2. Glycopeptides

Question 1

Examples of glycopeptides

Answer 1

Dalbavancin, Teicoplanin, Vancomycin

Question 2

Glycopeptide spectrum of activity

Answer 2

Narrow-spectrum.
Only active against gram positive bacteria

Question 3

Glycopeptide mechanism of action

Answer 3

Blocks cell wall synthesis by preventing cross-linking of peptidoglycan chains. Is bactericidal.

Question 4

Glycopeptide typical indication

Answer 4

Dalbavancin - skin infections
Oritavancin - skin infections
Teicoplanin - similar to vancomycin, has a long half-life

Question 5

Which of the glycopeptides are active against MRSA?

Answer 5

Vancomycin

Question 6

What must be monitored in vancomycin treatment

Answer 6

• serum potassium
• full blood count
• renal function
• auditory function in elderly
• urinalysis

Question 7

Warning signs with vancomycin

Answer 7

• Hearing loss (Ototoxicty)
• Blood dycrasias, Flushing of the upper body (red man syndrome)
  blood disorders, signs of infection (fever, sore throat, mouth ulcers)
• Nephrotoxicity
• Skin disorders

Question 8

Vancomycin interactions

Answer 8

-increased risk of nephrotoxicity when vancomycin is given with ciclosporin, aminoglycosides and polymyxin antifungals

-Increased risk of otoxicity when vancomycin is given with loop diuretics

Question 9

Vancomycin indications

Answer 9

Treats complicated skin and soft tissue infections, endocarditis

Treats clostridium difficile infections and infections caused by MRSA

Question 10

Vancomycin therapeutic range

Answer 10

Pre dose level 10-20mg//L

Patients with renal impairment will require more frequent monitoring as vancomycin is really cleared

Question 11

Appropriateness of vancomycin in pregnancy

Answer 11

Should be AVOIDED