Monobactams

Question 1

MOA

Answer 1

Bactericidal
Inhibits cell wall synthesis by binding to PBPs primarily PBP-3 of gram negative aerobes

Question 2

Mechanism of resistance

Answer 2

b-lactamases
decreased permeability

Question 3

Aztreonam spectrum of activity

Answer 3

Only active against gram negative aerobes

Gram negative aerobes: HENPEK-CSSS
H. Influenziae
E.Coli
Klebiella pneumoniae
P. mirabilis
S. Marcescens
Citrobacter
Morganella
Salmonella
Shigella
Pseudomonas aeurginosa

Question 4

Pharmacology

Answer 4

widely distributed
Time dependent
IV only

Question 5

Distribution

Answer 5

Penetrates CSF

Question 6

Elimination

Answer 6

Excreted in the urine as unchanged drug
Short elimination half life of 1.3-2.3 hours

Question 7

Clinical use

Answer 7

Used in patients with significant penicillin allergies
Infections due to susceptible gram negative Aerobes

Question 8

adverse effects

Answer 8

1. Gastrointestinal- nausea, diarrhea
2. Hypersensitivity: No cross reactivity with penicillins, can be used in penicillin allergic patients

Question 9

Which of the following antibiotics can be used in a patient who developed angioedema, hives and hypotension requiring ICU admission after an IM injection of penicillin?

A. Ampicillin
B. Meropenem
C. Ceftaroline
D. Aztreonam
E. None of the above

Answer 9

D. Aztreonam