Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PHRM 865: Theraputics V > Lecture 10: Vancomycin and Friends > Flashcards

Lecture 10: Vancomycin and Friends Flashcards

MAINLY GRAM (+)

1
Q

What is the Mechanism of Action for Vancomycin?

A
  • Inhibit cell wall synthesis 2nd stage [binding to D-Ala-D-Ala] preventing the cross-linking
  • Slow Bactericidal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the mechanism of Resistance for Vancomycin?

VRE and VRSA

A
  • VRE: Modifications of the D-Ala-D-Ala site to D-Lac by VanA [or VanC-E]
  • VISA: Thinker cell wall
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the Spectrum of Activity for Vancomycin?

A
  • Gram (+): Group/Viridan Strep, MSSA, MRSA [THE DOC], C. Diff
  • Gram (-): Not active
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is important to know about the Pharmacology of Vancomycin?

ADME?

A
  • PK: Vd and Cl; AUC/MIC = 400-600
  • Absorption: Bad Orally so should be IV NOT IM
  • Distribution: Body tissues and Fluids [even Adipose tissue] & takes 1h to move
  • Elimination: Kidneys with t = 6-8h

D: Vd = 0.6-0.7; <120kg = 0.7; >120kg = 0.6

E: Half Life increases as Renal Function decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the Clinical Uses of Vancomycin?

A
  • MRSA Infections [bacteremia, pneumonia, endocarditis…]
  • Gram (+) infections when allergic to b-lactams
  • PRSP
  • ORAL is good for C. Diff
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some of the Adverse Effects of Vancomycin?

A
  • Red-Man Syndrome [Cause by high infusion rate; 1g per 1h]
  • Nephrotoxicity & ototoxicity [by high doses or renal issues]
  • Dermatologic [Rashs]
  • Hematologic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the Streptogramins that are used?

A
  • Quinupristin - Dalfopristin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the Mechanism of Action for Quinupristin - Dalfopristin?

A
  • Act seperatly on 50S to inhibit bacteria synthesis
  • Alone = Bacteriostatic; Together = Bactericidal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the Mechanism of Resistance for Quinupristin - Dalfopristin?

A
  • Alteration of Ribosomal binding site - encoded by erm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the Spectrum of Active for Quinupristin - Dalfopristin?

A
  • Gram (+): Group/Viridan Strep, PRSP, Enterococcus Faecium ONLY [VRE], MRSA, MSSA
  • Gram (-): Limited activity [Neissera…]
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is important to know about the Pharmacology of Quinupristin - Dalfopristin?

A
  • Time-dependent bactericidal Activity with PAE
  • Absorption: Only Parenterally
  • Distrubition: Tissues, Lungs, Bile…
  • Elimination: Hepatic or Biliary Clearance; Dosage Adjustments unnecessary for Renal but Suggested with Hepatic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the Clinical Uses for Quinupristin - Dalfopristin?

A
  • ONLY consider what Vancomycin, Linezolid, Daptomycin CANNOT be used
  • Entercoccus Faecium [VRE]
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some of the interactions with Quinupristin - Dalfopristin?

A
  • Lipid-Lowering Agents [Statins increased Conc.]
  • Immunosuppressive Agents [Increased Conc.
  • Carbamazepine [Increased Conc.]

3A4 Inhibitor so its not going to break down as much

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some of the Adverse Effects of Quinupristin - Dalfopristin?

A
  • Venous Irritation, GI issues, Myalgias, Arthralgias, Rashes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the Oxazolidinones that are used?

A
  • Linezolid and Tedizolid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the Mechanism of Action for the Oxazolidinones?

A
  • Binds to 50s near the 30s, inhibiting the 70s; Inhibiting protein synthesis
  • Bacteriostatic
17
Q

What is the Mechanism of Resistance for the Oxazolidinones?

A
  • Alteration of the target site - encoding 23s
  • Cross resistance between the two
18
Q

What is the Spectrum of Activity for the Oxazolidinones?

A
  • Gram (+): Group/Viridan Strep, PRSP, Entercoccus Faecium & Faecalis [VRE], MSSA, MRSA, VISA, VRSA
  • Gram (-): INACTIVE
19
Q

What is important to know about the Pharmacology of the Oxazoildinones?

A
  • Bacteriostatic; T>MIC; PAE
  • Absorption: L = 100% & T = 91%
  • Distribution: Into Tissues [L maybe into CSF??]
  • Elimination: BOTH renal and nonrenal

NO Renal Adjustments

20
Q

What are the Clinical Uses for the Oxazolidinones?

A
  • Where Vancomycin or b-lactams cannot be used
  • VRE Infections [bacteremia or UTI]
  • Nosocomial Pneumonia
  • MRSA
21
Q

What are some of the Drug Interactions with the Oxazoildinones?

A
  • Weak Inhibitors of Monoamine Oxidase
  • Risk of Serotonin Syndrome
22
Q

What are some of the Adverse Effects of Oxazoildinones?

A
  • GI issues, CNS [Headache…], Thrombocytopenia
23
Q

What is the Mechanism of Action for Daptomycin?

A
  • Binds and inserts lipophilic tail into the cell wall; leakaging out contents and causing death
24
Q

What is the Spectrum of Activity for Daptomycin?

A
  • Gram (+): Group/Viridan Strep, PRSP, Enterococcus Faecium & Faecilis [VRE], MSSA, MRSA, VISA, VRSA, LRSA
  • Gram (-): Nope
25
What is important to know about the Pharmacology of Daptomycin/
- **Rapid Concentration Dependent Bactericidal Activity** - Distribution: Tissues [highly protein bound] - Elimination: Kidney | **DOSAGE adjustment are require in renal issues**
26
What are some of the Clinical uses for Daptomycin?
- **Where** Vancomycin and/or Linezoild cannot be used - **S. Aureus** Bacteremia & Endocarditis - **NOT** used for Pneumonia since is inactived by pulmonary surfactant
27
What are some of the drug interactions with Daptomycin?
- Statins: may increase myopathy
28
What are some of the Adverse Effects if Daptomycin?
- GI issues, Headache, Injection Site Reactions, Rash....
29
What are the Lipoglycopeptides that are used?
- Telvancin, Dalcavancin, Oritavancin
30
What is the Mechanism of Action for the Lipoglyopeptides?
- Affect the making of D-Ala-D-Ala - Orita & Tel have same MOA as Dapto
31
What is the Mechanism of Resistance for the Lipoglycopeptides?
- Alteration to peptidoglycan terminus [VanA] - Same MOR as Vancomycin
32
What is the Spectrum of Activity for the Lipoglycopeptides?
- Gram (+): Group/Viridan Strep, PRSP, **Enterococcus Faecium & Faecilis** [VRE], MSSA, MRSA, VISA, VRSA [Ortia mostly] - Gram (-): Nope
33
What is important to know about the Pharmacology of the Lipoglycopeptides?
- Concentration Dependent Bactericidal Activity - Distribution: into tissues; NOT CSF tho - Elimination: Tel = Kidneys; Dala = Poo/pee; Orita = ?? | Half Life: T = 7.5h, D = 346h, O = 245h
34
What are the Clinical Effects of the Lipoglycopeptides?
- **Where** Vancomycin, Linezoild, AND Daptomycin cannot be used
35
What are some of the Drug Interaction for the Lipoglycopeptides?
- None
36
What are some of the Adverse Effects of the Lipoglycopeptides?
- Red Man Syndrome - **Nephrotoxocity** [Have Renal issues, other nephrotoxins, >65 years] - **QTc** prolongation - Taste?

PHRM 865: Theraputics V (42 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions