Vancomycin and Lipoglycopeptide Flashcards
1
Q
What is the mechanism of action of vancomycin
A
- inhibits gram positive cell wall biosynthesis
- binds to peptidyl side chain D-Ala D-Ala terminus before cross linking
2
Q
- What mechanism is inhibited by vancomycin
A
- transpeptidase reaction to cross link peptidoglycan strands
- also inhibits the transglycolyation step in peptidoglycan synthesis
3
Q
What is the spectrum of activity of vancomycin?
A
- bactericidal
- active against gram positive bacteria
4
Q
What is the mechanism of resistance of VRE
A
- appears as a mutation of the peptidoglycan cell wall precursor
- D Ala D Ala –> D Ala D Lactate
- vancomycin cannot inhibit transpeptidase when substrate is D-Lactate due to lack of affinity
5
Q
How is vancomycin administered
A
Parenterally and orally (only in one case)
6
Q
What are the main therapeutic uses of vancomycin
A
- Oral vancomycin: C diff
- IV for MRSA
7
Q
What are the toxic effects of vancomycin?
A
- Red skin rash
- potential anaphylaxis
- neprotoxicity
- ototoxicity
8
Q
What are the PK of vancomycin?
A
- highly distributed
- 90% eliminated by glomerular filtration
9
Q
What type of antibiotic is oritavancin
A
semisynthetic lipoglycopeptide
10
Q
What is the mechanism of action of oritavancin
A
- inhibits transpeptidation
11
Q
what is the spectrum of activity of oritavancin
A
broad spectrum of gram positive bacteria including MRSA
12
Q
What is the mechanism of action of telavacin
A
- like vancomycin
- binds to the D-Ala D-Ala termius of the peptidoglycan
- inhibits transpeptidation and transglycosylation
13
Q
What is the therapeutic use o f telavancin
A
- MRSA and gram positive infections
14
Q
What type of lipoglycopeptide antibiotic is dalbavacin
A
- second generation
15
Q
What is the mechanism of action of dalbavancin
A
- identical to vancomycin
- binds to D-Ala D-Ala residue on growing peptidoglycan chains and prevents transglycosylation from occuring
