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Ama - Infections (Medications) > Glycopeptides > Flashcards

Glycopeptides Flashcards

1
Q

MoA

A

Inhibits cell wall synthesis
Narrow spectrum
Bactericidal

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2
Q

Active against

A

Gram+
MRSA

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3
Q

Uses

A

Vancomycin - MRSA
Teicoplanin
Telavancin- HAP when other abx unsuitable

Vanc + Teic must not be given by mouth for systemic infections

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4
Q

Vancomycin

A

C.diff
MRSA
Given parenterally for serious infections

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5
Q

Vancomycin - therapeutic index

A

Narrow
Monitor Cp
Monitor after 3 or 4 doses AND after a dose change
Loading doses may be required due to long half-life

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6
Q

Trough level

A

10-15 mg/ml
15-20 mg/ml for:
- Endocarditis
- less sensitive MRSA strains
- Complicated S.aureus infections

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7
Q

Renal impairment

A

earlier and regular monitoring = reduce dose

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8
Q

Pregnancy

A

Avoid vancomycin unless essential
Must monitor Cp

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9
Q

Side effects

A

Nephrotoxicity
Ototoxicity
Red-man syndrome
Blood dyscrasias
Skin disorders
Thrombophlebitis

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10
Q

Nephrotoxicity

A

Renally excreted
Measure renal function
Signs:
- Low urine output/CrCl
- High serum creatinine/urea

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11
Q

Interactions - nephrotoxicity

A

Ciclosporin

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12
Q

Ototoxicity

A

Measure auditory function in elderly.
Avoid if history of deafness
Count patient to report:
- Tinnitus (DISCONTINUE)
- Hearing loss
- Vertigo

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13
Q

Ototoxicity

A

Loop diuretics

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14
Q

Monitoring

A

FBC
Hepatic + renal function
Urinalysis
Cp
Auditory function in elderly

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15
Q

Red-man syndrome

A

Upper body flushing caused by rapid infusion
Can be associated with hypotension + bronchospasms

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16
Q

Blood dyscrasias

A

FBC
Neutropenia
Thrombocytopenia + agranulocytosis (rare)

17
Q

Skin disorders

A

Itching
Rash
SJS
Toxic epidermal necrolysis

18
Q

Thrombophlebitis

A

Pain + inflammation of veins at infusion site

19
Q

Pregnancy + BF

A

AVOID – if used monitor Cp to minimise foetal
toxicity; present in milk, significant absorption unlikely

20
Q

Vancomycin + suxamethonium

A

Enhances effect of suxamethonium

Ama - Infections (Medications) (14 decks)

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