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17 Cards in this Set
- Front
- Back
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Name the 4 types of antibiotics that are beta lactams.
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- Penicillins- Cephalosporins- Carbapenems- Monobactams
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"What are aminopenicillins sensitive to and how can we avoid it?"
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They are sensitive to penicillinase, and are therefore always combined with beta-lactamase inhibitors.
Ampicillin + sulbactamAmoxicillin + clavulanate |
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What are antipseudomonal penicillins sensitive to and what do we have to combine them with to prevent this?
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Sensitive to penicillinase. We can combine them with beta-lactamase inhibitors.
Ticarcillin + clavulanatePiperacillin + tazobactam |
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What are carbapenems not effective against?
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MRSA and enterococci
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Name carbapenems
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Imipenem, meropenem, ertapenem
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What is inipenem usually combined with and why?
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Imipenem is metabolized by dipeptidase in the kidneys. Cilastatin is a dipeptidase inhibitor and is given to increase the half-life of inipenem.
Other carbapenems are excreted unchanged. |
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Mechanism of resistance against carbapenems?
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They are not inactivated by beta-lactamases, but carbapenemases/metallo-beta-lactamases
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Administration of carbapenems?
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Intravenously because they have low oral bioavailability.
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Side effects of carbapenems?
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They lower the treshold for seizure and can cause convulsions. Especially imipenem.
- GI symptoms, hypersensitivity |
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Name monobactams
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Aztreonam
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What is so special about the structure of monobactams?
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They have monocyclic beta-lactam ring, while other beta-lactams have dicyclic beta-lactam rings.
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What are monobactams used for?
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They are effective only against gram negative aerobes like:- Pseudomonas- N. meningitidis- H. influenzae
They have no effect against gram positives or anaerobes |
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Name beta-lactamase inhibitors with beta-lamtam structure
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Clavulanate, sulbactam, tazobactam
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Name beta-lactamase inhibitors without beta-lactam structure
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Avibactam, vaborbactam
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Mechanism of action of beta-lactamase inhibitors with beta-lactam structure and their use?
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They irreversibly inactivate plasmid-encoded beta-lactamases. Used against staphylococcus, Neiserria, E.coli, Klebsiella, salmonella and shigella.
No effect against chromosomal beta-lactamases or metallobeta-lactamases. |
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Mechanism of action of beta-lactamase inhibitors with non-beta-lactam structure?
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They can inactivate both plasmid-encoded and chromosomal beta-lactamases. This give them a broad spectrum.
They still cannot inhibit metallobeta-lactamases. |
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Which beta-lactamase inhibitor is used with meropenem?
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Vaborbactam + meropenem
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