Pharmacology · MU Sofia

72. Carbapenems and monobactams. Glycopeptides.

Covers the three antibiotic groups in this topic: carbapenems, the monobactam aztreonam, and glycopeptides such as vancomycin and teicoplanin. It takes their classification, mechanism and spectrum of activity, then pharmacokinetics in a summary table, followed by side effects, therapeutic uses and pregnancy safety. It ends with five recap questions.

Inside: 8 sections · 3 labelled pictures · 4 tables · 10 flashcards · 3 min

Topic 71 of 93 in the MU Sofia syllabus for Pharmacology (Dental Medicine, Year 3). The free AceMed note covers it in 8 sections, about 177 words (3 min of reading), with 10 flashcards.

In this note

  1. Carbapenems, Monobactams & Glycopeptides
  2. Classification
  3. Pharmacodynamics
  4. Pharmacokinetics
  5. Side Effects
  6. Therapeutic Uses
  7. Pregnancy & Breastfeeding
  8. Recap Questions

Carbapenems, Monobactams & Glycopeptides

These are potent antibiotics used for serious or resistant infections, especially in hospital settings. They work by inhibiting bacterial cell wall synthesis, but they differ in spectrum and clinical application.

Pharmacodynamics

All are bactericidal

Side Effects

Common:

  • GI upset (nausea, vomiting, diarrhea)
  • Rash, hypersensitivity
  • C. difficile-associated diarrhea

Serious (rare):

  • Nephrotoxicity (esp. vancomycin)
  • Neurotoxicity (seizures with imipenem)
  • Hepatotoxicity
  • Red man syndrome (with rapid vancomycin infusion)
  • Blood dyscrasias (leukopenia, thrombocytopenia)

Therapeutic Uses

Used for severe infections, especially multi-drug resistant (MDR) organisms:

  • Carbapenems: Hospital-acquired pneumonia, intra-abdominal infections, septicemia, complicated UTI, skin/soft tissue infections, endocarditis
  • Monobactams (Aztreonam): Gram-negative infections in patients with penicillin allergies, including Pseudomonas
  • Glycopeptides: MRSA infections, Clostridium difficile colitis (oral vancomycin), enterococcal infections, endocarditis, osteomyelitis

Recap Questions

  1. 1. Which antibiotic is safe for use in penicillin-allergic patients and targets Gram-negative bacteria only?
  2. 2. What unique site of action do glycopeptides like vancomycin bind to in the bacterial cell wall?
  3. 3. Which carbapenem is co-administered with cilastatin and why?
  4. 4. Which class is effective against MRSA but has no activity against Gram-negative bacteria?
  5. 5. What is the side effect called that occurs with rapid vancomycin infusion?

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