3-[[2-(2-Amino-1,3-thiazol-3-ium-4-yl)-2-(2-carboxypropan-2-yloxyimino)acetyl]amino]-2-methyl-4-oxoazetidine-1-sulfonate

• 分子结构分类: 有机化合物 - 有机杂环化合物 - 内酰胺类
• 英文名称: 3-[[2-(2-Amino-1,3-thiazol-3-ium-4-yl)-2-(2-carboxypropan-2-yloxyimino)acetyl]amino]-2-methyl-4-oxoazetidine-1-sulfonate
• 英文别名: 3-[[2-(2-amino-1,3-thiazol-3-ium-4-yl)-2-(2-carboxypropan-2-yloxyimino)acetyl]amino]-2-methyl-4-oxoazetidine-1-sulfonate
• 化学式: C13H17N5O8S2
• 分子量: 435.4
• InChiKey: WZPBZJONDBGPKJ-UHFFFAOYSA-N

计算性质

• 辛醇/水分配系数(LogP)：
  0.3
• 重原子数：
  28
• 可旋转键数：
  7
• 环数：
  2.0
• sp3杂化的碳原子比例：
  0.46
• 拓扑面积：
  238
• 氢给体数：
  4
• 氢受体数：
  12

ADMET

毒理性

• 肝毒性

氨曲南具有与其他β-内酰胺类抗生素相似的全身毒性，但目前尚不清楚它是否会引起类似青霉素或头孢菌素类抗生素引起的肝损伤。在高剂量、静脉注射氨曲南治疗期间（10%至38%），无症状的血清转氨酶升高是常见的。这些酶异常通常是轻至中度的、无症状的、自限性的，不需要停药。与其它比较的抗生素相比，氨曲南治疗期间酶升高的发生率略高。由于没有报告过单个病例，因此可以认为由氨曲南引起的明显肝损伤和黄疸的情况极为罕见。因此，关于损伤的潜伏期或模式没有数据。有报道在开始使用氨曲南后3到5天内出现显著转氨酶升高的情况，但这些病例没有黄疸，并且一旦停药就迅速恢复。

Aztreonam has systemic toxicities that are similar to those of other beta lactam antibiotics, but it is unclear whether it can cause hepatic injury similar to that of the penicillins or cephalosporins. Asymptomatic serum aminotransferase elevations are common during high dose, intravenous aztreonam therapy (10% to 38%). The enzyme abnormalities are usually mild-to-moderate, asymptomatic, self-limited and not requiring drug discontinuation. Enzyme elevations occur slightly more commonly during aztreonam therapy than with other comparative antibiotics. Cases of frank liver injury and jaundice attributable to aztreonam must be extremely rare as no individual cases have been reported. For this reason, there is no data regarding the latency or pattern of the injury. Instances of marked aminotransferase elevations within 3 to 5 days of starting aztreonam have been reported, but these cases were without jaundice and resolved rapidly once the drug was stopped.

来源:LiverTox

毒理性

• 在妊娠和哺乳期间的影响

◉ 母乳喂养期间使用总结：有限的信息表明，阿兹特罗胺在乳汁中产生的水平较低，预计不会对哺乳婴儿造成不良影响。偶尔有报道称，β-内酰胺类抗生素会破坏婴儿的胃肠道菌群，导致腹泻或鹅口疮，但这些影响尚未得到充分评估。一个由欧洲、澳大利亚和新西兰的呼吸专家组成的小组发现，吸入妥布霉素与哺乳相容。阿兹特罗胺适用于哺乳期母亲。 ◉ 对哺乳婴儿的影响：截至修订日期，未找到相关已发布信息。 ◉ 对泌乳和母乳的影响：截至修订日期，未找到相关已发布信息。

◉ Summary of Use during Lactation:Limited information indicates that aztreonam produces low levels in milk that are not expected to cause adverse effects in breastfed infants. Occasionally disruption of the infant's gastrointestinal flora, resulting in diarrhea or thrush have been reported with beta-lactams, but these effects have not been adequately evaluated. A task force respiratory experts from Europe, Australia and New Zealand found that inhaled tobramycin is compatible with breastfeeding. Aztreonam is acceptable in nursing mothers. ◉ Effects in Breastfed Infants:Relevant published information was not found as of the revision date. ◉ Effects on Lactation and Breastmilk:Relevant published information was not found as of the revision date.

来源:Drugs and Lactation Database (LactMed)