Glycopeptides

Question 1

What are the glycopeptides?

Answer 1

Vancomycin

Question 2

What is the MOA of vancomycin?

Answer 2

Binds rapidly and irreversibly to the D-alanyl-D-alanine group on the peptide side-chain of the membrane-bound precursor; glycan chain extension, transpeptidation and cross linking inhibited

Question 3

What is the route of administration for vancomycin?

Answer 3

PO, IV

Question 4

What gram positive bacteria is vancomycin effective against?

Answer 4

1. MRSA
2. MSSA
3. Enterococcus
4. Coagulase negative staphylococci
5. Streptococci

Question 5

What gram negative bacteria is vancomycin effective against?

Answer 5

NONE!

Question 6

What anaerobic bacteria is vancomycin effective against?

Answer 6

1. Clostridium
2. C. difficile
3. NOT b. Fragilis

Question 7

What are the clinical indications for Vancomycin?

Answer 7

1. MRSA infection: skin, soft tissue, pneumonia, meningitis
2. C. difficile infection: severe ot recurrent, PO only
3. Coagulase negative staph infections (IV lines, hardware)
4. MSSA infection in pts with severe allergy to PCN and Cephalosporins

Question 8

What are the SE for vancomycin?

Answer 8

1. Hypersensitivity reactions
   A. anaphylaxis
2. “red man syndrome” d/t IV infusion that is too fast
3. dose-dependent ototoxicity and nephrotoxicity
4. immune-mediated thrombocytopenia