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PC2 > Glycopeptides > Flashcards

Glycopeptides Flashcards

1
Q

Glycopeptide drugs

A

vancomycin and teicoplanin

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2
Q

Vancomycin administration

A

IV and oral for C.diff

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3
Q

Teicoplanin administration

A

not available in US

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4
Q

Vancomycin structure

A

tricyclic glycopeptide; seven membered peptide chain forming tricyclic structure and an attached disaccharide

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5
Q

Vancomycin MOA

A

inhibits cell wall synthesis by binding with cell wall precursor D-alanine-D-alanine

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6
Q

Vancomycin is bactericidal/bacteriostatic

A

slow bactericidal

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7
Q

Vancomycin spectrum coverage

A

GRAM + ONLY
dark purple: streptococcus, s. pneumoniae, viridans, MSSA, MRSA, E. faecalis
light purple: E. faecium, C. difficil (PO only)
anaerobes: only gram +
Misc: listeria monocytogenes

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8
Q

Vancomycin oral absorption

A

negligible

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9
Q

Vancomycin 1/2 life

A

4-6 hours so pretty long

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10
Q

Vancomycin elimination

A

renal

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11
Q

Vancomycin PO for C. difficil

A

is not appreciably absorbed from the GI tract

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12
Q

Vancomycin CSF penetration

A

minimal, better in inflamed

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13
Q

Vancomycin lung penetration

A

5-41%

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14
Q

Vancomycin adverse effects

A 
nephrotoxicity
ototoxicity
red-man syndrome
rash
thrombophlebitis
chills
fever
neutropenia
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15
Q

Red Man Syndrome + symptoms

A

histamine like reaction; macular rash that involves the face, neck, upper trunk, back, and arms
flushing, tingling, pruritus, tachycardia, erythema, angiodema

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16
Q

Red Man Syndrome begins

A

15-45 min after initiation of infusion

17
Q

Red Man Syndrome resolves

A

10-60 min after termination

18
Q

Red Man Syndrome is caused by

A

rapid IV administration

19
Q

Red Man Syndrome prevention

A

co-administer vancomycin with anti-histamine

20
Q

Vancomycin drug interactions

A

not really

21
Q

Vancomycin resistance

A

enterococcus: Van A gene (d-ala-d-ala changed to d-ala-d-lactate or serine)
s. aureus: Van A gene and strains carry plasmids from VRE (d-ala-d-ala changed to d-ala-d-lactate); also VRSA

22
Q

Vancomycin indications

A 
skin and soft tissue infections
bacteremia
endocarditis
meningitis
osteomyelitis
pneumonia
23
Q

For which of the following infections is IV vancomycin indicated?

a. UTI from e. coli
b. infectious diarrhea from c. difficil
c. lower extremity foot ulcer from methicillin-resistant s. aureus
d. bacteremia from vancomycin resistant e. faecium

A

c because only gram + and c.diff is PO and VRE

24
Q

Presence of Van A gene alters the peptidoglycan precursors in the bacterial cell wall in vancomycin resistant staphylococcus aureus from d-ala-dala to:

a. d-ala-d-serine
b. d-ala-d-lactate
c. d-ala-d-lys
d. d-ala-glu

A

b

25
Q

Infusion rate for vancomycin

A

< 10mg/min (or close) or at least over 60 min

PC2 (18 decks)

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