Infectious Disease Book

http://www.fpnotebook.com/

LinezolidAka: Zyvox

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  1. See Also
    1. Antibiotic Resistance
  2. Indications
    1. Vancomycin Resistant Enterococcus
    2. Nosocomial Pneumonia
      1. Methicillin Resistant Staphylococcus Aureus
      2. Penicillin Sensitive Streptococcus Pneumoniae
    3. Complicated Skin Infections
      1. Methicillin Resistant Staphylococcus Aureus
      2. Streptococcus Pyogenes
      3. Streptococcus agalactiae
    4. Community Acquired Pneumonia (Not first line agent)
      1. Does not cover Haemophilus Influenzae
      2. Methicillin Sensitive Staphylococcus aureus
      3. Penicillin Sensitive Streptococcus Pneumoniae
  3. Mechanism
    1. Prototype for new Oxazolidinone Class
    2. Inhibits protein synthesis at unique site
    3. Spectrum
      1. Minimal activity against Gram Negative Bacteria
      2. Bacteriostatic activity
        1. Vancomycin Resistant Enterococcus faecium
        2. Methicillin Resistant Staphylococcus Aureus
      3. Bactericidal activity
        1. Streptococcus Pneumoniae
        2. Streptococcus Pyogenes
        3. Streptococcus agalactiae
  4. Pharmacokinetics
    1. Half Life: 5 hours
    2. Near 100% bioavailability after oral intake
  5. Dosing
    1. Linezolid 400 to 600 mg PO or IV q12 hours
    2. Administer intravenously over 30 to 120 minutes
  6. Adverse Effects
    1. Rash
    2. Headache
    3. Diarrhea
    4. Nausea or Vomiting
    5. Insomnia
    6. Constipation
    7. Fever
    8. Myelosuppression (requires discontinuation)
      1. Thrombocytopenia (2.4%)
  7. Drug Interactions
    1. No Cytochrome P450 activity or related drug interaction
    2. Reversible MAO inhibitor (Hypertensive response)
      1. Do not use with Tyramine Containing Foods
      2. Avoid with adrenergic drugs
        1. Avoid concurrent Pseudoephedrine use
        2. Use caution with concurrent Dopamine or Epinephrine
    3. Theoretical Serotonin Syndrome
      1. Not observed in clinical trials
      2. Use caution with SSRI Antidepressants
  8. Monitoring: Weekly Complete Blood Count Indications
    1. Linezolid use longer than 2 weeks
    2. Preexisting Myelosuppression or risk factors
    3. Chronic infection on concurrent other antibiotics
  9. Cost
    1. Costs $53 to $72 for each oral or intravenous dose
  10. References
    1. (2000) Med Lett Drugs Ther 42:45
    2. Ament (2002) Am Fam Physician 65(4):663
    3. Moellering (2003) Ann Intern Med 138:135

linezolid (C0663241)

Definition (NCI)A synthetic oxazolidinone derivative, Linezolid selectively inhibits an early step in bacterial protein synthesis and affects blood pressure through monoamine oxidase inhibition. It is effective against Gram-positive organisms, including methicillin-resistant Staphylococcus aureus strains, coagulase-negative Staphylococci, vancomycin-resistant Enterococci, and penicillin-resistant Streptococcus pneumoniae strains. (NCI04)
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHC098010
Englishlinezolid, LINEZOLID PREPARATION
Spanishlinezolida
Parent ConceptsAntibiotics (C0003232), Acetamides (C0000968), Oxazolidinones (C0887953), [AM900] ANTI-INFECTIVES, OTHER (C0973485), Drug allergen (C1320237), Oxazolidinone Antibacterials (C1579350)
SourcesLNC, MSH, MTHSPL, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Zyvox (C0876226)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHC098010
EnglishZyvox
SourcesMSH, NCI, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)



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