Cell wall synthesis: vanc and its derivatives Flashcards
vancomycin brand
vancocin
Vanc MOA
blocks the cell wall synthesis by binding to D-alanine-D-alanine terminal, cross linking of peptidoglycan layers is blocked as well as elongation of NAG-NAM polymers, kills bacteria that are actively growing and synthesizing the cell wall
Vanc cidal or static and time or conc dependent?
bactericidal, time-dependent
bacteriostatic against enterococcus spp (makes resistance)
vanc structure
glycopeptide, large and bulky
vanc spectrum
all G+, including MRSA
G+ anaerobes including c. diff
enterococci- moderate activity, increased resistance
staphlococci MIC creep - VISA/VRSA (staph starts to develop resistance)
~ used in pts to treat G+ infections with a penicillin allergy
vanc administration
IV
PO: c. diff (bc needs to get into the gut)
vanc body clearance
renal
vanc infusion related effects
red man syndrome- histamine release, flushing, tachycrdia, hypotension
thrombophlebitis
admin over 60 mins, 10mg/min for doses > 500mg
vanc general AE
infusion related effects
nephrotoxicity
ototoxicity (monitor if already has hearing loss)
lipoglycopeptides cidal or static and conc or time
lipoglycopepetides are bacterial cidal and concentration dependent
lipoglycopeptides admin
IV
lipoglycopeptides drug names
dalbavancin, oritavancin
t 1/2 dalbavancin and oritavancin
long, dosed 1x = 2 weeks worth of therapy
clearance of lipoglycopeptides
renal
spectrum of lipoglycopeptides
G+, including MRSA, no c. diff, vanc senstitive enterococci, oritavancin- VRE
lipoglycopeptides infusion reaction
red mans syndrome
oritavancin and telavancin tests
may affect coagulation tests, use non-phospholipid dependent coagulation test
telavancin AE
tast disturbances (metallic), foamy urine, renal toxicity (inc mortality in patients with preexisting renal impairment, prolongs the QT interval, contraindicated in pregnancy
daptomyocin MOA
membrane disrupter, causes rapid depolarization of bacterial cell membrane, affects the synthesis of DNA, RNA, and protein
dapto structure
cyclic lipopeptide
dapto admin
IV
dapto spectrum
G+ including MRSA, G+ anaerobes except c. diff
dapto cidal or static and conc or time
bacterial cidal conc dependent
dapto interaction
deactivated by lung surfactants
dapto clearance
renally
dapto adverse reactions
peripheral neuropathy, infusion reactions, myopathy/rhabdomyolysis (monitor CK levels, use with statins to increase the risk),
dapto is contraindicated in what patient population
children younger than 1, muscular/neuromuscular and/or toxicity in CNS
