10.carbapenems monobactams and beta lactamase inhibitors Flashcards
Monobactam
(“AZ-3M”)
- *Aztreonam**
- has activity against aerobic gram negative rods
-monobactams and carbapenems treat Pseudomonas infections
-monobactam treats serious systemic infection with gram negative pathogens
(meningitis, pneumonia, sepsis)
- monobactams can be used in patients with a H/O penicillin allergy
- monobactams are resistant to beta-lactamases, ring shape on gun to remind us that beta lactamases are encoded by plasmid genes. they cleave beta lactams
Carbapenems
(“hover car”)
Doripenem
Imipenem
Meropenem
Ertapenem
monobactams and Carbapenems treat pseudomonas infections
-broad spectrum carbapenems
-carbapenems treat anaerobic infections
(aspiration pneumonia, intra-abdominal infections)
“when others fail we get the job done”:
use of carbapenems with bugs resistant to other available treatments
-monobactam treats serious systemic infection with gram negative pathogens
(meningitis, pneumonia, sepsis)
- imipenem inactivated by dehydropeptidase in renal tubules
- cilastin inhibits dehydropeptidase in the renal tubules preventing degradation of imipenem
-GI side effects of carbapenems
- carbapenem may cause skin rash
- imipenem lowers the seizure threshold
- monobactams are resistant to extended spectrum beta-lactamases
B-Lactamase inhibitors
Tazobactam
Sulbactam
Calvulanic acid