Now, linezolid. This is in a new class of
drugs, and look at that name there.
That is a really interesting
one to pronounce.
We use this for killer bugs, so
this is a bad mama jama.
This drug is awesome, what it can do.
We use it against vancomycin-
resistant enterococcus, VRE,
and M-R-S-A, MRSA, methicillin-resistant
We can also use it with strep and
We can use it for strep aureus infection,
but we want to make sure that you only
keep it for very severe infections.
Remember the mistakes we
made with vancomycin?
Well, we don't want to make
them with this medication.
So we want to make sure that the
patient has a severe infection.
We just don't want to prescribe
it for anything.
Because it's active against VRE and MRSA,
we want to keep it that way.
So, you have to be very particular which
types of infection you use this medication.
Now, the most common adverse effect,
obviously, is GI distress.
We see that with everything,
but the most adverse -- this one,
I really want you to stop
and make sure you have this
laid out in your brain,
is a myelosuppression.
It is reversible, but when you
suppress bone marrow,
that's what myelosuppression means,
you're risking your white cells, your
red cells, and your platelets,
or all of them being too low.
Well, when my white cells are too low,
I can't fight off infection, because
those are my defenders.
If my red cells are too low, I'm really tired,
because that's what gives me my
energy and carries my oxygen.
If my platelets are low, that's
and I'm a bleeder, so if I bump something,
it's going to have a real hard
time clotting in my body.
Pancytopenia means it hits all of them.
So that's an unusual side
effect, it can be reversed.
We want you to watch that if you have
the patient on this medication.
So if you notice unusual bleeding,
if we're having a hard time
with infection with them,
you definitely would want to
check on their blood counts.
Now, if you have to be on long-term treatment,
which is possible if you have something
like VRE and MRSA,
sometimes people develop a
And that's kind of what we talk
about with diabetic patients,
but it's this really weird in sensation.
They might not have real good
feeling in an extremity,
but yet, they have this shooting,
burning, searing pain.
So, we want to try to avoid
that with a patient.
Be sure that you assess that with them, ask
them if they're having any problems,
and notify the health care provider
if they start to develop
that side effect, so they can make
the best decision to intervene.
Now, we have a combination drug.
That's why whenever you see that slash
in between that means we have
2 separate drugs that are
given in combination;
dalfopristin and quinupristin.
Now, the therapeutic use, that just
says what do we use these for?
And we use it for VRE.
It's really good for you to keep in mind
because we have these superbugs,
VRE and MRSA,
what are the drugs that are
actually effective for them?
This combination is one of them.
Now, the most significant
problem is hepatotoxicity.
Once again, toxic to your liver.
Now, I love what the artists have
done on this picture.
Take a look at it.
They have little AST and
ALT all over the liver.
That is brilliant. I really like
that they did that
because that helps you remember,
hey, for hepatotoxicity,
how do I watch for that, as a nurse?
I'm going to monitor their liver enzymes
and they put them right
there for you on the liver;
ALT and AST.
You're also going to look
at their bilirubin, okay?
And initially, when they start,
then kind of watch it weekly.
But for hepatotoxicity, I'm going
to watch the liver enzymes,
AST and ALT,
and I'm also going to look
at their bilirubin.
Now, I have a quick question for you.
Do you remember which of those
lab tests, AST or ALT,
is more specific for liver enzymes?
Hopefully, you remember that ALT
is the one that is more specific
for liver enzymes.
Both are good, but the ALT is more specific.
So, if we're given this wonder
drug to treat VRE,
you want to watch their liver
function very closely.