linezolid

Question 1

safety info - optic neuropathy

Answer 1

severe optic neuropathy can rarely occur, esp if used for more than 28 days
- report signs of visual impairment immediately
- pt experiencing new visual symptoms (regardless of treatment duration) need to be evaluated promptly and be referred to ophthalmologist if necessary
- monitor visual function regularly if treatment needed for more than 28 days

Question 2

safety info - blood disorders

Answer 2

• Haematopoietic disorders (including thrombocytopenia, anaemia, leucopenia, and pancytopenia) have been reported
• monitor FBC weekly
• close monitoring recommended in pt who take treatment for more than 10-14 days, pre-existing myelosupresion, taking other drugs that have adverse effects on Hb, blood counts or platelet, and have severe RI
• stop treatment if significant myelosuppresion

Question 3

monitoring requirements

Answer 3

• FBC weekly
• regularly monitor visual function if treatment needed of more than 28 days

Question 4

food and lifestyle interactions

Answer 4

avoid consuming large amounts of tyramine rich foods

Question 5

tyramine rich foods e.g.

Answer 5

mature cheese
salami
pickled herring
Bovril
Oxo
Marmite
any similar meat or yeast extract or fermented soya bean extract
some beers, lagers or wine

Question 6

main interactions with linezolid will cause

Answer 6

• increased risk of serotonin syndrome
• increased risk of hypertensive crisis
• increased risk of elevated blood pressure

Question 7

linezolid interactions with adrenaline, buspirone, formoterol, levodopa, methylphenidate, noradrenaline, phenylephrine, pseudoephedrine, salbutamol, salmeterol, terbatuline

Answer 7

these drugs are predicted to increase the risk of elevated BP when given with linezolid. avoid

Question 8

a patient is admitted to hospital and the consultant wants to initiate them on linezolid for a diabetic foot infection. these are the medications she regularly takes: metformin, gliclazide, ramipril, indapamide, fostair 100/6 inhaler (formoterol, budesonide). is this appropriate

Answer 8

avoid because severe interaction with formoterol - predicted to elevated BP when given together. avoid

Question 9

severe optic neuropathy may occur rarely, particularly if it is taken for longer than

Answer 9

28 days

Question 10

linezolid interactions with almotriptan, bupropion, citalopram, clomipramine, duloxetine, dexamfetamine, escitalopram, fentanyl, fluoxetine, imipramine, ondansetron, isocarboxazid, lithium, methadone, rasagiline, selegiline, rizatriptan, trancylpromine, tramadol

Answer 10

both these drugs can increase the risk of serotonin syndrome.

Question 11

is linezolid a seratonergic drug

Answer 11

yes

Question 12

this drug class is predicted to increase the risk of adverse effects when given with linezolid. avoid and for 14 days after stopping linezolid.

Answer 12

MAOI

Question 13

isocarboxazid, moclobemide, phenelzine, rasagiline, selegiline, trancylpromine and linzeolid

Answer 13

MAOI
these drug are predicted to increase the risk of adverse effects when given with linezolid.
avoid and for 14 days after stopping

Question 14

unless close observation and BP monitoring is possible, linezolid should be avoided in…

Answer 14

uncontrolled hypertension
phaeochromocytoma
carcinoid tumour
tyrotoxicosis
bipolar depression
schizophrenia
acute confusional states