Linezolid Tigecycline Dapto Telavancin

Question 1

Individually static but combinatorially cidal drugs

Answer 1

Quinupristin/Dalfopristin (Synercid)

Question 2

The mechanism for quinupristin/dalfopristin

Answer 2

irreversible bind to the 50S bacterial ribosomal subunit

Question 3

What does Quinupristin inhibit?

Answer 3

inhibits chain formation resulting in early termination

Question 4

What does Dalfopristin inhibit?

Answer 4

inhibits peptide elongation by interfering with peptidyl transferase

Question 5

What are quinupristin/dalfopristin effecting against?

Answer 5

MRSA, PCN-resistant Strep pneumo, VRE

not good against E. faecalis

Anaerobes, some G -

Question 6

What is the route of administration for Quinupristin/Dalfopristin?

Answer 6

IV only - PICC or Central line

Question 7

Mechanism of Linezolid (Zyvox)

Answer 7

binds 23S ribosomal RNA of 50S subunit

Question 8

What is special about Linezolid

Answer 8

IV = PO (100% bioavailable)

Question 9

What does Linezolid work against?

Answer 9

MRSA, VISA, VRE, PCN-resistant Strep pneumo

Question 10

Adverse effects of Linezolid?

Answer 10

Thrombocytopenia, superinfection (yeast), mitochondrial toxicity

Question 11

Drug-drug intrxn of Linezolid

Answer 11

watch for serotinin storm

Question 12

Used topically for MRSA colonization eradication from Nares?

Answer 12

Mupirocin (Bactroban)

Question 13

Colistin - cidal or static?
coverage?
when is it used?
ADR?

Answer 13

cidal
SPACE coverage
last ditch efforts - against Pan-resistant gram neg organisms, SPACE (Psudomonas, Acinetobacter), resistant PEK bugs
Nephro/Neurotoxicity

Question 14

What is the only use of Fosfomycin?

Answer 14

UTIs

Question 15

What pathogens/patients is Fosfomycin good for?

Answer 15

MDR pathogens - G+ and -, MRSA/VRE, ESBL org

Multiple Abx allergy patient

Question 16

Dose and ADR for Fosfomycin

Answer 16

3g/dose, GI tolerance in nature

Question 17

What is important about Tigecycline (Tygacil)?

Answer 17

Bacteriostatic

Does NOT attain high serum concentrations (XX Bacteremia XX)

Question 18

Unique coverage of Tigecycline?

Answer 18

MRSA/VRE
G - : CRE
Acinetobacter - not Psudomonas
Anaerobes (GI infections)

Question 19

Uses for Tigecycline?

Answer 19

Complicated skin infections, intra-abdominal infections, Community acquired pneumonia (CAP)

Question 20

Why does Daptomycin not cover pneumonia?

Answer 20

Inactivated by pulmonary surfactant

Question 21

ADR for Daptomycin

Answer 21

Rhabdomyolysis

Eosinophilic pneumonia

Question 22

What is the semi-synthetic derivative of Vanc?

Answer 22

Telavancin

Question 23

What are ADRs associated with Telavancin?

Answer 23

Nephrotoxicity
Red man syndrome with infusion
QT prolongation
Pancreatitis

Question 24

What does Telavancin cover?

Answer 24

G+ orgs including MRSA