monobactams and carbapenems

Question 1

monobactam

Answer 1

aztreonam

Question 2

aztreonam mechanism

is it resistant to penicillinase?

Answer 2

• monobactam that works by preventing peptidoglycan XL
• works synergistically with aminoglycosides
• no cross allergenicity with pcns

Question 3

spectrum of aztreonam?

Answer 3

GNRs ONLY, AEROBES only

not effective against GP’s or anaerobes

Question 4

use of aztreonam in pts who are ___

Answer 4

allergic to pcns, and those with renal insuff who cannot tolerate aminoglycosides

Question 5

SE of aztreonam?

Answer 5

GI upset

Question 6

carbapenems (4)

Answer 6

doripenem
imipenem
meropenem
ertapenem

Question 7

which of the carbapenems is broad-spectrum and b-lactamase-resistant?

Answer 7

imipenem

Question 8

always give ___ with carbapenems to ____

Answer 8

cilastatin
to inhibit renal dehydropeptidase 1 from breaking imipenem into nephrotoxic metabolite and decrease inactivation of the drug in the renal tubules
“with imipenem, “the kill is LASTIN’ with ciLASTATIN”

Question 9

what do carbapenems cover?

Answer 9

GPC, GNR, anaerobes

Question 10

when do you use carbapenems and why?

Answer 10

its a wide spectrum abx but has SE that limits its use to life-threatening infections when other drugs have failed.

Question 11

toxicity of carbapenems

Answer 11

GI distress, rash, CNS tox (seizures) at high plasma levels

Question 12

which abx inhibits cell wall peptidoglycan formation by binding D-ala D-ala portion of cell wall precursors and is bactericidal?

Answer 12

vancomycin

Question 13

use for vanco?

Answer 13

Gram positives only! that are resistant to other abx: MRSA, enterococci, metronidazole resistant-C-diff (oral dose for pseudomembranous colitis)

Question 14

vanco toxicity

Answer 14

NOT trouble free
nephrotox
ototox
thrombophlebitis
diffuse flushing - RED MAN SD!

Question 15

how is red man sd from vanco toxicity prevent?

Answer 15

preRx with antihistamines and slow infusion rate