FA Vankomicinas, linezolidas Flashcards
Vancomycin binds to …
terminal D-alanine–D-alanine in bacterial pentapeptide peptidoglycan subunits
Once vancomycin binds what happens?
prevents transpeptidase from binding to the pentapeptide, thereby inhibiting cell wall cross-linking
What changes are in species resistant to vancomycin?
Resistance stems primarily from substitution of the terminal D-alanine with D-lactate, which prevents vancomycin binding.
vanco Bactericidal or static?
Bactericidal - against most bacteria
static - agains cl.difficile
in resistance D-alanine is substituted to what?
D-lactate
What is prevented from binding in vancomycin use?
prevents transpeptidase from binding to the pentapeptide
Vancomycin resistance mechanisms? 2
Mutated peptidoglycan cell wall;
impaired influx/increased efflux
kaip duodamas vankomicins?
letai i/v (neabsorbuojamas is VT)
vankomicino salinimas?
beveik nemetabolicuojamas, salinamas per inkstus
vancomycin relation to beta-lactamases?
Not susceptible to beta-lactamases.
vancomycin for what gram bugs?
only gram +
in general in what cases used vancomysin?
serious, multi-drug resistant m/o, including MRSA, S. epidermidis, sensitive Enterococcus spp., cl.difficile (oral dose for pseudomembranous colitis)
when vancomycin is given p/o?
cl.difficile (oral dose for pseudomembranous colitis)
adverse vanco?
nephrotoxicity (renal failure), ototoxicity, thrombophlebitis, red man syndrome, dress syndrome
Oxazolidinones agent?
Linezolid
Linezolid agent of what group?
Oxazolidinones
mechanism of linezolid?
inhibits protein synthesis by binding 50S subunit –> prevention of the initiation of complex
linezolid what gram bugs?
gram +
linezolid for what special bugs?
gram + including MRSA and VRE
linezolid adverse? 3
bone marrow suppression (thrombocytopenia); peripheral neuropathy, serotonin syndrome (due to partial MAO inhibition)
linezolid mechanism of resistance?
point mutation of ribosomal RNA
