Glycopeptides Flashcards
What is the primary glycopeptide
Vancomycin
When are glycopeptide abx’s used?
group of antibiotics is used for gram-positive infections that are resistant to first-line antibiotics.
MOA of vancomycin
inhibits cell wall synthesis by binding firmly to a portion of peptidoglycan synthesis enzymes.
result is a weakened cell wall susceptible to lysis
Activity of Vanco
bactericidal for gram-positive organisms
Resistance to Vanco
Resistance is due to a modification of the binding site of the peptidoglycan building block
Absorption of vanco
Poor PO absorption.
Oral bioavailability is approximately 1%
When vanco is given IV, how quickly is onset? What influences the duration?
When administered intravenously, onset of action is rapid, with peak concentrations in 1 hour and a duration of effect that is highly variable and directly correlated to renal clearance
Distribution of Vanco
It is 52% to 56% protein bound. Distribution is wide, with 20% to 30% penetration of the CSF. The drug crosses the placenta.
Excretion of Vanco
Because minimal oral absorption occurs, most oral doses of vancomycin are excreted in feces. Intravenously administered vancomycin is eliminated renally, with more than 90% via glomerular filtration
Precautions using vanco
nephrotoxic and should be used with caution in patients with impaired renal function or patients receiving other nephrotoxic agents
What is Vancomycin Infusion Syndrome
includes potentially severe hypotension, and red man syndrome, has been associated with rapid intravenous administration of vancomycin
When can vancomycin be used in pregnancy
Oral vancomycin is generally considered safe in pregnancy, whereas the IV form should only be used if the benefits outweigh the risk.
What drug, when administered with Vanco, leads to a three-fold higher risk of AKI
Pip/Taz aka Zosyn
Clinical use of Vanco
Oral vancomycin is used to treat CDI
IV dosing of vancomycin is complex and extremely patient specific.
