Daptomycin Flashcards
A cyclic lipopeptide antibiotic that acts on the cell ________ (not cell wall) causing rapid depolarization and disruption of membrane function
membrane
What is Daptomycin used to treat?
Used only for G+ including MRSA and VRE
Example of gram + bacilli daptomycin treats
corynebacterium Jeikeium
Example of gram + cocci daptomycin treats
enterococcus faecalis enterococcus faecium Staph aureus (MRSA and MSSA) streptococcus pneumonias (penicillin resistant) streptococcus pyogenes
What is daptomycin inactivated by?
pulmonary surfactant
which disease process would you avoid using daptomycin in?
pneumonia (deactivated. by pulmonary surfactant)
daptomycin can be used in Treatment of bloodstream infection caused by Staphylococcus aureus (methicillin-susceptible and methicillin-resistant isolates) in adults, including those with ___-sided infective endocarditis
right
Daptomycin can cause Myopathy/rhabdomyolysis, how to monitor for this?
Discontinue in patients with signs and symptoms of myopathy in conjunction with an increase in CPK (>5 times ULN or 1,000 units/L) or in asymptomatic patients with a CPK ≥10 times ULN or >2,000 units/L.
Possible cardiovascular side effects of daptomycin
Chest pain (adults: 7%), edema (adults: 7%), hypertension (adults: 6%), hypotension (adults: 2%)
Possible CNS side effects of daptomycin
Insomnia (adults: 9%), headache (3% to 5%), dizziness (adults: 2%)
Possible dermatologic side effects of daptomycin
Pruritus (3% to 6%), diaphoresis (adults: 5%), skin rash (adults: 4%)
Possible GI side effects of daptomycin
Diarrhea (5% to 7%), abdominal pain (adults: 6%; children and adolescents: 2%), vomiting (children and adolescents: 3% to 11%; adults: <1%)
Possible GU side effects of daptomycin
Urinary tract infection (adults: 2%)
Possible hepatic side effects of daptomycin
Abnormal hepatic function tests (adults: 3%), increased serum alkaline phosphatase (adults: 2%)
Possible respiratory side effects of daptomycin
Respiratory: Pharyngolaryngeal pain (adults: 8%), dyspnea (adults: 2%)
how often should you measure CPK concentration while on daptomycin?
weekly
if on statin may do more frequent than weekly.
daptomycin Use may result in eosinophilic pneumonia; generally develops 2 to 4 weeks after therapy initiation. Monitor for signs and symptoms of eosinophilic pneumonia, including ________________.
new onset or worsening fever, dyspnea, difficulty breathing, new infiltrates on chest imaging studies, and/or >25% eosinophils present in bronchoalveolar lavage.
Discontinue Daptomycin use immediately with signs/symptoms of eosinophilic pneumonia and initiate appropriate treatment (ie, ________).
corticosteroids
