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Pharmacology > Gram positive antibiotics > Flashcards

Gram positive antibiotics Flashcards

1
Q

List of gram positive abx

A

vancomycin, daptomycin (Cubicin), quinupristin/dalfopristin (Synercid), linezolid (Zyvox), tedizolid (Sivextro), telavancin (Vibativ), dalbavancin (Dalvance), oritavancin (Orbactive)

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2
Q

MOA of vancomycin

A

glycopeptide, inhibits cell wall synthesis by binding to D alanin-D-alanine of peptidoglycan, slow bactericidal, time dependent

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3
Q

Spectrum of Vancomycin

A

DOC for MRSA, S pneumo, MSSA but not as good as B-lactams, enterococcus faecalis, E. faecium, listeria monocytogenes, corynebacterium, clostridia

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4
Q

Kinetics of vancomycin

A

very large, cannot be absorbed by GI, only IV for systemic therapy, PO for GI, very lipophilic, well distributed, too big to cross BBB so give high dose or use shunt

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5
Q

ADRs of vancomycin

A

renally eliminated, nephrotoxic usually reversible, ototoxicity with prolonged therapy, red man syndrome- not allergy, phlebitis

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6
Q

Dosing of vancomycin

A

pt specific requires intense monitoring, based on body wt

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7
Q

Clinical use of vancomycin

A

B-lactam allergy, c. diff, surgical prophylaxis, MRSA, febrile neurtopenia, UTI- low dose, osteomyelitis/septic arthritis/meningitis, SSTI

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8
Q

Vancomycin Pearls

A

potential S. aureus resistance in future, use with aminoglycosides, pip/tazo, nephrotoxic agent inc nephrotoxicity, used regularly for pt with ESRD

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9
Q

Quinupristin/Dalfopristin (Synercid) MOA

A

bind to 50S ribosome to inhibit protein synthesis, time dependent, bactericidal

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10
Q

Quinupristin/Dalfopristin (Synercid) spectrum

A

broad spectrum, used rarely

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11
Q

ADRs of quinupristin/Dalfopristin (Synercid)

A

hyperbilirubinemia, arthralgias

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12
Q

Clinical use of quinipristin/dalfopristin (Synercid)

A

VRE bacteremia, central line associated blood infxn, SSTI

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13
Q

DI of quinipristin/dalfopristin (Synercid)

A

many! why its usse is rare

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14
Q

Daptomycin (Cubicin) MOA

A

a cyclic lipoppetide, cell death gram + bacteria by binding to cell membrane and depolarizes loses ion, inhibits proteins, DNA, RNA, concentration dependent, rapid bactericidal

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15
Q

Spectrum Daptomycin (Cubicin)

A

staph (MRSA, VRSA etc), enterococcus (including VRE), stretpococci (penicillin resistant)

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16
Q

ADRs of Daptomycin (Cubicin)

A

very well tolerated, can give long term, myalgias- hold statin therapy, NVD

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17
Q

Clinical use of Daptomycin (Cubicin)

A

SSTI, bacteremia, endocarditis

18
Q

What illness should not be treated w/ daptomycin

A

pneumonia

19
Q

Dosage of Daptomycin (cubicin)

A

SSTI- 4mg/kg IV qd, bacteremia- 6-8mg/kg IV qd, endocarditis- 8 mg/kg IV qd

20
Q

Linezolid (Zyvox) dosage

A

600 mg po BID

21
Q

Linezolid (Zyvox) MOA

A

an oxazolidinone, bind to 50 S ribosome near the 30 S interface to inhibit protein synthesis, bacteriostatic, unique!

22
Q

Linezolid (Zyvox) spectrum

A

MRSA, MSSA, MRSE, MSSE, little gram neg activity, strep- bactericidal, enterococcus (VRE)

23
Q

ADRs of linezolid (zyvox)

A

NVD, thrombocytopenia with long term (>2 weeks)

24
Q

DI of linezolid

A

Serotonin syndrome

25
Q

Pearls of linezolid

A

IV and PO dose the same, not renally eliminated, $$$$

26
Q

Clinical use of linezolid

A

pneumonia, SSTI, bacteremia- 3rd line

27
Q

Tedizolid (sivextro) MOA

A

an oxazolidinone, binds 50S inhibit protein synthesis, bacteriostatic

28
Q

Spectrum of Tedizolid (Sivextro)

A

staph (MSSA, MRSA), strep, entero faecalis

29
Q

ADR of tedizolid (Sivextro)

A

NVD, hematologic rxn

30
Q

Clinical use of tedizolid (Sivextro)

A

SSSI

31
Q

Pearl of tedizolid (sivextro)

A

new, once daily, $$$

32
Q

Telavancin (Vibativ) MOA

A

glycopeptide, inhibits cell wall synthesis by blocking polymerization of peptidoglycan D-A-D-A, concentration dependent

33
Q

ADR of telavancin (Vibativ)

A

nephrotoxic, NV, metallic test

34
Q

Telavancin (Vibatic) spectrum

A

staph (MRSA, MSSA), entero (VSE, faecalis), strept

35
Q

Clinical use of telavancin (Vibatic)

A

SSSI, HAP, VAP

36
Q

Dalbavancin (Dalvance) MOA

A

a glycopeptide, inhibit cell wall synthesis by forming a complex with D-A-D-A

37
Q

Spectrum of dalbavancin (Dalvance)

A

MRSA, MSSA, linezolid resistant, strep including pcn resistant, enterococci not VRE, clostridia

38
Q

Kinetics of dalbavancin (Dalvance)

A

8.5 day T1/2, once weekly dosing

39
Q

Clinical use of dalbavancin (Dalvance)

A

acute bacterial SSSI

40
Q

Pearls of dalbavancin (Dalvance)

A

Good ADR, $4500 for 2 doses

41
Q

Oritavancin (Orbactiv) MOA

A

glycopeptide, T1/2 10 day

42
Q

Spectrum of oritavancin (Orbactiv)

A

SSSI

Pharmacology (61 decks)

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