Podcast
Questions and Answers
What type of antibiotic is vancomycin?
What type of antibiotic is vancomycin?
- Macrolide
- Glycopeptide (correct)
- Penicillin
- Cephalosporin
Against which type of bacteria does vancomycin show activity?
Against which type of bacteria does vancomycin show activity?
- Aerobic gram-negative
- Gram-negative
- Gram-positive (correct)
- Anaerobic gram-negative
What forms of vancomycin are available?
What forms of vancomycin are available?
- Capsules and syrups
- Tablets and injections
- Suspensions and injections
- Oral and injections (correct)
What condition might enhance systemic absorption of vancomycin?
What condition might enhance systemic absorption of vancomycin?
What is a contraindication for the use of vancomycin?
What is a contraindication for the use of vancomycin?
What inactivates benzyl penicillin?
What inactivates benzyl penicillin?
Which of the following is true about benzyl penicillin?
Which of the following is true about benzyl penicillin?
Why is benzyl penicillin no longer the first choice of drug for pneumococcal meningitis?
Why is benzyl penicillin no longer the first choice of drug for pneumococcal meningitis?
Why is the absorption of benzyl penicillin from the gastrointestinal tract low?
Why is the absorption of benzyl penicillin from the gastrointestinal tract low?
Which route of benzyl penicillin administration is not recommended?
Which route of benzyl penicillin administration is not recommended?
Which side effect is associated with rapid intravenous injection?
Which side effect is associated with rapid intravenous injection?
What is Red man syndrome a possible side effect of?
What is Red man syndrome a possible side effect of?
Which side effect involves difficulty in breathing?
Which side effect involves difficulty in breathing?
Which of the following is not a side effect of intravenous use?
Which of the following is not a side effect of intravenous use?
Which side effect is related to a drop in blood pressure?
Which side effect is related to a drop in blood pressure?
What can high doses of sodium for injection lead to, especially in patients with renal failure?
What can high doses of sodium for injection lead to, especially in patients with renal failure?
Is it safe to use sodium for injection during pregnancy and lactation?
Is it safe to use sodium for injection during pregnancy and lactation?
What specific neurotoxicity symptoms can occur due to accumulation of sodium for injection?
What specific neurotoxicity symptoms can occur due to accumulation of sodium for injection?
For doses of 50mg/kg or greater, what is recommended during intravenous infusion?
For doses of 50mg/kg or greater, what is recommended during intravenous infusion?
In which patients is accumulation of sodium for injection more likely to occur?
In which patients is accumulation of sodium for injection more likely to occur?
What type of antibiotic is Chloramphenicol?
What type of antibiotic is Chloramphenicol?
Which serious side effect is associated with Chloramphenicol?
Which serious side effect is associated with Chloramphenicol?
Why should Chloramphenicol be avoided during pregnancy?
Why should Chloramphenicol be avoided during pregnancy?
What is a potential side effect of Chloramphenicol in breastfeeding infants?
What is a potential side effect of Chloramphenicol in breastfeeding infants?
Which group should avoid using Chloramphenicol?
Which group should avoid using Chloramphenicol?
Gentamycin is active against which types of bacteria?
Gentamycin is active against which types of bacteria?
How are Gentamycin doses calculated?
How are Gentamycin doses calculated?
Which of the following is a caution for using Gentamycin?
Which of the following is a caution for using Gentamycin?
Which of the following is NOT a side effect of Gentamycin?
Which of the following is NOT a side effect of Gentamycin?
How common is nausea/vomiting as a side effect of Gentamycin?
How common is nausea/vomiting as a side effect of Gentamycin?
What is the primary function of corticosteroids in the context provided?
What is the primary function of corticosteroids in the context provided?
When should corticosteroids be started in relation to antibacterial treatment?
When should corticosteroids be started in relation to antibacterial treatment?
Which drug is mentioned as part of the adjunctive treatment with corticosteroids?
Which drug is mentioned as part of the adjunctive treatment with corticosteroids?
What effect do corticosteroids have on CSF hydrostatic pressure?
What effect do corticosteroids have on CSF hydrostatic pressure?
How do corticosteroids aid in the penetration of antibiotics?
How do corticosteroids aid in the penetration of antibiotics?
Which of the following is a common side effect of Ciprofloxacin?
Which of the following is a common side effect of Ciprofloxacin?
Which medicine is associated with the risk of causing renal toxicity?
Which medicine is associated with the risk of causing renal toxicity?
Which of the following medicines can interact significantly with calcium-containing drugs?
Which of the following medicines can interact significantly with calcium-containing drugs?
