Vancomycin Flashcards
Mechanism of action what does it inhibit? bactericidal or bacteriostatic? What effect does it exhibit? (Vanc)
inhibits the biosynthesis of peptidoglycan during cell wall formation
Bactericidal
Post abx effect (PAE)
What does it form a complex with?
Vanc
D-alanyl-D-alanine precursor
What is the IV used for? Oral route?
How is the absorption from GI tract?
(Vanc)
IV-systemic infection
PO- Clostridium difficile
Poor absportion
How does it distribute?
Vanc
Freely - most body fluids and tissues, CSF with inflammation
Excretion?
Vanc
almost entirely unchanged via glomerular filtration
What does higher trough range indicate?
Vanc
Endocarditis
Osteomyelitis
Meningitis
What are the adverse effects?
Vanc
Red-Man syndrome Neutropenia Thrombocytopenia Nephrotoxicity Ototoxicity
What is Red-Man Syndrome? How can it be overcome?
Vanc
Histamine-like reaction
Slowing down the infusion can bring patient back to normal
Spectrum of activity
Vanc
Gram positive - excellent
When is vancomycin used as prophylaxis? (3)
- surgery involving implantation of prosthetic materials
- as surgical prophylaxis if patient has allergy to beta-lactam abx
- endocarditis
When should Vancomycin be avoided?
- Routine surgical prophylaxis
- Empiric use
- Coagulase neg. Staph
- others
What should be used as surgical prophylaxis instead of vancomycin?
Cefazolin
Where does MRSA colonize?
Nares
Where does VRE colonize?
GI
What is the best dosing method?
Pharmacokinetic principles - lowest toxicity/failure rates
