Carbapenems and Monobactams Flashcards
Monobactam: MOA
inhibits PBP-3 of GRAM NEGATIVE AEROBES
Bactericidal
Time-dependent
Monobactam: MOR
B-lactamases
porin Alteration
Monobactam: Spectrum of activity
GRAM NEGATIVE AEROBES!!!
PSEUDOMONAS!!
Monobactam: Clinical use
Drug of choice PSEUDO infections
UTI, respiratory tract inf, meningitis, bacteremia, SSSI, gram negative intra-abdominal infections
Monobactam: AEs
Hypersensitivity Rxn
* GI : N/D
NO CROSS REACTIVITY with other b-lactams
Monobactams: Pharm
Absorption: ONLY IV
Wide distribution, CSF only when menings are inflamed
Eliminatino: Renal, unchanged
- ADJUST FOR RI
- *REMOVED VIA HD**
Short half life
Carbapenems AKA??
THE BIG GUNS!!
Why? BROADEST SPECTRUM DRUG!
Carbapenems drugs?
the -penems!
Imipenem
meropenem
ertapenem
doripenem
Carbs MOA
Inhibits cell wall synthesis of PBP2
Bactericidal
Time-dependent
Carbs MOR
Like other B-lactams
B-lactamase
PBP alterations
Porin alterations
Carbs Spectrum of activity
THE BROADEST!!
Some major players it covers:
MSSA (ID)
Clostridium YAY but NO C. DIFF, boo
Enterococcus! YAY but bacteriostatic no cidal, boo
B-lactamase producers! (MDs are good at that!)
PSEUDOMONAS! except ertapenem
BACTEROSIDES GROUP
WHOA carbs cover alot..what don’t they cover??!
NO: C.diff MRSA PRSP VRE Coag Neg Staph (wah!) Atypical bac Stenotrophomas Maltophila (leave that to Bactrim!)
Carbs clinical use??
EMPIRIC TX for nosocomial infections!
Polymicrobial infections
B-lactamase producing infections (SPICE, SPACE!)
Pseudomonas! (except, no ertapenems!)
What are the AEs associated with Carbs??
Hypersensitivity (DONT de-sen if Ig mediated!)
CNS toxicity!! such as seizures
high risk: PTs with CNS disorders, high doses, RI
GI issues!
Pharm related with carbs?
Wide distribution in tissue and fluids!
CNS TOO! Meropenem is the best for this!
Renally eliminated and RI adjustment REQUIRED!
Exception imipenem – (another flashcard!)
Short half - life, except ertapenem (lasts 4 hrs)
