C10. Carbapenems, monobactams, beta lactamases Flashcards
Carbapenems
Mention 1st and 2nd generation drugs
1st generation: Ertapenem 2nd generation: impienem meropenem doripenem
mechanism of carbapenems
Resistant to ?
cell wall synthesis inhibitors
Resistant to beta lactamases
spectrum of carbapenems
Gram + aerboic Yes
Gram + anerobic Yes
Gram - aerobic Yes
Gram - anaerboic yes
Gram positive cocci gram negative rods (enterobacter and pseudomonas spp.) and anerobs.
Broad spectrum- bactericidal:
Includes pseudomonas, acinetobacter, penicillin resistant pneumococci, enterococcus faecalis and B frailis
Not active against MRSA/E and more.
Kinetics of carbapenems:
enters CNS
kidney elimination
Imipenem is given with cilastatin, a dihydropeptidase inhibitor (to prevent inactiveion in the kidneys).
administration of cabapenems
PArental only, 3x4 times a day
Indications of carbapenems:
hospital infections
multimicrobial infections
Infections with unknown cause
sepsis
adverse effects of carbapenemes
GI symptoms, pseudomembrenous colitis
allergy, seizures (imipenem).
Allergy
Monobactam drug?
Aztreonam
Resistant to Beta lactamase
SAme mechanism as other beta lactamas
Uses:
IV drug mainly active versus gram negative rods
No cross allergenicity with penicilins or cephalosporins
Gram positive anerobic and anerobic = NO
Only work against gram negative aerobs
Given IV
Penetrates CNS
clinical use of monobactam
aztreonam
Pneumonia, meningitis, sepsis causeed by G- bacteria
Beta lactamase inhibitors
clavulanic acid, sulbactam, tazobactam
Amoxicillin+ clavulanic acid
Ampicillin Sulbactam
Piperacillin and tazobactam