Merrem - Meropenem

Merrem (Meropenem). AstraZeneca. US Prescribing information, February 2007. 

Meropenem (Merrem IV) inhibits syndiesis of die bacterial cell wall and causes die deadi of susceptible cells. This drug is used for intra-abdominal infections caused by Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, and odier susceptible organisms Meropenem also is effective against bacterial meningitis caused by Neisseria meningitidis, Streptococcus pneumoniae, and Hemophilus influenzae. 

Mercaptopurine [6-MP] (Purinethol) [Antineoplastic/ Antimeta lite] Uses Acute leukemias, 2nd-line Rx of CML NHL, maint ALL in children, immunosuppressant w/ autoimmune Dzs (Crohn Dz) Action Antimetabolite, mimics hypoxanthine Dose Adults. 80-100 mg/mVd or 2.5-5 mg/kg/d maint 1.5-2.5 mg/kg/d Peds. Per protocol X w/ renal/hepatic insuff on empty stomach Caution [D, ] Contra Severe hepatic Dz, BM suppression, PRG Disp Tabs SE Mild hematotox, mucositis, stomatitis, D rash, fever, eosinophilia, jaundice. Hep Interactions T Effects W/ allopurinol T risk of BM suppression W/ trimethoprim-sulfamethoxazole X effects OF warfarin EMS May falsely T glucose OD May cause NA and liver necrosis symptomatic and supportive Meropenem (Merrem) [Antibiotic/Carbapenem] Uses lntra-abd Infxns, bacterial meningitis Action Carbapenem X cell wall synth, a [3-lactam Dose Adults. 1 to 2 g IV q8h Peds. >3 mo, <50 kg 10-40 mg/kg IV q 8h in renal insuff Caution [B, ] Contra [3-Lactam sensitivity Disp Inj 500 mg, 1 g SE Less Sz potential than imipenem D, thrombocytopenia Interactions T Effects W/ probenecid EMS Monitor for signs of electrolyte disturbances and... 

Meropenem (Merrem) is another carbapenem antibiotic with a broad spectrum of activity comparable to that of imipenem. A methyl group attached at the one-position on the five-member ring confers stability to dehydropeptidase 1. Consequently, meropenem does not require administration with cilastatin. When compared in human trials, imipenem-cilastatin and meropenem achieve similar clinical outcomes in patients with serious intraabdominal and soft tissue infections. Both imipenem-cilastatin and meropenem are used to treat infections caused by highly resistant Klebsiella pneumoniae producing ESBLs.The major cUnicaUy relevant distinction between imipenem-cilastatin and meropenem... 

Parenteral powder to reconstitute for injection (250, 500, 750 mg imipenem per vial) Meropenem (Merrem IV)... 

Meropenem (Merrem IV) is a dimethylcarbamoyl pyro-lidinyl derivative of thienamycin. It does not require coadministration with cilastatin because it is not sensitive to renal dipeptidase. Its toxicity is similar to that of imipenem except that it may be less likely to cause seizures (0.5% of meropenem- and 1.5% of imipenem-treated patients seized). Its in vitro activity is similar to that of imipenem, with activity against some imipenem-resistant P. aeruginosa but less activity against Gram-positive cocci. Chnical experience with meropenem demonstrates therapeutic equivalence with imipenem. 

MEROPENEM Meropenem (merrem iv) is a derivative of thienamycin that does not require coadministration with cilastatin because it is not sensitive to renal dipeptidase. Its toxicity and clinical efficacy are similar to imipenem, except that it may be less likely to cause seizures. 

An example highlighting the impact of crystallinity on stability is that of meropenem (MERREM ), a trihydrate of a carbapenem antibiotic. Meropenem batches of different hydration states were examined for solid-state stability at 40 °C over a 1 month period [59]. An increase in amorphous content was shown to lead to a higher extent of and more rapid degradation in the solid state. However, the crystalline trihydrate exhibited a nearly 300-fold improvement in stability compared with a sample which was 80% amorphous. Similar observations have also been made on cephalosporin antibiotics as reported by Pikal and co-workers [58]. 

Meropenem (Merrem, Zeneca Pharmaceuticals Wilmington, DE) (53) is a new carbopenem antibiotic approved in 1996 for use as a broad-spectrum injectable antibiotic for treatment of intraabdominal infections and for pediatric bacterial meningitis. The only other carbopenem available on the market today is imipenem. 

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