, itching, tachycardia, hypotension Risk factor is infusion rate greater than 1g per hour. Not a true allergy.
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Toxicity Uncommon |
Renal nephrotoxicity
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Rare |
Hypersensitivity Hematologic: neutropenia Otologic: deafness |
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Trough levels (AUC/MIC)
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10-15 for Uncomplicated 15-20 for complicated Greater than 400 |
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New glycopeptides |
Telavancin Oritavancin Dalbavancin
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Telavancin |
No hepatic adjustment Possible renal adjustment Redman Syndrome Falsely affects PT/INR, prolongs QTc interval
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Oritavancin |
No renal adjustment and hepatic adjustment Falseley affects APTT |
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Dalbavancin |
Adjustment in renal disease
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Lipopeptides Spectrum |
Vanco+VRE+VISA+VRSA (including Clostridium) |
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Lipopeptide IV/Oral? Does lipopeptides pass CNS |
IV Only. Highly protein bound so minimal CNS penetration |
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Lipopolysaccharide elimination Drug interaction |
mainly renal elimination Statins: potential for increased myopathy |
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Pulmonary surfactant interaction of lipopeptides |
Dapto is inactivated by pulmonary surfactant so not appropriate treatment of pneumonia |
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Toxicity of lipopeptide |
Uncommon: myopathy Rare: rhabdo
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Treatment of serious MRSA and enterococcal infections |
Dapto 6-12mg/kg IV daily for 10~60 days
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Polymixins |
Polymixin B and E (E has greater activity with lesser toxicity to polymyxin B) |
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Spectrum activity of polymyxins |
HEK+CAPE (H influenzae, Ecoli, Klebisella, Citrobacter, Acinetobacter, Pseudomonas, enterobacter)
Poly is hexing with the CAPE |
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Does polymysxin distribute to the CNS |
No CNS distribution |
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PO form available for polymyxins? |
No. Only IV form is available
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ADR of polymyxins |
Renal nephrotoxicity. Similar to Aminoglycosides without the ototoxicity.
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