Linezolid Flashcards
MoA
Selectively inhibits bacterial protein synthesis
Narrow-spectrum
Bacteriostatic
Effective against which organisms?
Gram + aerobes
MSRA
Vancomycin resistant cocci.
- Used as an alternative to vancomycin in MRSA infection.
Indications
Complicated skin + soft tissue infections
Pneumonia
Side effects
Diarrhoea
GI disturbances
Taste disturbances
Headache
Blood disorders
Optic neuropathy
Contraindications and cautions
- Confusional states
- Bipolar depression
- Elderly (increased risk of disorders)
- History of seizures
- Uncontrolled hypertension
Monitoring
FBC weekly
Blood disorders
- Thrombocytopenia
- Anaemia
- Leucopoenia
- Pancytopenia
Increased risk in elderly.
Monitor FBC weekly
If significant myelosuppresion occurs, stop treatment unless it is essential. - In which case intensive monitoring of blood counts and appropriate management implemented.
Blood disorders - close monitoring in those who:
- Receive treatment for more than 10-14 days.
- Pre existing myelosuppression.
- Receiving drugs that may have adverse effects on Hb, blood counts or platelet
- Severe renal impairment
Optic neuropathy
May occur rarely, especially if used for longer than 28 days.
Patient counselling
- Report symptoms of visual impairment, including blurred vision, visual field defect, changed in visual acuity and colour vision.
- Patients experiencing new visual symptoms, regardless of treatment duration should be evaluated promptly.
- Visual function should be monitored regularly if treatment is required for 28+ days.
Interactions - hypertensive crises
SSRI
TCAs
MAOIs (wait 2 weeks after stopping)
Sympathomimetics
Dopaminergics
Opioids
5-HT 1 agonists (triptans)
Buspirone
Pethidine
MAOI inhibitor
Linezolid is a reversible, non-selective monoamine oxidase inhibitor (MAOI).
Patients should avoid consuming large amounts of tyramine rich foods.
Do not give with another MAOI or within 2 weeks of stopping another MAOI
Tyramine rich foods
Mature cheese
Undistilled alcoholic beverages
Fermented soya beans
