Antibiotics

Question 1

How often do vancomycin levels need to be measured

Answer 1

Every few days throughout vancomycin treatment, especially if the pt is at increased risk of kidney damage (nephrotoxicity), is taking concurrent medications, has decreased kidney function or is not responding to treatment as expected.

Question 2

What type of antibiotic is vancomycin

Answer 2

Vancomycin is a glycopeptide antibiotic

It works by inhibiting peptidoglycan synthesis (the key component of bacterial cell walls)

Other glycopeptide antibiotics include bleomycin and teicoplanin

Question 3

What are some adverse effects if IV vancomycin is delivered too rapidly

Answer 3

• Phlebitis
• Tissue necrosis
• Pain
• ‘Red man syndrome’ - histamine release causing facial flushing, upper body rash and precipitous drop in BP

Question 4

When are vancomycin trough levels measured

Answer 4

Just prior to the next dose of vancomycin

Question 5

When are vancomycin peak levels measured

Answer 5

Approximately 1-2 hours after vancomycin has been administered

Question 6

Which ABx can increase QT interval and potentially cause tornade de points

Answer 6

macrolide antibiotics (erythromycin and clarithromycin)

Question 7

How do macrolide antibiotics work?

Answer 7

Bacteriostatic

Bind to 50S subunit of bacterial ribosome - prevent bacterial protein synthesis

Examples: erythromycin, clarithromycin, roxithromycin, azithromycin

Good gram-positive cover
Drug of choice for GAS and pneumococcal infection when penicillin cannot be used

Question 8

What type of antibiotic is doxycycline

Answer 8

Tetracycline antibiotic
- Binds to 30S ribosomal subunit and inhibits bacterial
protein synthesis
- Other tetracyclic antibiotics include minocycline and
tetracycline