10. Carbapenems. Monobactams. Beta-lactamase inhibitors

Question 1

Carbapenems

Answer 1

1st generation - Ertapenem

2nd generation:
Imipenem
Meropenem
Doripenem

Question 2

Monobactams

Answer 2

Aztreonam

Question 3

Beta-lactamase inhibitors

Answer 3

Sulbactam
Clavulanate
Tazobactam

Question 4

Ertapenem
Imipenem
Meropenem
Doripenem

Answer 4

Carbapenems
Cell wall inhibitor
Synthetic 𝛽 lactam sulfur has been exteranlized
Bactericidal

Spectrum: G+ive ,G-ive, anaerobes (2nd gen also pseudomonas, Enterococcus, acinetobacter)

Kinetics: Parenteral administration only
Excelant tissue penetration including CNS
Elimination by Glomerular filtration
Imipenem given with cilastatin (dehydropeptidase inhibitor → prevents inactivation in the kidney) (*no effect on spectrum)

AE: GI side effects
Seizures (high doses of imipenem)

Question 5

differans between 1st & 2nd generations Carbapenems

Answer 5

2nd gen also works against pseudomonas, Enterococcus, acinetobacter

Question 6

Aztreonam

Answer 6

Monobactams
Cell wall inhibitor
𝛽 lactam
Bactericidal

Spectrum: G-ive (anaerobic rods, pseudomonas)

Kinetics: Parenteral administration  only 
enter CNS (treats meningitis)

No penicillin cross reaction

Question 7

Sulbactam
Clavulanate
Tazobactam

Answer 7

Beta-lactamase inhibitors

Question 8

Fixed combinations of Beta-lactamase inhibitors

Answer 8

Sulbactam + Ampicillin/ Piperacillin
Clavulanate + Amoxicillin/ Ticarcillin
Tazobactam + Piperacillin