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14 Cards in this Set
- Front
- Back
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Carbapenem clinical activity
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Broad spectrum antibiotic
Specifically: Intra-abdominal infections, polymicrobial infections, P. aeruginosa |
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Carbapenem adverse effects
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CNS: headache, seizures
GI upsed Hypersensitivity (penicillin problems) Irritation at infection site |
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Carbapenem mechanism
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Bacteriocidal at cell wall
Resistant to beta lactamase |
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Carbapenem resistance
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Little inactivation by beta-lactamases
Reduced membrane permeability Increased efflux |
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Imipenem
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Digested by renal hydropeptidases (prevented by being administered with cilastatin)
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Meropenem, Ertapenem, Doripenem
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Not digested by renal dehydropeptidases
Similar activity to imipenem |
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Beta lactamase classifications
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Class A-D
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Class A Beta lactamases
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TEM, SHV: penicillins, early cephalosporins
CTX-M: 3rd gen. cephs, aztreonam KPC: carbapenems, 3rd. gen. cephs |
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Class B Beta lactamases
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IMP: carbapenems (REQUIRE METAL)
VIM: carbapenems |
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Class C Beta lactamases
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AmpC: cephalosporins
Chromosomally encoded; upregulated in response to antibiotics |
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Class D Beta lactamases
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OXA: oxacillin, 3rd gen. cephs.
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KPC carbapenemase
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Encoded by plasmid/transposon
Comes with other beta lactamases Also, resistance to other antibiotics (aminoglycoides, fluoroquinolones, most tetracyclines) |
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New Delhi metallo-beta-lactimase (NDM-1)
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Plasmid in K. pneumoniae, E. coli
Resistance to carbapenems, extended spectrum beta lactams Other genes on plasmid give resistance to nearly all other anti bacterials |
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Carbapenem pharmacokinetics
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Parenteral
Penetrates CSF (increased when meninges are inflamed) Renal excretion T 1/2 = 1 hr. (ertapenem is 4 hrs.) |
