Meropenem Meropenem Uses, Side Effects &amp

Meropenem Meropenem Uses, Side Effects &amp

Meropenem

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Meropenem
Meropenem.svg
Meropenem-from-xtal-1992-3D-balls.png 2x” data-file-width=”1100″ data-file-height=”499″ />
Clinical data
Trade names Merrem, others
AHFS / Drugs.com Monograph
Pregnancy
category
  • AU: B2
  • US: B (No risk in non-human studies)
Routes of
administration
Intravenous
ATC code
  • J01DH02 ( WHO )
Legal status
Legal status
  • AU: S4 (Prescription only)
  • UK: POM (Prescription only)
  • US: ℞-only
Pharmacokinetic data
Bioavailability 100%
Protein binding Approximately 2%
Elimination half-life 1 hour
Excretion Renal
Identifiers
IUPAC name
  • (4R,5S,6S)-3-(((3S,5S)-5-(Dimethylcarbamoyl)pyrrolidin-3-yl)thio)-6-((R)-1-hydroxyethyl)-4-methyl-7-oxo-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic acid
CAS Number
  • 119478-56-7  ☑Y
PubChem CID
  • 441130
DrugBank
  • DB00760  ☑Y
ChemSpider
  • 389924  ☑Y
UNII
  • FV9J3JU8B1
KEGG
  • D02222  ☑Y
ChEBI
  • CHEBI:43968  ☑Y
ChEMBL
  • ChEMBL127  ☑Y
PDB ligand
  • MEM ( PDBe , RCSB PDB )
ECHA InfoCard 100.170.691 Edit this at Wikidata
Chemical and physical data
Formula C17H25N3O5S
Molar mass 383.464 g/mol
3D model ( JSmol )
  • Interactive image
SMILES
InChI
  • InChI=1S/C17H25N3O5S/c1-7-12-11(8(2)21)16(23)20(12)13(17(24)25)14(7)26-9-5-10(18-6-9)15(22)19(3)4/h7-12,18,21H,5-6H2,1-4H3,(H,24,25)/t7-,8-,9+,10+,11-,12-/m1/s1 ☑Y
  • Key:DMJNNHOOLUXYBV-PQTSNVLCSA-N ☑Y

   (verify)

Meropenem, sold under the brandname Merrem among others, is a broad-spectrum antibiotic used to treat a variety of bacterial infections . [1] Some of these include meningitis , intra-abdominal infection , pneumonia , sepsis , and anthrax . [1] It is given by injection into a vein . [1]

Common side effects include nausea, diarrhea, constipation, headache, rash, and pain at the site of injection. [1] Serious side effects include Clostridium difficile infection , seizures , and allergic reactions including anaphylaxis . [1] Those who are allergic to other β-lactam antibiotics are more likely to be allergic to meropenem. [1] Use in pregnancy appears to be safe. [1] It is in the carbapenem family of medications. [1] Meropenem usually results in bacterial death through blocking their ability to make a cell wall . [1]

Meropenem was patented in 1983. [2] It was approved for medical use in the United States in 1996. [1] It is on the World Health Organization’s List of Essential Medicines , the most effective and safe medicines needed in a health system . [3] The wholesale cost in the developing world is between 3.44 and 20.58 USD per one gram vial as of 2015. [4] In the United Kingdom this amount costs the NHS about 16 pound in 2015. [5]

Contents

  • 1 Medical uses
    • 1.1 Administration
  • 2 Side effects
  • 3 Pharmacology
    • 3.1 Mechanism of action
  • 4 Society and culture
    • 4.1 Trade names
  • 5 References
  • 6 External links

Medical uses[ edit ]

The spectrum of action includes many Gram-positive and Gram-negative bacteria (including Pseudomonas ) and anaerobic bacteria. The overall spectrum is similar to that of imipenem, although meropenem is more active against Enterobacteriaceae and less active against Gram-positive bacteria. It works against extended-spectrum β-lactamases, but may be more susceptible to metallo-β-lactamases. [6] Meropenem is frequently given in the treatment of febrile neutropenia . This condition frequently occurs in patients with hematological malignancies and cancer patients receiving anticancer drugs that suppress bone marrow formation. It is approved for complicated skin and skin structure infections, complicated intra-abdominal infections and bacterial meningitis .

In 2017 the FDA granted approval for the combination of meropenem and vaborbactam to treat adults with complicated urinary tract infections . [7]

Administration[ edit ]

Meropenem is administered intravenously as a white crystalline powder to be dissolved in 5% monobasic potassium phosphate solution. Dosing must be adjusted for altered kidney function and for haemofiltration . [8]

Side effects[ edit ]

The most common adverse effects are diarrhea (4.8%), nausea and vomiting (3.6%), injection-site inflammation (2.4%), headache (2.3%), rash (1.9%) and thrombophlebitis (0.9%). [9] Many of these adverse effects were observed in severely ill individuals already taking many medications including vancomycin . [10] [11] Meropenem has a reduced potential for seizures in comparison with imipenem . Several cases of severe hypokalemia have been reported. [12] [13] Meropenem, like other carbapenems, is a potent inducer of multidrug resistance in bacteria.

