University:
University of North Carolina at Chapel Hill
Course:
NURS 312 | Pharmacology
Academic year:

2020
Views:

275

Pages:

1
Author:

5prinzg1s

1.5 – “The ccoverage overage is stron strongg with this one”: monobactams & carbape carbapenems nems • Monobactams & carbapenems (car repair) • β-lactams (ringed planet). Bacterial peptidoglycan cell wall is synthesized by repeating D-alanyl-D-alanine oligopeptides (coccoid Death Star with D-ALA scaffolding). PBPs remove terminal alanine in the process of forming crosslinks between peptides. βlactams inhibit this transpeptidation reaction by covalently binding PBPs, preventing bacterial cell wall synthesis. Effective in actively growing cells. • Monobactams include aztreonam (one-eyed repair android AZ 3M) o Spectrum covers aerobic G- rods similar to 3rd gen cephalosporins. Has no activity against G+ or anaerobes (bellows blowing on red rod-shaped robot). Active against effective against Pseudomonas (android with the enigmatic smile). o Helpful with h/o penicillin anaphylaxis as there is no monobactam immunologic cross-reactivity (purple pencil stabbing infected robot) o Resistant to most β-lactamases (junkyard bot scaring off person with β-lactamase ring-shaped gun) o Penetrates CNS o Indications: ▪ PNA (lung shaped rust spots on android) ▪ Meningitis (red mohawk helmet) ▪ sepsis (red-colored android body) • Carbapenems include imipenem (Amy’s repair; Amy repairing car), ertapenem, meropenem, doripenem o Broad spectrum (prism hood ornament). Good activity against G+, G- rods including pseudomonas, anaerobes (android with the enigmatic smile standing between both sides; gas mask) o Imipenem (Amy) inactivated by dehydropeptidases in renal tubules. Co-administered with cilastatin to inhibit (pouring Cilastatin oil into car) o Indications. Penetrate tissue well and cross the BBB. (“When others fail, we get the job done.”) ▪ Intraabdominal infections ▪ Anaerobic PNA (Amy wearing gas mask) ▪ Systemic infections with G- bugs (red theme) ▪ Treatment of choice for infection with extended spectrum β-lactamases (ineffective rainbow β guard) o Side effects especially with imipenem ▪ Skin rash (rusty robot on ground) ▪ GI effects including diarrhea & abdominal pain (robot sitting in mud puddle) ▪ Lowers seizure threshold, especially in patients with renal dysfunction (seizing android)