2.1 Platelet and white blood cell counts should be monitored at baseline and every 7 days during treatment 2.2 Blood pressure and heart rate H. Infectious Disease Authorization
What should the nurse Monitor during the course of linezolid?
The nurse monitors lab values and assesses for adverse effects during the course of Alexander's treatment with linezolid. ... What should the nurse assess Alexander for during the course of antibiotic therapy?
How many serum linezolid concentrations available after antibiotic therapy?
Trough concentrations were determined with and without a haemodialysis session performed after linezolid infusion. A total of 222 serum linezolid concentrations were available over 36 days of antibiotic therapy, during which patients underwent 31 haemodialysis sessions.
How do you measure linezolid dosage?
- Place the medication cup on a flat surface at eye level. (To safely measure the prescribed dose, the medication cup must be on a flat surface at eye level.) The nurse monitors lab values and assesses for adverse effects during the course of Alexander's treatment with linezolid.
What is the pharmacokinetics of linezolid?
General pharmacokinetics. Linezolid is well absorbed, with a bioavailability of approximately 100% in healthy volunteers. This characteristic is a major benefit, allowing this agent to be used early intravenously, then switching to oral, or indeed even to commence treatment of infection with oral therapy.
What is skin integrity?
The term 'skin integrity' refers to the skin being a sound and complete structure in unimpaired condition. Conversely, impaired skin integrity is defined as an "altered epidermis and/or dermis... destruction of skin layers (dermis), and disruption of skin surface (epidermis)" (NANDA 2013).
Which areas are most important for the nurse to observe for additional pressure ulcers?
High risk areas include; sacrum, heels, elbows, wrists, temporal region of skill, ears, shoulders, back of head (especially in children less than 36 months of age), knees, and toes.
Which technique should the PN use to mix the linezolid Zyvox?
Which technique should the nurse use to mix the linezolid (ZYVOX)? Turn the bottle upside down 3 to 5 times. This method mixes the suspension according to manufacturer's specifications. Linezolid (ZYVOX) should never be shaken.
What are five 5 main criteria that should be included when examining and assessing a pressure injury?
Usual practice includes assessing the following five parameters:Temperature.Color.Moisture level.Turgor.Skin integrity (skin intact or presence of open areas, rashes, etc.).
What is Braden score assessment?
The Braden Scale is a scale made up of six subscales, which measure elements of risk that contribute to either higher intensity and duration of pressure, or lower tissue tolerance for pressure. These are: sensory perception, moisture, activity, mobility, friction, and shear.
How do you mix linezolid?
The liquid form of linezolid should be gently mixed by turning the bottle upside down 3 to 5 times before each dose. Do not shake this product. Measure the medicine with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid.
What is the best antibiotic used for treatment of mixed infections?
The IDSA recommends IV clindamycin and penicillin therapy for severe group A streptococcal and clostridial necrotizing infections.
Is Eschar necrotic tissue?
Eschar is a type of necrotic tissue that is dryer than slough, adheres to the wound bed, and has a spongy or leather-like appearance.
What is linezolid used for?
Linezolid is a synthetic antibacterial agent of the oxazolidinone class, which has clinical utility in the treatment of infections caused by aerobic Gram-positive bacteria. The in vitro spectrum of activity of linezolid also includes certain Gram-negative bacteria and anaerobic bacteria. Linezolid binds to a site on the bacterial 23S ribosomal RNA of the 50S subunit and prevents the formation of a functional 70S initiation complex, which is essential for bacterial reproduction. The results of time-kill studies have shown linezolid to be bacteriostatic against enterococci and staphylococci. For streptococci, linezolid was found to be bactericidal for the majority of isolates.
How much linezolid is in zyvox?
When constituted as directed, each bottle will contain 150 mL of a suspension providing the equivalent of 100 mg of linezolid per each 5 mL. ZYVOX for Oral Suspension is supplied as follows:
How to use Zyvox suspension?
ZYVOX for Oral Suspension is supplied as a powder/granule for constitution. Gently tap bottle to loosen powder. Add a total of 123 mL distilled water in two portions. After adding the first half, shake vigorously to wet all of the powder. Then add the second half of the water and shake vigorously to obtain a uniform suspension. After constitution, each 5 mL of the suspension contains 100 mg of linezolid. Before using, gently mix by inverting the bottle 3 to 5 times. Do not shake. Store constituted suspension at room temperature. Use within 21 days after constitution.
Does linezolid cause birth defects?
Available data from published and postmarketing case reports with linezolid use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. When administered during organogenesis, linezolid did not cause malformations in mice, rats, or rabbits at maternal exposure levels approximately 6.5 times (mice), equivalent to (rats), or 0.06 times (rabbits) the clinical therapeutic exposure, based on AUCs. However, embryo-fetal lethality was observed in mice at 6.5 times the estimated human exposure. When female rats were dosed during organogenesis through lactation, postnatal survival of pups was decreased at doses approximately equivalent to the estimated human exposure based on AUCs (see Data ).
Can zyvox cause lactic acidosis?
Lactic acidosis has been reported with the use of ZYVOX. In reported cases, patients experienced repeated episodes of nausea and vomiting. Patients who develop recurrent nausea or vomiting, unexplained acidosis, or a low bicarbonate level while receiving ZYVOX should receive immediate medical evaluation.
Is Zyvox I.V. infusion made of latex?
