Pharmacology - Vancomycin Bacitracin and Streptogramins 1

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kyleannkelsey
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257867
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Pharmacology - Vancomycin Bacitracin and Streptogramins 1
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2014-01-22 10:01:17
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Pharmacology Vancomycin Bacitracin Streptogramins
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Pharmacology - Vancomycin Bacitracin and Streptogramins 1
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Pharmacology - Vancomycin Bacitracin and Streptogramins 1
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  1. What enzyme do B-lactams inhibit (primarily)?
    Dipeptidase
  2. What is the MOA of Vancomycin?
    Inhibits transglycosylases that creates linear chains (pre-crosslinking) by inhibiting D-alanyl-D-alanyl linking in the cell wall ( cell wall synthesis inhibitor)
  3. What are the glycopeptide antibiotics?
    Vancomycin and telavancin ( a derivative of vanco)
  4. Glycopeptide antibiotics only treat what?
    G+
  5. Is Vancomycin narrow or broad spectrum?
    Narrow
  6. Does Vancomycin treat aerobic or anaerobic bacteria?
    Both
  7. Can Vancomycin treat MRSA?
    Yes
  8. What are the main groups of bacteria that Vancomycin can treat?
    Staph aureus, Strep, Enterococci and C. diff
  9. Is Vanco a small or large molecule?
    Large
  10. Why does Vancomycin only treat G+?
    Too big to get through G- porins
  11. Is Vancomycin cidal or static?
    Bacteriocidal
  12. What would be the advantage of using nafcillin (2nd gen penicillin) over vancomycin?
    Nafcillin is more rapid, Vanco is slower
  13. When treating what organism would you consider using aminoglycosides with Vancomycin for the synergistic effects?
    Enterococci
  14. Is vanco a time dependent drug?
    Yes
  15. Is Vancomycin absorbed orally?
    No, but is active orally for GI infections, only IV for systemic use
  16. Why is Vancomycin not given IM?
    Causes too much pain
  17. What % of Vancomycin is bound to plasma proteins?
    30%
  18. Under what conditions can Vancomycin enter the CNS?
    When meninges are inflamed
  19. How is Vancomycin excreted?
    Largely unchanged via the kidney (small amount is metabolized)
  20. Does resistance to Vancomycin occur rapidly or slowly?
    Slowly
  21. How does some enterococci resistance to Vancomycin occur?
    Produces PBPs that compete for D-ala-D-ala or may change D-ala-D-ala to something else
  22. What are the adverse effect sof Vancomycin?
    Hypersensitivity/Red man syndrome (IV to quickly causes cells to release histamine), shock, thrombophlebitis, ototoxicity (could be permanent) and nephrotoxicity
  23. What should you do if a patient is experiencing Red man syndrome with Vancomycin?
    Slow the IV and give an antihistamine
  24. When is ototoxicity most common with vancomycin?
    High doses
  25. What symptom is related to older formulation of vancomycin?
    Nephrotoxicity
  26. What are the main indications for Vancomycin?
    Strep, MRSA, meningitis due to Strep, enterococci and antibiotic associated colitis (C. diff)
  27. When you give vancomycin for strep pneumonia caused meningitis, what might you give it with?
    Cephalosporin (Not Ceptazadine, b/c doesn't treat G+) + or - rifampin
  28. When you are treating an enterococci with Vancomycin, why would you use aminoglycosides in combination?
    To prevent vancomycin resistant enterococci
  29. What should you give with vancomycin when treating Enterococci?
    Aminoglycosides
  30. What symptom should you be wary of when treating an enterococci infection with aminoglycosides and vancomycin?
    Ototoxicity, since both can cause this issue
  31. What is the main use of Telavancin?
    Treat strains that have become resistant to Vancomycin
  32. What is the MOA of Telavancin?
    Blocks cell wall synthesis like vancomycin and disrupts cell membrane potential and increases permeability

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