vancomyacin and fosfomycin Flashcards
Name four other cell wall inhibitors.
Vancomycin (PO/IV/PR), Aztreonam (IM/IV), Fosfomycin (PO), Telavancin (IV).
Why is vancomycin commonly used in hospitals?
It is effective against serious infections like MRSA and C. difficile.
Is vancomycin well absorbed in the GI tract?
No, it is poorly absorbed orally, so it is usually given IV.
When is vancomycin given PO?
For C. difficile infections (because it stays in the GI tract).
What are the main adverse effects of vancomycin?
Ototoxicity, nephrotoxicity, infusion reactions (Red Man Syndrome), IV site pain/thrombophlebitis.
What is ototoxicity, and what symptoms should patients report?
Hearing damage; symptoms include tinnitus (ringing in ears), dizziness, and hearing loss.
What medications increase the risk of ototoxicity with vancomycin?
Loop diuretics (e.g., furosemide).
What is a vancomycin trough level, and why is it important?
The lowest concentration in the blood before the next dose; ensures effectiveness while avoiding toxicity.
What is the therapeutic trough level for vancomycin?
10-20 mcg/mL.
Does PO vancomycin require blood level monitoring?
No, only IV vancomycin does.
What is Red Man Syndrome, and what causes it?
Flushing, erythema, and itching due to rapid IV infusion of vancomycin.
How should Red Man Syndrome be managed?
Stop infusion, give IV histamine blockers (diphenhydramine, cimetidine), then restart at half the original rate or ≤10 mg/min over 4+ hours.
How long should vancomycin IV be infused?
At least 60 minutes to reduce infusion reactions.
What should be monitored during vancomycin IV infusion?
BP, HR, renal function, blood levels, hearing, fluid balance.
What are signs of nephrotoxicity with vancomycin?
Oliguria, cloudy or pink urine.
In which patients should vancomycin be used cautiously?
Those with renal impairment and/or hearing loss.
What is fosfomycin used for?
Single-dose therapy for uncomplicated UTIs.
How is fosfomycin typically administered?
As a single oral dose.
What are common adverse effects of fosfomycin?
Diarrhea, headache, vaginitis, drowsiness, abdominal pain.