ZYVOX I.V. Injection is available in single-dose, ready-to-use flexible plastic infusion bags in a foil laminate overwrap. The infusion bags and ports are not made with natural rubber latex. The infusion bags are available in the following package sizes:
Does linezolid affect cytochrome P450?
Linezolid is not an inducer of cytochrome P450 (CYP450) in rats. In addition, linezolid does not inhibit the activities of clinically significant human CYP isoforms (e.g., 1A2, 2C9, 2C19, 2D6, 2E1, 3A4). Therefore, linezolid is not expected to affect the pharmacokinetics of other drugs metabolized by these major enzymes. Concurrent administration of linezolid does not substantially alter the pharmacokinetic characteristics of (S)-warfarin, which is extensively metabolized by CYP2C9. Drugs such as warfarin and phenytoin, which are CYP2C9 substrates, may be given with linezolid without changes in dosage regimen.
How much Linezolid is available?
Linezolid is available in an intravenous formulation, film-coated tablets and oral suspension. The dose is 600 mg every 12 h and no dose adjustment is needed when switching from the intravenous to oral formulations or when there is moderate renal or hepatic derangement.
What is the clearance rate of Linezolid?
The clearance rate (±SD) is 80 ± 29 mL/min and by non-renal (65%) and renal mechanisms. Renal tubular reabsorption may occur.
How much of linezolid is excreted in urine?
At steady state, 30% of a linezolid dose is excreted unchanged in the urine, the remaining renal excretion being the two inactive metabolites of linezolid. Thus there are good concentrations of the active drug present in urine, well above the MICs of potential Gram-positive pathogens. 1
How old do you have to be to take linezolid?
Because of the higher clearance and lower AUC, a shorter dosing interval for linezolid is likely to be required for children younger than 12 years of age in order to produce adequate drug exposure against target Gram-positive pathogens.
Can linezolid be used for renal impairment?
In patients with severe renal impairment requiring haemodialysis, the exposure to the two primary metabolites was 7- to 8-fold higher than in patients with normal renal function. Therefore it is recommended that linezolid be used with caution in patients with severe renal insufficiency.
Is Linezolid absorbed by the body?
Linezolid is well absorbed, with a bioavailability of approximately 100% in healthy volunteers. 5 This characteristic is a major benefit, allowing this agent to be used early intravenously, then switching to oral, or indeed even to commence treatment of infection with oral therapy.
Is Linezolid a synthetic antimicrobial?
Linezolid is the only licensed member of the new group of synthetic antimicrobials within the class oxa zolidinones that have activity against most Gram-positive bacteria and mycobacteria. Linezolid has been in widespread use for 10 years, during which time a considerable body of clinical and pharmacokinetic data have been accumulated.
When a patient does not benefit from antimicrobial therapy chosen on the basis of clinical presentation, are additional investigations needed
Similarly, when a patient does not benefit from antimicrobial therapy chosen on the basis of clinical presentation, additional investigations are needed to determine the etiologic agent or exclude noninfectious diagnoses.
When is the antimicrobial procedure useful?
This procedure is useful when the organism burden is very high or in the management of abscesses, for which the penetration and activity of antimicrobial agents are often inadequate. Other therapies used in the treatment of infectious diseases involve modulating the host inflammatory response to infection.
What is antimicrobial therapy?
Antimicrobial agents are some of the most widely, and often injudiciously, used therapeutic drugs worldwide. Important considerations when prescribing antimicrobial therapy include obtaining an accurate diagnosis of infection; understanding the difference between empiric and definitive therapy; identifying opportunities to switch ...
Why are gram positive bacteria endemic?
They are commonly caused by drug-resistant organisms, both gram-positive (eg, methicillin-resistant Staphylococcus aureus[MRSA]) and gram-negative (eg, Pseudomonas aeruginosa) bacteria, which are often endemic in hospitals because of the selection pressure from antimicrobial use.
What are some examples of adverse effects of metronidazole?
Examples include nephrotoxicity with aminoglycosides, neurotoxicity of penicillins, and peripheral neuropathy with prolonged use of metronidazole ; these potential adverse effects need to be discussed with patients before initiation of therapy.
What is the difference between antibacterial and bactericidal?
A commonly used distinction among antibacterial agents is that of bactericidal vs bacteriostatic agents. Bactericidal drugs, which cause death and disruption of the bacterial cell, include drugs that primarily act on the cell wall (eg, β-lactams), cell membrane (eg, daptomycin), or bacterial DNA (eg, fluoroquinolones).
Why is combination therapy used for HIV?
This is why combination drug therapy is used as the standard for treatment of infections such as tuberculosis and the human immunodeficiency virus (HIV) when treatment duration is likely to be prolonged, resistance can emerge relatively easily, and therapeutic agents are limited.
What are the symptoms of Clostridium difficile?
These signs should be reported to the HCP immediately as they are signs of clostridium difficile associated. Diarrhea Diarrhea, abdominal cramping, and blood stools may be a side effect of this medication. These signs should be reported to the HCP immediately as they are signs of clostridium difficile associated.
How to protect skin from fecal toxins?
Apply a moisture-repellent ointment to intact skin areas. . After the skin is cleaned and dried, a moisture-repellent ointment should be applied to protect and moisturize the skin. Fecal toxins are damaging to tissue, and excessive moisture causes skin.
Does linezolid cause rash?
Rash and itching are identified side effects of linezolid. The nurse should, however, continue to monitor for a more severe. Alexander has been receiving antibiotic therapy for several days. He has a mild elevation in blood pressure and a 2 x 2 had two diarrheal stools in 4 hours.