Linezolid
Which of the following should be monitored in patient receiving linezolid therapy?
| A |
Renal function |
|
| B |
Liver function |
|
| C |
Auditory function |
|
| D |
Platelet count |
Which of the following should be monitored in patient receiving linezolid therapy?
| A |
Renal function |
|
| B |
Liver function |
|
| C |
Auditory function |
|
| D |
Platelet count |
All of the following are side effects of Linezolid, EXCEPT:
| A |
Optic neuropathy |
|
| B |
Pancytopenia |
|
| C |
Cardiac arrhythmia |
|
| D |
Lactic acidosis |
All of the following are side effects of Linezolid, EXCEPT:
| A |
Optic neuropathy |
|
| B |
Pancytopenia |
|
| C |
Cardiac arrhythmia |
|
| D |
Lactic acidosis |
Adverse effects may include optic and peripheral neuropathy, pancytopenia, and lactic acidosis.
Ref: Harrison’s Principles of Internal Medicine, 18th Edition, Page 1379
All of the following toxicities are known with linezolid, EXCEPT:
| A |
Thrombocytopenia |
|
| B |
Lactic acidosis |
|
| C |
Vomiting |
|
| D |
Peripheral neuropathy |
All of the following toxicities are known with linezolid, EXCEPT:
| A |
Thrombocytopenia |
|
| B |
Lactic acidosis |
|
| C |
Vomiting |
|
| D |
Peripheral neuropathy |
A diabetic patient developed cellulitis due to S. aureus, which was found to be methicillin resistant on the antibiotic sensitivity testing. All of the following antibiotics will be appropriate except ‑
| A |
Vancomycin |
|
| B |
Imipenem |
|
| C |
Teicoplanin |
|
| D |
Linezolid |
A diabetic patient developed cellulitis due to S. aureus, which was found to be methicillin resistant on the antibiotic sensitivity testing. All of the following antibiotics will be appropriate except ‑
| A |
Vancomycin |
|
| B |
Imipenem |
|
| C |
Teicoplanin |
|
| D |
Linezolid |
Ans. is ‘b’ i.e., Imipenem
Methicillin – resistant staphylococcus – aureus (MRSA)
.Most staphylococci are penicillin resistant because they secrete penicillinase.
.To overcome this resistance, penicillinase resistant penicillins, e.g. methicillin and nafcillin were developed.
. MRSA is a strain of staphylococcus aureus that has acquired multi-drug resistance – even against methicillin and nafcillin (penicillinase resistant penicillin).
Treatment of S. aureus infections
.Sensitive to penicillin —> Penicillin G is the DOC.
. Pt. with penicillin allergy —> Cefazoline is the DOC.
MRSA —> Vancomycin is the DOC.
Methicillin – resistant staphylococcus – aureus (MRSA)
.Most staphylococci are penicillin resistant because they secrete penicillinase.
.To overcome this resistance, penicillinase resistant penicillins, e.g. methicillin and nafcillin were developed.
. MRSA is a strain of staphylococcus aureus that has acquired multi-drug resistance – even against methicillin and nafcillin (penicillinase resistant penicillin).
Treatment of S. aureus infections
.Sensitive to penicillin —> Penicillin G is the DOC.
.Pt. with penicillin allergy —> Cefazoline is the DOC.
.MRSA—> Vancomycin is the DOC.
.Other drugs for MRSA are
-TMP – SMX – Levofloxacin – Linezolid –Tigecyclin
-Minocyclin – Quinopristin – Daptomycin – Teicoplanin (KDT – 691)
-Ciprofloxacin- Dalfopristin- Oritavancin
.Adjunctive drugs (those that should be used only in combination with other antimicrobial agents) for M.R.S.A. are gentamycin, rifampin, fusidic acid.
“The carbapenem imipenem has excellent activity against methicillin – senstive S. aureus but not M.R.S.A.”
A patient is receiving linezolid therapy for 14 days, which of the following should be monitored-
| A |
Renal function tests |
|
| B |
Liner enzymes |
|
| C |
Platelet monitoring |
|
| D |
Monitoring of reflex |
A patient is receiving linezolid therapy for 14 days, which of the following should be monitored-
| A |
Renal function tests |
|
| B |
Liner enzymes |
|
| C |
Platelet monitoring |
|
| D |
Monitoring of reflex |
Ans. is ‘c’ i.e., Platelet monitoring
o The major side effects oflinezolid are thrombocytopenia and neutropenia .Platelet and neutrophil count should be monitored.
Drugs indicated in MRSA infection are all except:
March 2012
| A |
Vancomycin |
|
| B |
Teicoplanin |
|
| C |
Linezolid |
|
| D |
Imipenem |
Drugs indicated in MRSA infection are all except:
March 2012
| A |
Vancomycin |
|
| B |
Teicoplanin |
|
| C |
Linezolid |
|
| D |
Imipenem |
Ans: D i.e. Imipenem
Drugs and indications
- Vancomycin is the preferred surgical prophylactic in MRSA prevalent areas and in penicillin allergic patients
- Teicoplanin is indicated in enterococcal endocarditis (along with gentamicin); MRSA and penicillin resistant streptococcal infections, osteomyelitis and as alternative to vancomycin
- Linezolid is active against MRSA and some VRSA, VRE, penicillin-resistant Strep. Pyogenes, Strep. viridians and Strep. Pneumonia, M. tuberculosis, Corynebacterium, Listeria, Clostridia and Bact. Fragilis
- Imipenem (with cilastatin) has proved effective in a wide range of serious hospital acquired infections including those in neutropenic, cancer and AIDS patients
