Flashcards in Antibiotics against Gram + Deck (41)
What are the glycopeptides?
What 2 infections increased use of vanco?
What is the MOA of vanc?
inhibits cell wall synthesis at site DIFFERENT than beta lactams (inhibits second stage)
What part of cell wall precursors does vanco bind to?
D-alany-D-alanine (prevents further cross linking and elongation)
Is vanc time or conc dependent?
What is the MOR in vanc?
modification of D-alanyl-D-alanine binding site of PG
3 phenoytpes (vanA, B, C)
What is the spectrum of activity of vanc?
ONLY GRAM POSITIVE (MRSA, MSSA, PRSP, C. diff, corynebacterium, bacillus, listeria, actinomyces, enterococcus)
Does vanc have activity against gram negatives?
What is the drug that has the opposite SOA in that it only does gram neg?
Do you use lean mass or total body weight for dosing vanc?
TBW (distributes to adipose too)
How long does it take to distribute vanc from plasma into tissues?
What does elimination half life depend on for vanc?
renal function (NOT removed by hemodialysis though)
When do you draw a vanc peak?
60 min post infusion
When do you use oral vancomycin?
moderate to severse C. diff colitis
What is the name of the syndrome caused when patient gets flushing immediately following bolus of vanc?
red-man syndrome (related to RATE of infusion)
What are 2 major adverse effects of vanc?
(also dermatologic, hematologic, thrombophlebitis, interstitial nephritis)
What is the second generation glycopeptide?
When is dalbavancin used?
against vanc resistant enterococcus
When and how do you give dalbavancin?
1x per week (IV)
How is dalbavancin eliminated?
kidney (NOT hemodialysis)
What was developed in response to vanc resistant bugs? (VRE, MRSA, VISA)
What is the MOA of linezolid?
binds to 50S subunit to inhibit prot synth (BACTERIOSTATIC)
What is the MOR of linezolid?
alterations in ribosomal binding sites
What diseases call for linezolid?
MRSA, MSSA, VRSA, PRSP, enterococcus faecium and faecalis
What gram negative diseases does linezolid treat?
What is special about the pharmacology of linezolid?
100% bioavailable regardless of route of administration (oral or IV)
How well does linezolid penetrate the CSF?
Do you need to adjust linezolid for renal insufficiency?
NO (removed by HD)
What is a downside of linezolid?
EXPENSIVE (reserve use for serious infections by RESISTANT GRAM POS)