Which is a potential side effect of using Meropenem?
Which is a potential side effect of using Meropenem?
Which drug is primarily used to treat bacterial infections but can also pose a risk of bone marrow suppression?
Which drug is primarily used to treat bacterial infections but can also pose a risk of bone marrow suppression?
For an adult patient over 60 kg with a creatinine clearance rate of 25 mL/min, what is the appropriate frequency of gentamicin administration?
For an adult patient over 60 kg with a creatinine clearance rate of 25 mL/min, what is the appropriate frequency of gentamicin administration?
What is the serum creatinine range for administering gentamicin every 36 hours to an over 60 kg adult?
What is the serum creatinine range for administering gentamicin every 36 hours to an over 60 kg adult?
For an adult patient over 60 kg with a blood urea nitrogen level of 35 mg%, how frequently should gentamicin be administered?
For an adult patient over 60 kg with a blood urea nitrogen level of 35 mg%, how frequently should gentamicin be administered?
Which frequency of administration is appropriate for a patient with a creatinine clearance rate of 12 mL/min?
Which frequency of administration is appropriate for a patient with a creatinine clearance rate of 12 mL/min?
An over 60 kg adult has a serum creatinine level of 4.0 mg%. What is the recommended administration frequency for gentamicin?
An over 60 kg adult has a serum creatinine level of 4.0 mg%. What is the recommended administration frequency for gentamicin?
What combination has been found to reduce hearing loss and death in children and adults?
What combination has been found to reduce hearing loss and death in children and adults?
What is the effect of starting dexamethasone with the appropriate antibiotic's first dose?
What is the effect of starting dexamethasone with the appropriate antibiotic's first dose?
Dexamethasone is found to be effective when started with which dose of the appropriate antibiotic?
Dexamethasone is found to be effective when started with which dose of the appropriate antibiotic?
In which age group has dexamethasone been found to be effective when administered with the appropriate antibiotic?
In which age group has dexamethasone been found to be effective when administered with the appropriate antibiotic?
What is the primary benefit of starting dexamethasone with the first dose of the appropriate antibiotic in treatment?
What is the primary benefit of starting dexamethasone with the first dose of the appropriate antibiotic in treatment?
Study Notes
VANCOMYCIN
- Glycopeptide antibiotic active against aerobic and anaerobic gram-positive bacteria
- Available in oral and injection forms
- Systemic absorption may be enhanced in inflammatory disorders of the intestinal mucosa/pseudomembranous colitis
- Contraindicated in previous hearing loss
Side effects of intravenous use
- Back pain
- Bradycardia
- Cardiac arrest
- Cardiogenic shock (on rapid intravenous injection)
- Chest pain
- Dyspnea
- Hearing loss
- Hypotension
- Red man syndrome
- Pseudomembranous enterocolitis
- Nephrotoxicity
Benzyl Penicillin
- Inactivated by bacteria beta lactamases
- Not the first choice for pneumococcal meningitis
- Inactivated by gastric acid with low absorption from the gastrointestinal tract
- Intrathecal injection not recommended
Warning and Safety Information
- Accumulation of sodium for injection can occur with high doses, especially in patients with renal failure, leading to neurotoxicity
- Safe to use during pregnancy and lactation
- Intravenous infusion should have a longer administration time with doses of 50mg/kg or greater
Chloramphenicol
- Potent broad-spectrum antibiotic
- Associated with serious hematological side effects
- Avoided in pregnancy due to gray baby syndrome
- Avoided in breastfeeding due to bone marrow toxicity
Gentamycin
- Active against gram positive and gram negative bacteria
- Doses calculated based on patient's weight and renal function
- Narrow therapeutic window
Caution
- Auditory disorder (tinnitus)
- Conditions characteristic of muscular weakness (impair neuromuscular transmission)
Side Effects
- Skin disorders
- Nephrotoxicity
- Ototoxicity
- Nausea/vomiting (uncommon)
Dosage Guidelines for Gentamycin
- Calculated based on renal function tests, including creatinine clearance rate and serum creatinine
Corticosteroids
- Adjunctive treatment with dexamethasone
- Regulate components of inflammatory response and lower CSF hydrostatic pressure
- Started before or with first dose of antibacterial
- Reducing inflammation, blood brain barrier, and the CSF penetration of antibiotics
Steroids
- Dexamethasone started with the first dose of antibiotic reduces hearing loss and death in children and adults
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Description
Learn about the antibiotic activity, administration, and precautions of vancomycin, a glycopeptide antibiotic effective against gram-positive bacteria.