Pharmacology[ edit ]

Mechanism of action[ edit ]

Meropenem is bactericidal except against Listeria monocytogenes , where it is bacteriostatic . It inhibits bacterial cell wall synthesis like other β-lactam antibiotics. In contrast to other beta-lactams, it is highly resistant to degradation by β-lactamases or cephalosporinases. In general, resistance arises due to mutations in penicillin-binding proteins , production of metallo-β-lactamases, or resistance to diffusion across the bacterial outer membrane. [9] Unlike imipenem , it is stable to dehydropeptidase -1, so can be given without cilastatin .

In 2016, a synthetic peptide-conjugated PMO (PPMO) was found to inhibit the expression of New Delhi metallo-beta-lactamase , an enzyme that many drug-resistant bacteria use to destroy carbapenems. [14] [15]

Society and culture[ edit ]

Trade names[ edit ]

Trade names
CountryNameMaker
IndiaInzapenumDream India
Aurobindo Pharma
PenmerBiocon
MeronirNirlife
MerowinStrides Acrolab
AktimerAktimas Biopharmaceuticals
NeopenemNeomed
MexopenSamarth life sciences
MeropeniaSYZA Health Sciences LLP
IvpenemMedicorp Pharmaceuticals
Merofit
LykapiperLyka Labs
WinmeroParabolic Drugs
BangladeshInpenNavana pharma
I-PenamIncepta
MerocilPharmacil
IndonesiaMerofenKalbe
BrazilZylpenAspen Pharma
Japan, KoreaMeropen
AustraliaMerem
TaiwanMepem
GermanyMeronem
USMeronemAstraZeneca
MerosanSanbe Farma
MerobatInterbat
Zwipen
Carbonem
RonemOpsonin Pharma, BD
Neopenem
MeroconContinental
CarnemLaderly Biotech
PenroBosch
MerozaGerman Remedies
MerotrolLupin)
MeromerOrchid Chemicals
MepenoxBioChimico
MeromaxEurofarma
RopenMacter
MeropexApex Pharma Ltd.
MerostarkylHefny Pharma Group [16]

References[ edit ]

  1. ^ a b c d e f g h i j “Meropenem” . The American Society of Health-System Pharmacists. Retrieved 8 December 2017.

  2. ^ Fischer, Janos; Ganellin, C. Robin (2006). Analogue-based Drug Discovery . John Wiley & Sons. p. 497. ISBN   9783527607495 .
  3. ^ “WHO Model List of Essential Medicines (20th List)” (PDF). World Health Organization. March 2017. Retrieved 29 June 2017.
  4. ^ “Single Drug Information” . International Medical Products Price Guide. Retrieved 9 December 2017.
  5. ^ British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 379. ISBN   9780857111562 .
  6. ^ AHFS Drug Information (2006 ed.). American Society of Health-System Pharmacists. 2006.
  7. ^ Commissioner, Office of the. “Press Announcements – FDA approves new antibacterial drug” . www.fda.gov.
  8. ^ Bilgrami, I; Roberts, JA; Wallis, SC; Thomas, J; Davis, J; Fowler, S; Goldrick, PB; Lipman, J (July 2010). “Meropenem dosing in critically ill patients with sepsis receiving high-volume continuous venovenous hemofiltration” (PDF). Antimicrobial Agents and Chemotherapy. 54 (7): 2974–8. doi : 10.1128/AAC.01582-09 . PMC   2897321 . PMID   20479205 .
  9. ^ a b Mosby’s Drug Consult 2006 (16 ed.). Mosby, Inc. 2006.
  10. ^ Erden, M; Gulcan, E; Bilen, A; Bilen, Y; Uyanik, A; Keles, M (7 March 2013). “Pancytopenýa and Sepsýs due to Meropenem: A Case Report” (PDF). Tropical Journal of Pharmaceutical Research. 12 (1). doi : 10.4314/tjpr.v12i1.21 .
  11. ^ “Meropenem side effects – from FDA reports” . eHealthMe.
  12. ^ Margolin, L (2004). “Impaired rehabilitation secondary to muscle weakness induced by meropenem”. Clinical drug investigation. 24 (1): 61–2. doi : 10.2165/00044011-200424010-00008 . PMID   17516692 .
  13. ^ Bharti, R; Gombar, S; Khanna, AK (2010). “Meropenem in critical care – uncovering the truths behind weaning failure” . Journal of Anaesthesiology Clinical Pharmacology. 26 (1): 99–101.
  14. ^ “New molecule knocks out superbugs’ immunity to antibiotics” . newatlas.com. Retrieved 2017-01-25.
  15. ^ K., Sully, Erin; L., Geller, Bruce; Lixin, Li,; M., Moody, Christina; M., Bailey, Stacey; L., Moore, Amy; Michael, Wong,; Patrice, Nordmann,; M., Daly, Seth. “Peptide-conjugated phosphorodiamidate morpholino oligomer (PPMO) restores carbapenem susceptibility to NDM-1-positive pathogens in vitro and in vivo” . Journal of Antimicrobial Chemotherapy. doi : 10.1093/jac/dkw476/2691388/peptide-conjugated-phosphorodiamidate-morpholino .
  16. ^ “Hefny Pharma Group” . hefnypharmagroup.info. Retrieved 2018-05-22.

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