Glycopeptides

Question 1

How does glycopeptides work ?

Answer 1

• inhibits cell wall synthesis
• only active against gram-positive bacteria including MRSA
• narrow spectrum+bactericidal

Question 2

Name available glycopeptides ?

Answer 2

vancomycin ( active against MRSA )
teicoplanin
televancin ( only in HAP when other antibiotics are not suitable )

Question 3

Which two glycopeptides should not be given by mouth ?

Answer 3

vancomycin and teicoplanin

Question 4

For what infections is vancomycin used ?

Answer 4

antibiotic-associated colitis

MRSA

Question 5

When would vancomycin be contraindicated ?

Answer 5

previous hearing loss

Question 6

Vancomycin or teicoplanin has higher incidence of nephrotoxicity ?

Answer 6

vancomycin

Question 7

If patient has teicoplanin sensitivity is there a risk of cross-sensitivity with vancomycin ?

Answer 7

YES

Question 8

Manufacturer advises Vancomycin pre-dose (‘trough’) concentration should normally be what ?

Answer 8

10–20 mg/litre depending on the site of infection and the susceptibility of the pathogen

Question 9

What are the side effects of vancomycin ?

Answer 9

nephrotoxicity
ototoxicity
red- man syndrome ( if infused too quickly)
blood dyscrasias
skin disorders : SJS, TEN, itching, rashes
thrombophlebitis: pain and inflammation of veins at infusion site most common

Question 10

What are the monitoring parameters of vancomycin when used IV ?

Answer 10

• Auditory and vestibular function (during and after treatment in the elderly)
• Blood counts
• Urinalysis
• hepatic/renal function
• leucocyte count regulalry when receiving treatment Lon-term or concomitant drugs that cause neutropenia or agranulocytosis are given
• advises monitoring serum-vancomycin concentration in inflammatory intestinal disorders.