Other beta lactams
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- Which beta lactam is active ONLY against gram negative aerobic bacteria ?
- Aztreonam
- What organisms is Aztreonam active against ?
-
N.gonorrhea
H flu
P arugunosa - What type of diseases would indicate treatment with Aztreonam ?
- UTI's, URI, LRTI, intrabdominal and gynecological infections
- Can Aztreonam be given in pg >
- yes
- What are the Carbapemens ?
-
Impenem (Primaxin)
Merrem (Metropenem) - How does the Carbapemems work ?
- bind to two ppb's and cause weakening of cell wall and death
- This feature of the Carbapenems broades its spectrum even further ...?
- it is resistant to practically ALL beta lactamases AND can penetrate the gram negative cell envelope
- Which is specifically approved for bacterial meningitis ?
-
Meropenem is specifically approved for Bacterial Meningitis in kids 3 months and up
-also used for complicated intraabdominal infections - Which Rx has THE broadest antimicrobial spectrum of any drug ?
- Imipenem (Primaxin)
- Can any of the carbapenems be given PO ?
- no, all required IV or IM admin
- How are the carbapenems exceted ?
-
renally
Imipenem must be combined with cilastatin to prevent it from being inactivated by an enzyme in the kidney - Is Imipenem the *best* choice for a P. Aruginosa infection ?
- No...when given alone to treat psuedemonas, resistance has been noted. Should be combined with another antipsuedemonal drug
- What are the common side effects ?
- pain at the site of injection
- What are the approved uses for Metropenem ?
-
1. Bacterial meningitis in kids > 3 months
2. complicated intraabdominal infections - Imipenem is THE most effective beta lactam antibiotic for use against anerobic bacteria...TRUE OR FALSE ?
- TRUE.