Remaining Beta lactams and Non-beta lactams?

Question 1

What are 4 facts about Monobactam Azetronam?

Answer 1

1. Gram - ONLY, no gram + activity
2. Excellent activity pseudomonas aeruginosa
3. IV use only
4. Well tolerated, minial hypersensitivity, not nephrotoxic

Question 2

What are 5 facts about Carbapenems: Imipenem/cilastatin?

Answer 2

1. Very broad with gram - (pseudomonas aeruginosa and ESBL producing enterobacteriaceae
2. Active against gram + and anerobes but NOT MRSA
3. cilastatin inhibits degradation of imipenem by renal dehydropeptidase in proximal renal tubule
4. Not degraded by beta lactamases
5. adverse effect include lowering the seizure threshold and requires modification in renal insufficiency, low rate of cross reactivity with ocn

Question 3

What are 6 facts about vancomycin?

Answer 3

1. only active against most gram + including MRSA (used for serious gram + infections in patients with pcn allergy ei endocarditis)
2. Oral form used to treat c.diff
3. for PCN and cephalsporin resistant strep pneumoniae (menigitis)
4. Vancomycin infusion rxn with rash nuck up with pruritis, histamine mediated flusing, not a true allergy, give slow infusion to minimize effects
5. excreted by kidneys, dose reduction required in kidney dysfunction, need to monitor serum drug levels because can cause kidney toxicity
6. oral absroptions cause no systemic effect

Question 4

What are 4 facts about daptomycin?

Answer 4

1. depolarize cell membrane
2. ONLY active against gram + MRSA and VRE
3. used for resistant gram + infections
4. IV prep only, renal excretion, long hald life
5. NOT used for pneumonia because inactivated by alveolar surfactant
6. Adverse effects influce sekeltal muscle toxicity, need to monitory creatine phosphokinase, can cause eosinophilic pneumonia