University:
University of North Carolina at Chapel Hill
Course:
NURS 312 | Pharmacology
Academic year:

2020
Views:

215

Pages:

1
Author:

esfredint7qo

1.6 – “MRSA… why did it have tto o be MRSA?”: Vanc Vancomycin omycin • Glycopeptide antibiotic active only against G+ bacteria (staph, strep, enterococcus) (purple coccoid temples). Directly inhibits cell-wall synthesis by binding to D-ala-D-ala oligopeptides (temple wall hieroglyphs), sidestepping MRSA (and other bacterial) mutations to PBPs (mind altered Anubis minion). Resistant to β-lactamases (guard wearing ring-shaped jewelry trying to shoot down professor and missing) • Indications: o Administered IV (ivy rope). o Widely distributed in body including CSF, making it effective for meningitis (meningitis mohawk). Often combined with 3rd gen cephalosporin to treat meningitis. o One of the big guns for distributed infection with MRSA (no mercy pharaoh statue) o Effective against penicillin resistant S. pneumoniae (PRSP). o MRSA osteomyelitis d/t penetration of bone (fish bones) o Effective against most staph, including S. epidermidis which forms biofilms, especially on valves and lines ( plumber under van). o Addition of vancomycin or other MRSA protection a good idea in empiric treatment of hospital-acquired infections (nurse with lung stains on uniform) o First line for empiric treatment of endocarditis (heart shaped headpiece of staph staff). o Poorly absorbed in GI tract, making it effective in C. difficile treatment (Mayan temple with chocolate-colored fountains) • Vancomycin-resistant enterococcus (VRE) are a growing concern d/t altered peptidoglycan structure. Terminal D -alanine is replaced with D-lactate (temple of doom constructed of D-lac blocks, with explorer’s adventure blocked by a block). May also see resistance impaired influx or increased efflux. • 90% excreted by glomerular filtration. Plasma monitoring is necessary especially if co-administered with other nephrotoxic agents or in patients with renal disease • Adverse effects o Red Man syndrome d/t direct activation of histamine release from mast cells (giant red statue). Treat with antihistamines or prolonged infusion. o Thrombophlebitis at injection site (veiny legs) o Ototoxicity & nephrotoxicity rare in isolation. More likely if administered in conjunction with other agents with these toxicities (red statue with cracked ears & cracked kidneys). o DRESS syndrome = “drug reaction with eosinophilia & systemic symptoms”. Presents with fever, generalized lymphadenopathy (Gal in spotted dress with eosinophil slingshot)