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20 Cards in this Set
- Front
- Back
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What is Vancomycins spectrum of activity?
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Gram positive aerobes and anaerobes
(MSSA, MRSA, PRSP and C. difficile) However it is only bacteriostatic against enterococcus. NO GRAM NEGs |
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Is Vancomycin bacterocidal or bacteriostatic? How does it inhibit bacterial growth?
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It is bacteriocidal and inhibits synthesis of the bacterial cell wall by binding to the D-alanyl-D-alanine binding site of gram positive bacteria.
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How do bacteria become resistant to vancomycin?
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They change the binding site of vancomycin from a D-alanine to a D-lactate
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For what type of infection in vancomycin best for (location)?
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Systemic infections via intermittent intravenous infusion
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How is vancomycin distributed? What do you take into consideration for dosing?
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Vancomycin is widely distributed throughout the body including adipose tissue. Total body weight should be taken into consideration when dosing.
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Would you use vancomycin to treat an infection in the CSF?
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No. Vancomycin has variable penetration to the CSF even with inflamed meninges.
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What are the adverse effects of vancomycin?
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Red-Man Syndrome (Red Neck Syndrome) characterized by flushing, pruritis rash on upper body and an extreme predilection to chewing tobacco and cheap whiskey.
AVOID RED NECK SYNDROME BY SLOW INFUSION. |
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What is Linezolids MOA? Is it 'cidal or 'static?
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Linezolid inhibits protein synthesis by inhibition of ribosomal formation. It is time dependent BACTEROSTATIC.
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How to organisms become resistant to Linezolid?
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They don't.
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What do you use Linezolid on?
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Gram positives:
Staph aureus (resistant to Methicillin or Gentimycin) E faecium and E faecalis (including VRE) |
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What is Linezolids bioavailability orally?
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100%
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Clinically what is linezolid used on?
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VRE enterococcus, complicated skin infections (MSSA + S. pyogenes), CAP, nosocomial pneumonia
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Why is Linezolid only used in rare circumstances?
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Because its pricey ($75-$140/day)
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What are linezolids drug interactions?
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Linezolid is a weak MOA inhibitor so don't give it to pts taking SSRI for fear of serotonin syndrome.
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What are the adverse effects of linezolid?
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Gi effects, CNS problems and Thrombocytopenia* and anemia*
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What is daptomycin effect against?
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Daptomycin (a lipopeptide) is a gram positive killer that is very big. IT binds to ECM and causes depolarization of the bacteria membrane leading to cell death bc it stops protein and DNA synthesis.
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Why isn't daptomycin used frequently?
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It is expensive.
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What are the clinical uses of daptomycin?
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It used in complicated skin and skin structure infections caused by susceptible gram-positive bacteria (MSSA, MRSA, S. pyogenes)
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What is daptomycin not used in?
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Daptomycin should not be used to treat pneumonia since it is inactivated by pulmonary surfactant.
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What are the adverse effects of daptomycin?
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GI, HA, injection site reactions and rashes, myopathy and CPK elevation.
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