allergic to penicillin & cephalosporin
Aztreonam is used in patients who are what?
contains single mono ring; doesn't bind with body proteins associated w penicillin allergies
What is unique about Aztreonam's structure?
KES; Pseudomonas , Gm +
Aztreonam is used for moderate/severe _____ infections, also active against _______. Not active against ________.
ceftazidime
What Cephalosporin side chain does Aztreonam contain?
a,c,d
Which are broad-spectrum antibiotics with resistance to anaerobes?
a) Recarbio
b) Aztreonam
c) Imipenem
d) Meropenem
to prevent metabolism so the patient can reach therapeutic concentrations ; DHP-1
Why is Cilastatin added to Imipenem? What enzyme does it inhibit?
this is a polar group that increases gm (-) porin penetration; increases stability to b-lactamases; thienamycin
This is the structure of Imipenem.
a) What is the structure the first arrow points to responsible for?
b) How does this lack of sulfur & reversed configuration assist this drug molecule?
c) Which species is this developed from?
rash, high doses can cause seizures, 50% cross-allergenic with pens
AE associated with Imipenem?
imipenem, cilastatin, relebactam
Recarbio is a combination of what drug molecules?
complicated: uti, intra-abdominal infections
Recarbio is used to treat what?
carbapenems strong induce bacteria to produce b-lactamases
What is a strong reason why we should consider penicillins and cephalosporins before carbapenems?
stability to DHP-1; no need for cilastatin
Meropenem's altered side-chain allows for what?
Meropenem + Vaboractam
What are the drug molecules that make up Vabomere?
new non-suicidal b-lactamase inhibitor
What is unique about Vabomere's MOA?
complicated uti
Vabomere is used to treat _________ in patients 18 years of age and older.
a
Which carbapenem is not stable to DHP-1 and requires cilastatin?
a) imipenem
b) meropenem
c) ertapenem
d) doripenem
imipenem, meropenem, vabomere, ertapenem, doripenem
What are our Carbapenems?
d
Which Carbapenem can be used against some resistant strains of hospital-acquired Pseudomonas?
a) imipenem
b) meropenem
c) ertapenem
d) doripenem
c
Which Carbapenem do we NOT use against Pseudomonas?
a) imipenem
b) meropenem
c) ertapenem
d) doripenem
Cephalosporins dose is reduced more
In general, when it comes to dose restrictions based on kidney failure; how do Cephalosporins compare to Carbapenems?
c
Which Carbapenem has a long half life?
a) imipenem
b) meropenem
c) ertapenem
d) doripenem
d
Which Carbapenem has a short half life?
a) imipenem
b) meropenem
c) ertapenem
d) doripenem
passes through gm- cell wall via passive & active diffusion due to siderophore structure and gm- need for iron.
Fetroja MOA?
resistant to all known b-lactamases; porin channel deletion, efflux- pump up-regulation
Fetroja resistance?
Fetroja
-used for MDR gm (-) pseudomonas, acinetobacter baumannii, MDR-KES, Hospital-acquired pneumonia, and ventilator-associated bacterial pneumonia.
PBP 2 & 1B
The Carbapenam nucleus binds to ______ and _____ in Enterobacteria and Pseudomonas aerguinosa.