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Carbapenems, Monobactams and Vancomycin

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shevyatiwari's version from 2015-04-20 05:47

Carbapenems

 

Question Answer
Imipenem is combined with a natural inhibitor of renal dehydropeptidase enzymeT, cilastatin. Provides renal toxicity protection
Carbapenems have a limited range of antibacterial coverF
Carbapenems are not active against B fragilisF
Carbapenems have a low cross reactivity with penicillinsF, high degree (5.2 times greater)
Carbapenems Increase seizure thresholdF, lower seizure threshold
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Monobactams

Question Answer
Aztreonam is one of many monobactamsF, is the only monobactam
Aztreonam has similar S/E to B lactam antibacterialsT
Penicillin hypersensitivity is an absolute C/I to aztreonamF - can be given aztreonam safely
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Vancomycin

Question Answer
MRSA derives resistance pattern via ribosomesF, via staphylococcal casette type IV chromosome mec element (SCC MEC)
Slow infusion of vancomycin can cause red man syndrome or shockF, fast infusion
An uncommon cause of linear IgA bullous dermatosisF, one of the most common
Ototoxicity is more likely in those with renal failureT
Neprhotoxicity is potentiated when aminoglycosides are usedT
Fever, neutrophilia, thrombocytopenia and phlebitis can occur at the infusion siteF, neutropenia, others correct
May reduce activity of non depolarising muscle relaxantsF, increases activity
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