Linezolid

Question 1

outline the spectrum of activity of linezolid (oxazolidinone antibacterial) (MAOI)

Answer 1

1) Gram-positive bacteria including (MRSA), and glycopeptide-resistant enterococci.
2) Linezolid is not active against common Gram-negative organisms; it must be given in combination with other antibacterials
3) Vancomycin-resistant cocci

Question 2

What is the MoA of linezolid

Answer 2

1) Selectively inhibits bacterial protein synthesis

2) MAOI

Question 3

what is inezolid indicated for?

Answer 3

1) Pneumonia
2) Complicated skin & soft tissue infections
↳ specialist

Question 4

outline the side effects caused by linezolid

Answer 4

1) GI disturbances
2) Taste disturbances
3) Optic neuropathy - if more than 28 days, report visual impairment
4) Blood disorders

Question 5

Severe optic neuropathy may occur rarely, particularly if linezolid is used for longer than 28 days. what are the recommendations regarding how this should be managed?

Answer 5

1) report symptoms of visual impairment (including blurred vision, visual field defect, changes in visual acuity and colour vision) immediately
2) patients experiencing new visual symptoms, evaluated promptly, and referred
3) monitor visual function regularly if treatment is >28d

Question 6

Haematopoietic disorders have been reported in patients receiving linezolid. It is recommended that full blood counts are monitored weekly, who should this be done in?

Answer 6

1) receive treatment for more than 10–14 days
2) have pre-existing myelosuppression
3) are receiving drugs that may have adverse effects on haemoglobin, blood counts, or platelet function;
4) severe renal impairment.

Question 7

Unless close observation and blood pressure monitoring is possible, who should linezolid be avoided in?

Answer 7

avoided in uncontrolled hypertension, phaeochromocytoma, carcinoid tumour, thyrotoxicosis, bipolar depression, schizophrenia, or acute confusional states.

Question 8

what councelling should be provided to those taking linezolid?

Answer 8

1) avoid consuming large amounts of tyramine-rich foods
2) No other MAOI until after 2 weeks of stopping linezolid
3) read information leaflet

Question 9

which patients is linezolid contraindicated in?

Answer 9

1) Confusion
2) Bipolar
3) Elderly - increased risk of blood disorders
4) Seizures
5) Uncontrolled hypertension

Question 10

what should be monitored in those taking linezolid?

Answer 10

Weekly FBC

Question 11

what are the important interactions with regards to linezolid?

Answer 11

1) SSRIs
2) 5HT1 agonists - triptans
3) TCAs
4) Dopaminergics