Platelet counts should be monitored at baseline and at least every 7 days during treatment. 2.0 The use of antimicrobial agents may promote the overgrowth of nonsusceptible organisms. Appropriate measures should be taken if superinfection occurs during the course of treatment.
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.
Does linezolid cross-resistance exist with other antibiotics?
Linezolid (Zyvox®-Pfizer) is an antimicrobial agent of the oxazolidinone class that possesses a wide spectrum of activity against gram-positive organisms, including MRSA and VRE. Because of linezolid’s novel mechanism of action, cross-resistance with other antimicrobial agents is not expected.
What is the contraindication for linezolid?
1.0 Linezolid is contraindicated in any person with a known hypersensitivity to linezolid or any of the product components.
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.
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).
What are 4 things to look for during a skin assessment?
Inspection should include assessment of the skin's colour, temperature, texture, moisture, integrity and include the location of any skin breakdown or wounds.
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.).
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.
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:
What is zyvox used for?
ZYVOX is indicated for the treatment of complicated skin and skin structure infections, including diabetic foot infections, without concomitant osteomyelitis, caused by Staphylococcus aureus (methicillin-susceptible and -resistant isolates), Streptococcus pyogenes, or Streptococcus agalactiae.
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:
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.
What is Alexander's primary developmental task?
As a young adult, Alexander's primary developmental task, according to the theorist Erikson, is to develop intimacy. The nurse should emphasize interaction with a small group of intimate friends to support this developmental task.
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.
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.
Why is linezolid used only for infections?
To reduce the development of drug-resistant bacteria and maintain the effectiveness of linezolid and other antibacterial drugs, linezolid should be used only to treat infections that are proven or strongly suspected to be caused by susceptible bacteria.
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.
How is linezolid metabolized?
Linezolid is primarily metabolized by oxidation of the morpholine ring, which results in two inactive ring-opened carboxylic acid metabolites: the aminoethoxyacetic acid metabolite (A), and the hydroxyethyl glycine metabolite (B). Formation of metabolite A is presumed to be formed via an enzymatic pathway whereas metabolite B is mediated by a non-enzymatic chemical oxidation mechanism in vitro. In vitro studies have demonstrated that linezolid is minimally metabolized and may be mediated by human cytochrome P450. However, the metabolic pathway of linezolid is not fully understood.
How long does linezolid last?
Visual blurring has been reported in some patients treated with linezolid for less than 28 days. Peripheral and optic neuropathy has also been reported in children.
How long does it take for a preterm neonate to get linezolid?
Neonates less than 7 days: Most pre-term neonates less than 7 days of age (gestational age less than 34 weeks) have lower systemic linezolid clearance values and larger AUC values than many full-term neonates and older infants. These neonates should be initiated with a dosing regimen of 10 mg/kg every 12 hours.
Is Linezolid a Gram negative drug?
Linezolid is indicated for the treatment of infections caused by susceptible strains of the designated microorganisms in the specific conditions listed below. Linezolid is not indicated for the treatment of Gram-negative infections. It is critical that specific Gram-negative therapy be initiated immediately if a concomitant Gram-negative pathogen ...
Is linezolid a prophylactic drug?
Prescribing linezolid in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.