ZYVOX I.V. Injection is supplied as a ready-to-use sterile isotonic solutionfor intravenous infusion. Each mL contains 2 mg of linezolid. Inactive ingredients are sodium citrate, citric acid, and dextrosein an aqueous vehicle for intravenous administration. The sodium (Na+) content is 0.38 mg/mL (5 mEq/300-mL bag and 1.7 mEq/100-mL bag).
As the age of pediatric patients increases, the weight-based clearance of linezolid gradually decreases, and by adolescence mean clearance values approach those observed for the adult population.
The pharmacokinetics of the parent drug, linezolid, are not altered in patients with any degree of renal impairment; however, the two primary metabolites of linezolid accumulate in patients with renal impairment, with the amount of accumulation increasing with the severity of renal dysfunction (see Table 10).
ZYVOX I.V. Injection is supplied as a ready-to-use sterile isotonic solution for intravenous infusion. Each mL contains 2 mg of linezolid. Inactive ingredients are sodium citrate, citric acid, and dextrose in an aqueous vehicle for intravenous administration. The sodium (Na +) content is 0.38 mg/mL (5 mEq/300-mL bag and 1.7 mEq/100-mL bag).
Patients receiving linezolid may have an enhanced pressor response to sympathomimetic agents including dopamine. Myelosuppression has been reported and therefore complete blood counts should be monitored weekly in patients on linezolid therapy, particularly for therapy beyond 2 weeks [1,196].
increased white blood cells. itching, other than application site.
Linezolid may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:diarrhea.headache.nausea.vomiting.stomach pain.change in the way things taste.rash.itching.More items...
in patients receiving linezolid for more than 14 days and treatment should be discontinued if there is evidence of myelosuppression.
Hgb, hemoglobin. Inhibition of erythropoiesis by linezolid. Linezolid therapy was associated with a worsening of anemia and a profound decrease in the reticulocyte count.
When taken with certain foods or drinks, linezolid can cause an increase in blood pressure.
Because of side effects of linezolid, i.e. nephrotoxicity, we recommend close monitoring of kidney function tests when linezolid therapy is attempted. Clinicians should be aware of these potential life- threatening adverse reactions and monitor kidney function while patients are using linezolid.
Check with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.
Drugs in the MAO-inhibitor class—for example, linezolid—cause increases in synaptic concentrations of biogenic amines (eg, dopamine, norepinephrine, and serotonin). When these agents are combined with proserotonergic agents, synaptic concentrations of serotonin rise to toxic levels and precipitate the syndrome.
Monitoring C min is a common form of TDM used to monitor linezolid toxicity. Clinicians can reliably decrease the risk of toxicity by decreasing linezolid dose and/or frequency whenever C min exceeds a pre-established toxicity threshold.
Assess heart rate, ECG, and heart sounds, especially during exercise (See Appendices G, H). Report any rhythm disturbances or symptoms of increased arrhythmias, including palpitations, chest discomfort, shortness of breath, fainting, and fatigue/weakness.
Linezolid is a rare but potential cause of hypoglycemia, particularly in patients on concomitant hypoglycemic therapies.
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.
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.
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:
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.
In limited clinical experience, 5 out of 6 (83%) pediatric patients with infections due to Gram-positive pathogens with minimum inhibitory concentrations (MICs) of 4 mcg/mL treated with ZYVOX had clinical cures. However, pediatric patients exhibit wider variability in linezolid clearance and systemic exposure (AUC) compared with adults. In pediatric patients with a sub-optimal clinical response, particularly those with pathogens with MIC of 4 mcg/mL, lower systemic exposure, site and severity of infection, and the underlying medical condition should be considered when assessing clinical response [see CLINICAL PHARMACOLOGY and DOSAGE AND ADMINISTRATION ].
Linezolid is a reversible, nonselective inhibitor of mono amine oxidase [see CONTRAINDICATIONS and CLINICAL PHARMACOLOGY ].
In the event of overdosage, supportive care is advised, with maintenance of glomerular filtration. Hemodialysis may facilitate more rapid elimination of linezolid. In a Phase 1 clinical trial, approximately 30% of a dose of linezolid was removed during a 3-hour hemodialysis session beginning 3 hours after the dose of linezolid was administered. Data are not available for removal of linezolid with peritoneal dialysis or hemoperfusion. Clinical signs of acute toxicity in animals were decreased activity and ataxia in rats and vomiting and tremors in dogs treated with 3,000 mg/kg/day and 2,000 mg/kg/day, respectively.
The nurse monitors lab values and assesses for adverse effects during the course of Alexander's treatment with linezolid.
Prior to administering the first dose of the antibiotic, the nurse asks Alexander about any drug allergies.
The area of redness should be measured to evaluate progression or healing.
After establishing the priority diagnosis, the nurse identifies goals and expected outcomes.
During the assessment of these high-risk areas, the nurse finds no redness, but the underlying tissue feels spongy.
After assessing for sinus tracts, the nurse irrigates the wound as prescribed with normal saline.
The nurse prepares a written positioning schedule and places it in Alexander's room as a reminder for the unlicensed assistive personnel (UAP) assigned to help with Alexander's care. The charge nurse removes the schedule and states that it violates Alexander's privacy.
Rationale: the area of redness should be measured to evaluate progression or healing.
The nurse prepares a written positioning schedule and places it in Alexander's room as a reminder for the UAP assigned to help with Alexander's care. The charge nurse removes the schedule and states that it violates Alexander's privacy.
No evidence of drug toxicity is found. Alexander's next BP is within normal limits for him and he has no further episodes of diarrhea. The wound eschar has all been removed, and there is no further drainage. A hydrocolloid dressing is placed over the wound, and Alexander is discharged. Aaron will complete the 2-week antibiotic treatment at home.
Whether linezolid is excreted in breast milk or is safe to use during breastfeeding is unknown.
Peripheral and optic neuropathy may occur with prolonged use , and patients taking long-term linezolid therapy should be closely monitored for these disorders.
Linezolid has not been studied in patients with carcinoid syndrome; it should be used only if patients are closely monitored for symptoms and signs of serotonin syndrome.
Animal reproduction studies with linezolid show some risk, and no adequate, well-controlled studies have been done in pregnant women. Linezolid should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Linezolid is contraindicated in patients with a prior allergic reaction to it.
In clinical trials, risk of serotonin syndrome and thrombocytopenia was lower with tedizolid than with linezolid. Tedizolid, like linezolid, can cause significant neutropenia, and the use of these oxazolidinone antibiotics is not recommended in patients with neutrophil counts of < 1000 cell/mcL (< 1 × 10 9 /L) when acceptable alternatives exist.
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.
O Place the medication cup on a flat surface at eye level.
Assist the patient in sitting on the side of the bed for several minutes before standing. Raise the head of the bed slowly. Take the patient's blood pressure while the patient is sitting upright prior to standing. The nursing process (nursing care plan) is not part of the EMR.
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.