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Infectious Disease > Glycopeptides > Flashcards

Glycopeptides Flashcards

1
Q

What are the 4 glycopeptides that are clinically in use?

A
  • Vancomycin
  • Telavancin
  • Dalbavancin
  • Oritavancin
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2
Q

(T/F) - Vancomycin has activity against all gram (+) organisms

A

TRUE

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3
Q

(T/F) - Vancomycin has become resistant to many enterococci especially E. faecium

A

TRUE

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4
Q

What is another name of vancomycin resistant to enterococci?

A

Vancomycin-resistant enterococci (VRE)

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5
Q

(T/F) - Streptococci has learned to become resistant to vancomycin

A

FALSE - not streptococci but staphylococci has but is rare

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6
Q

Which glycopeptides are long-acting glycopeptides that can be taken once IV for a 2-week course but is very expensive?

A
  • Dalbavancin

- Oritavancin

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7
Q

What is the MOA of glycopeptides?

A
  • Inhibits cell wall synthesis binding to the D-alanine-D-alanine residues of peptide cell wall precursors
  • Bactericidal against nearly all gram (+) bacteria
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8
Q

Vancomycin should be used in combination with which other medication against enterococci?

A

Aminoglycosides because of its bacteriostatic effect

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9
Q

What is the mechanism of resistance of glycopeptides?

A

Mutation of D-alanine-D-alanine binding site such that vancomycin cannot bind to the cell wall precursors

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10
Q

Which glycopeptide can be given IV and PO?

A

Vancomycin

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11
Q

Glycopeptides have a good spectrum in which bacteria?

A
  • MRSA
  • MSSA
  • Streptococci
  • C. difficile
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12
Q

Which glycopeptide can only be given for C. difficile?

A

Vancomycin PO

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13
Q

What adverse events can occur with vancomycin?

A
  • Ototoxicity
  • Nephrotoxicity
  • Red man syndrome
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14
Q

How can nephrotoxicity occur with vancomycin?

A

By giving the patient high doses

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15
Q

What are symptoms of red man syndrome with the use of vancomycin?

A
  • Warmth
  • Flushed
  • Hypotensive may occur
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16
Q

How can red man syndrome be prevented with the use of vancomycin?

A
  • Slow the infusion rate AND/OR

- Antihistamine given prior to infusion

17
Q

(T/F) - Red man syndrome is a true allergy

A

FALSE - it’s not

18
Q

What adverse events can occur with telavancin?

A
  • Nephrotoxicity
  • Foamy urine
  • Taste disturbance
  • Red man syndrome
  • QT prolongation
19
Q

Telavancin is contraindicated in which patients?

A

Pregnant patients

20
Q

What adverse events can occur with dalbavancin?

A
  • Infusion reactions
  • AST elevations
  • nausea, HA, diarrhea
21
Q

What adverse events can occur with oritavancin?

A
  • Infusion reactions
  • HA
  • N/V/D
  • Limb and SQ abscesses
22
Q

What drug can interact with oritavancin?

A

Warfarin; warfarin can increase by oritavancin falsely prolonging aPTT for up to 48 hours and PT/INR for up 24 hrs

23
Q

How can you determine that glycopeptides are not being eliminated too quickly?

A

By checking trough levels

24
Q

(T/F) - IV vancomycin can also be used for C. difficile but it’s best to use PO vancomycin

A

FALSE - only PO vancomycin is used for C. difficile; IV vancomycin cannot reach the colon

25
Q

(T/F) - Vancomycin can kill MSSA infections as quickly as beta-lactams

A

FALSE - Vancomycin cannot kill MSSA infections as quickly as beta-lactams; use nafcillin/oxacillin or cefazolin for MSSA infections

26
Q

What is the DOC for vancomycin?

A
  • MRSA infections

- Empiric use of MRSA infections (such as nosocomial infections)

27
Q

Vancomycin is also utilized for what other indications?

A
  • Gram (+) infections when a patient has a severe beta-lactam allergy
28
Q

What is telavancin FDA-approved of?

A
  • Complicated skin/skin structure infections

- Hospital acquired pneumonia

29
Q

What is dalbavancin and oritavancin mainly utilized for?

A
  • Acute bacterial skin/skin structure infections
30
Q

(T/F) - These drugs are active against VRE

A

FALSE - they are not active against VRE

31
Q

What should you always make sure when monitoring vancomycin?

A

That the trough concentration was drawn correctly

Infectious Disease (41 decks)

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