C10. Carbapenems, monobactams, beta lactamases Flashcards

1
Q

Carbapenems

Mention 1st and 2nd generation drugs

A
1st generation:
Ertapenem
2nd generation:
impienem
meropenem
doripenem
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2
Q

mechanism of carbapenems

Resistant to ?

A

cell wall synthesis inhibitors

Resistant to beta lactamases

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3
Q

spectrum of carbapenems

A

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.

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4
Q

Kinetics of carbapenems:

A

enters CNS
kidney elimination
Imipenem is given with cilastatin, a dihydropeptidase inhibitor (to prevent inactiveion in the kidneys).

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5
Q

administration of cabapenems

A

PArental only, 3x4 times a day

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6
Q

Indications of carbapenems:

A

hospital infections
multimicrobial infections
Infections with unknown cause
sepsis

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7
Q

adverse effects of carbapenemes

A

GI symptoms, pseudomembrenous colitis
allergy, seizures (imipenem).
Allergy

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8
Q

Monobactam drug?

A

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

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9
Q

clinical use of monobactam

A

aztreonam

Pneumonia, meningitis, sepsis causeed by G- bacteria

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10
Q

Beta lactamase inhibitors

A

clavulanic acid, sulbactam, tazobactam

Amoxicillin+ clavulanic acid
Ampicillin Sulbactam
Piperacillin and tazobactam

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