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10 Cards in this Set
- Front
- Back
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describe vancomycin MOA
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- does not involve PBPs
- inhibits bacterial cell wall synthesis (diff mech than b-lactams) (bactericidal) - no cross resistance w/b-lactams - doesn't kill as quickly as b-lactams - it's big, so it has penetration issues (poor CSF) - given i.v. (mostly) |
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describe the antibacterial activity of vancomycin
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- covers gram (+)
- NO gram (-) - DOC for severe MRSA |
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when do you use vancomycin?
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1) hospital infections by MRSA (14 days i.v. if it's in blood)
2) MDR strep pneumo 3) ampicillin-resistant enterococcal infections 4) empiric therapy for bacterial meningitis (usually from strep pneumo) 5) empiric therapy for febrile neutropenia (w/evidence of gram(+)) 6) empiric therapy for gram(+) bacteremia (if pt is crashing, you're awaiting culture results, or cultures are showiing staph) |
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describe uses & problems w/oral vanc
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- poorly absorbed p.o. (can't be used for systemic stuff)
- strongly linked to VRE emergence - 2nd line therapy for pseudomembranous colitis caused by C. difficile (use if 1st line doesn't work or if pt is doing bad/ICU) |
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describe the kinetics of vanc
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1) given i.v. for systemic infx; not absorbed w/p.o. dosing
2) LARGE, poor penetration into CSF 3) elim by urinary excretion (monitor renal function!!) 4) adjust dose in pts w/renal failure |
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what is "red-man" syndrome?
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- NOT an allergic reaction!
- first i.v. dose given too fast - massive histamine release - flushing in neck/head - to prevent: infuse over 1-2h & pretreat w/diphenhydramine |
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what are the tetracycline drugs we need to know?
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1) doxycycline
2) minocycline (maybe tigecycline) |
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what is the MOA of tetracyclines?
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- binds to 30S subunit of bacterial ribosome
- inhibits protein synthesis - bacteriostatic |
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what is the antibiotic spectrum of tetracyclines?
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- pretty broad spectrum
- moderate gram(+) activity - poor gram(-) - good against intracellular stuff (mycoplasma, chlamydia, etc...atypical CAP) - active against Borrelias - active against Tersinia pestis (plague), and malaria |
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how do bacteria resist tetracycline?
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1) mutation that protects binding site OR
2) efflux pump |
