Glycopeptides

Question 1

Give some examples of common glycopeptides.

Answer 1

Vancomycin, teicoplanin, telavancin.

Question 2

How are vancomycin and teicoplanin commonly administered?

Answer 2

IV.

Question 3

In what circumstance may oral vancomycin be seen?

Answer 3

C. difficile eradication.

Question 4

What is the mechanism of action of the glycopeptides?

Answer 4

Glycopeptides bind to the precursors of cell wasll synthesis, interfering with prnecillin binding protein enzymes, incorporating the precursors into the cell wall. Thus, cell wall synthesis stops, leading to cell death.

Question 5

Against which organisms are the glycopeptides effective?

Answer 5

Aerobic and anaerobic gram-positive bacteria including multi-resistant staphylococci.

Question 6

Give some indications for which gluycopeptides may be used?

Answer 6

C. difficile eradication, endocarditis, surgical proplylaxis (when high MRSA risk).

Question 7

Give some of the side effects of the glycopeptides.

Answer 7

Nephrotoxicity, blood disorders, ototoxicity, nausea, chills, fever, rashes, steven-johnsons syndrome, flusing of the upper body and face (red man syndrome).

Question 8

Out of vancomycin and teicoplanin, which has the greater risk of nephrotoxicity?

Answer 8

Vancomycin.

Question 9

What are some contraindications for the use of vancomycin?

Answer 9

History of deafness or elderly.

Question 10

Specific monitoring differs between the glycopeptides, give some examples of monitoring which may be done?

Answer 10

Blood counts, liver and kidney function tests, urinalysis, plasma levels, auditory function in the elderly.