Test 3 - Metronidazole & Vancomycin (Josh)

Question 1

Which bacteria only targets anaerobic bacteria?

Answer 1

Metronidazole

Question 2

Which drug works like a Trojan horse? What is it similar to in this regard?

Answer 2

Metronidazole

Similar to nitrofurantoin (UTI drug)

Question 3

Once it’s absorbed, what does Metronidazole do?

Answer 3

Becomes toxic to bacterial DNA

Remember, it’s harmless to other microbes and only targets ANAEROBIC bacteria

Question 4

MOA: Vancomycin

Answer 4

Inhibits cell wall synthesis and promotes bacterial cell lysis and death

• similar to Beta-Lactams though it doesn’t interact w/ PBPs (proteins)
• instead it binds to molecules that serve as precursors for cell wall biosynthesis (the building blocks)

Question 5

Metronidazole and Vancomycin are especially useful for treating what?

Answer 5

C. diff (STOP, SWAP, ZOLE)

STOP the other antibiotic
SWAP the hand foam for hand soap
metraonidaZOLE (or Vancomycin)

Question 6

S/E for Metronidazole

Answer 6

• N/V (all antibiotics)
• Metallic Taste (similar to Macrolide) (metros [subways] are made of metal)
• Peripheral Neuropathy (tingling) (rare)
• Disulfrium (no alcohol)

Question 7

Don’t drink what w/ Metronidazole?

Answer 7

ETOH

disulfrium type reaction

Question 8

S/E for Vancomycin

Answer 8

• Nephrotoxicity (hard on kidneys)
• Ototoxicity
• Thrombophlebitis (hard on veins)
• Red Man Syndrome (release lots of histamine)

Question 9

When on Vancomycin, what do we monitor?

Answer 9

Kidneys

• check blood levels (Vancomycin Trough)
• watch Serum Creatinine levels (if increase by 50%, lower dose)

Question 10

When should we check Vancomycin Trough?

Answer 10

30 mins before next dose

Question 11

How do we deal w/ the S/E of Vancomycin that it’s hard on veins?

Answer 11

Rotate IV sites

Question 12

Red Man Syndrome is a S/E of which drug?

Answer 12

Vancomycin

• causes itching, redness, tachycardia, hypotension (not anaphylaxis)
• slow down the infusion and give Benadryl

Question 13

S/S of Red Man’s Syndrome

Answer 13

caused by Vancomycin

• Itching
• Redness
• Tachycardia
• Hypotension

Question 14

Patients allergic to penicillin —- have vancomycin.

Answer 14

can

Question 15

Which two drugs work like a Trojan Horse?

Answer 15

• nitrofurantoin

- metronidazole

Question 16

Where do we typically use metronidazole?

Answer 16

Infections below the diaphragm b/c it works on anaerobic bacteria, which is found typically in the gut

Question 17

Someone having abdominal surgery would take which antibiotic prophylactically?

Answer 17

Metronidazole

b/c it works on anaerobic bacteria found in the gut

Question 18

Treatment regimen for H. pylori (#1 cause of stomach ulcers)

Answer 18

• metronidazole
• tetracycline
• bismuth subsalicylate (Pepto-Bismol®).
• -prazole or -tidine

Question 19

Common, not serious complication from vancomycin?

Answer 19

Redneck Syndrome (sunburn like redness)

Question 20

Most commonly prescribed antibiotic in the hospital is —-

Answer 20

vancomycin

Question 21

—— is a good alternative to people allergic to -cillin because it kills a lot of stuff.

Answer 21

vancomycin

Question 22

Is Vancomycin lipid soluble?

Answer 22

NO

So if taken PO it will not be absorbed and will stay in gut

ONLY give PO if infection is in GI tract.

Question 23

Vancomycin Trough

Answer 23

V looks like a trough filled w/ urine

Always check the vancomycin trough 30 mins before next dose… usually before the 4th dose