Aztreonam (Inhalation solution)

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Aztreonam Inhalation solution (Cayston) is a monobactam antibiotic used to improve breathing symptoms in people with cystic fibrosis (CF) who have Pseudomonas aeruginosa (P. aeruginosa) in their lungs.

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[edit] BRAND NAMES

[edit] STRUCTURE

Aztreonam.jpg

[edit] MECHANISM OF ACTION

Aztreonam inhalation is a monobactam antibiotic. The monobactams are structurally different from beta-lactam antibiotics (e.g., penicillins, cephalosporins, carbapenems) due to a monocyclic nucleus.

The Aztreonam monobactam nucleus contains several side chains; sulfonic acid in the 1-position activates the nucleus, an aminothiazolyl oxime side chain in the 3-position confers specificity for aerobic Gram-negative bacteria including Pseudomonas spp., and a methyl group in the 4-position enhances beta-lactamase stability.

Aztreonam exhibits activity in vitro against Gram-negative aerobic pathogens including P. aeruginosa. Aztreonam binds to penicillin-binding proteins of susceptible bacteria, which leads to inhibition of bacterial cell wall synthesis and death of the cell.

Aztreonam is resistant to beta-lactamases produced by certain gram-negative bacteria, but is inactivated by extended-spectrum beta-lactamases.

Aztreonam has no activity against gram-positive bacteria or anaerobes

[edit] INDICATIONS

Aztreonam (Inhalation solution) is indicated to improve respiratory symptoms in cystic fibrosis (CF) patients with Pseudomonas aeruginosa.

[edit] DOSAGE

Administer one dose (75 mg/1 ml) by inhalation, 3 times a day for 28 days.

Administer only with the Altera® Nebulizer System. Do not administer with any other type of nebulizer.

Patients should use a bronchodilator before administration of Aztreonam (Inhalation solution). Short-acting bronchodilators can be taken between 15 minutes and 4 hours prior to each dose of Aztreonam (Inhalation solution). Alternatively, long-acting bronchodilators can be taken between 30 minutes and 12 hours prior to administration of Aztreonam (Inhalation solution).

[edit] CONTRAINDICATIONS

  • Patients with a known allergy to aztreonam.

[edit] PRECAUTIONS

  • Allergic reactions was seen in clinical trials. Stop treatment if an allergic reaction occurs. Use caution when Aztreonam (Inhalation solution) is administered to patients with a known allergic reaction to beta-lactams.
  • Bronchospasm has been reported. Stop treatment if chest tightness develops during nebulizer use

[edit] INTERACTIONS

[edit] PREGNANCY AND LACTATION

  • Pregnancy Category B (US). Aztreonam (Inhalation solution) should be used during pregnancy only if clearly needed.
  • Use of Aztreonam (Inhalation solution) during breastfeeding is unlikely to pose a risk to infants.

[edit] SIDE EFFECTS

Common adverse reactions (more than 5%) occurring more frequently in Aztreonam Inhalation solution (Cayston) patients are cough, nasal congestion, wheezing, pharyngolaryngeal pain, pyrexia, chest discomfort, abdominal pain and vomiting.

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