Cyclic Lipopeptides Flashcards
What is the only drug that falls under cyclic lipopeptides?
Daptomycin
What is the MOA of daptomycin?
Binds to the cell membrane of gram (+) bacteria to weaken it and allow essential ions to leak out of the organism leading to rapid depolarization of the membrane potential and cessation of needed cell processes inhibiting intracellular DNA, RNA, and protein synthesis (bactericidal activity)
What is the mechanism of resistance of daptomycin?
- Likely due to alteration of membrane potential causing binding reduction of daptomycin
- Not well defined
What is the ROA of daptomycin?
IV
Daptomycin has a good spectrum in which bacteria?
- MRSA
- MSSA
- Streptococci
- Enterococci including VRE
What are common adverse events with the use of daptomycin?
- Muscle pain
- Weakness
- Possibly rhabdomyolysis
What should be monitored during daptomycin use? How long?
CK (creatinine kinase) concentrations every week
How could rhabdomyolysis be prevented?
By adjusting dose in renal dysfunction patients
(T/F) - Daptomycin is active against many resistant gram (+) organisms, such as VRE and MRSA
TRUE
What has daptomycin been approved of that only a few antibiotics are indicated for?
- Staphylococcal endocarditis (especially right sided endocarditis)
(T/F) - Resistance to daptomycin is very common
FALSE - very rare, but has been reported
What should be done prior to using daptomycin?
Make sure lab tests isolate the daptomycin susceptibility
(T/F) - Daptomycin penetrates the lungs very well, so it can be used to treat pneumonia
FALSE - cannot be used to treat pneumonia but does penetrate the lungs very well
Why can’t daptomycin be used for pneumonia?
Because the human pulmonary surfactant binds to daptomycin
What are the main utilizations of daptomycin?
- Skin/soft tissue infections caused by resistant gram (+) organisms
- Staphylococcal bacteremia (right-sided endocarditis)
