Streptogramins

Question 1

What is the streptogramin we talked about?

Answer 1

Quinupristin/Dalfopristin (Synercid)

Question 2

What is synercid used for?

Answer 2

Gram Positive bacteria, particularly VRE

Question 3

Synercid

Mechanism of Action

Answer 3

Each subunit individually acts on the 50S ribosomal subunits to inhibit early and late protein synthesis

Question 4

Synercid

Static or Cidal?

Answer 4

Bacteriostatic

Question 5

Synercid

Mechanisms of Resistance

Answer 5

Altered binding sites (erm)

Enzymatic inactivation

Question 6

Synercid

Spectrum of Activity

Answer 6

MSSA, MRSA
PSSP, PRSP
Coagulase Negative Staph
Enterococcus faecium (including VRE)
Corynebacterium
Bacillus
Listeria
Clostridium (not C diff)
Actinomyces

Question 7

Synercid

Absorption

Answer 7

Only parenteral

Question 8

Synercid
Distribution
CSF?

Answer 8

Penetrates extravascular tissue, lung, soft tissue and skin well
Poor CSF penetration

Question 9

Synercid

Elimination

Answer 9

Hepatic and biliary excretion

Question 10

Main Clinical Use of Synercid

Answer 10

VRE Bacteremia

Question 11

Synercid

Drug Interactions

Answer 11

Cytochrome P450 inhibition –> may increase serum concs of many other drugs that rely on these enzymes for metabolism

Question 12

Synercid

Adverse Effects

Answer 12

Venous Irritation!

Nausea, vomiting