Vancomycin Flashcards
Vancomycin is only affective against
gram + bacteria
what is unique about vancomycin as a treatment
you will hold it in reserve to treat resistant producing gram + bacteria
vancomycin inhibits what and how
peptidoglycan cell wall synthesis by binding to the D-ala D-ala that comes off each NAM preventing the addition of amino acids being incorporated into the growing cell wall
how is resistance confered
it is caused by an ensemble of 9 genes which are on a transposable element present on a plasmid
- Vancomycin cannot bind to D-alanine-D-lactate and therefore it will lose its ability to inhibit cell wall synthesis in these resistant bacteria.
where does vancomycin distribute well
pleural, pericardial, synovial and ascitic fluids
this gram + attacking, parenterally taken drug is excreted unchanged in the urine
vancomycin
vancomycin has a large molecular weight so it can cause the adverse effect of
infusion reactions
what are some common adverse effects of taking vancomycin
release of histamine causes hypotension, erythema of face and upper trunk
phlebitis
ototoxic
nephrotoxic
vancomycin can cause damage or cause irritation
to the vein phelebitis
it can damage CNVIII in ototoxicity
renal toxicity
vancomycin use is for
MRSA caused sepsis or endocarditis
enterococcal endocarditis
pneumococcal meningitis
what are some drug combinations for vancomycin
vancomycin plus gentamicin
vancomycin plus cefotaxime or ceftriaxone or rifampin
resistant strains have emerged for
enterobacter faecalis and faecium
and it is no longer the drug of choice for clostridium difficile pseudomembranous colitis
vancomycin + ceftriaxone or ceftraxime
penicillin resistant pneumococcal meningitis
vancomycin + gentamicin
penicillin resistant enterococcal endocarditis