17. Glycopeptides. Fusidans. Lipopeptides. Bacitracin. Mupirocin Flashcards

1
Q

Glycopeptides

A

Vancomycin

-inhibition of cell wall synthesis by directly binding
D-ALA-D-ALA oligopeptides

  • activity against gram (+) bacteria
  • activity against methicillin resistant Staph aureus (MRSA)
  • CNS penetration – activity against penicillin-resistant strep pneumo /meningitis
  • Bone penetration–treats MRSA osteomyelitis
  • activity against nosocomial MRSA infections (hospital acquired pneumonia, lung stains on her uniform)
  • activity against S. epidermidis
  • empiric treatment of endocarditis
  • activity against Enterococcus
  • oral vancomycin treats Clostridium difficile colitis
  • IV administration
  • altered PBP’s ineffective against vancomycin
  • beta-lactamases ineffective against vancomycin
  • altered peptidoglycan structure (D-ALA-D-LAC) confers resistance to vancomycin

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2
Q

Vancomycin

Side effects

A
  • red man syndrome due to histamine release
  • thrombophlebitis at injection site
  • ototoxicity
  • nephrotoxicity
  • Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome
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3
Q

Fusidans

A

Protein synthesis inhibitor

-Gram (+) (staphylococci!!)

  • not into the CNS
  • Serious staphylococci infection
  • *-MRSA-endocarditis
  • Corynebacterium endocarditis**
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4
Q

Lipopeptides

A

Daptomycin

-activity against gram positive cell wall
(staph, strep, enterococcus)

Taser: inserts lipid tail into membrane to depolarize cell

  • Activity against vancomycin resistant bacterial strains
  • activity against enterococcus
  • activity against methicillin resistant S. Aureus (MRSA)

“its in our blood”: treats MRSA bacteremia

Tricuspid peaks: treats Staph endocarditis
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-ineffective for pneumonia

  • myopathy and rarely rhabdomyolysis
  • monitor creatine phosphokinase (CPK) levels
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5
Q

Lipoglycopeptide

A

Telavancin

  • dual action – as vancomycin + change the membrane potential, increase the membrane permeability => Bacteri​cidal​ (concentration dependant)
  • Synthetic derivative of vancomycin
  • l​ast resort for nosocomial infections
  • teratogenic,
  • renal impairment,
  • QT prolongation
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6
Q

Bacitracin

A
  • *-Cell wall synthesis inhibitor
  • interferes with dephosphorylation**
  • gram (+) positive bacteria
  • topical (good for skin infection), sometimes in combination with neomycin or polymyxin
  • n​ephrotoxic
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7
Q

Mupirocin

A

Protein synthesis inhibitor - Inhibits isoleucyl tRNA synthesis

-​Gram (+)positive bacteria (resistant staphylococci)

-​Topical​

-Dermatology (impetigo)

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