It shares a common zinc protease motif (His-Glu-Xaa-Xaa-His) that researchers hypothesized was essential for target cleavage until this was more recently confirmed by experiment: when all zinc was removed from the neuron with heavy metal chelators, the toxin was inhibited, only to be reactivated when the zinc was added back in. The light chain binds to VAMP and cleaves it between Gln76 and Phe77. Without VAMP, vesicles holding the neurotransmitters needed for motor neuron regulation (GABA and glycine) cannot be released, causing the above-mentioned deregulation of motor neurons and muscle tension. Diagnosis
There are currently no blood tests for diagnosing tetanus. The diagnosis is based on the presentation of tetanus symptoms and does not depend upon isolation of the bacterium, which is recovered from the wound in only 30% of cases and can be isolated from people without tetanus. Laboratory identification of C. tetani can be demonstrated only by production of tetanospasmin in mice. Having recently experienced head trauma may indicate cephalic tetanus if no other diagnosis has been made.The "spatula test" is a clinical test for tetanus that involves touching the posterior pharyngeal wall with a soft-tipped instrument and observing the effect. A positive test result is the involuntary contraction of the jaw (biting down on the "spatula") and a negative test result would normally be a gag reflex attempting to expel the foreign object.
Piperacillin-tazobactam is recommended by the National Institute for Health and Care Excellence as first-line therapy for the treatment of bloodstream infections in neutropenic cancer patients.For β-lactam antipseudomonal antibiotics, including piperacillin/tazobactam, prolonged intravenous infusion is associated with lower mortality than bolus intravenous infusion in persons with sepsis due to Pseudomonas aeruginosa. Adverse effects
The most common adverse effect is diarrhea (7–11%). Another adverse effect is inhibition of platelets which is also known as thrombocytopenia. Contraindications
Zosyn is contraindicated when a patient has hypersensitivity to penicillins, cephalosporins, beta-lactamase inhibitors or any component of the formulation. Society and culture
Trade names
Apart from Tazocin and Zosyn, the drug is marketed in various countries under other trade names such as Tazovex,Tazact, Biopiper TZ, Brodactam, Piptaz, Maxitaz, Kilbac, Trezora, Du-Tazop, Tazopen, Sytaz, Tazin, and Inzalin TZ. 2017 shortage
Various sources have referred to a shortage of the drug since May 2017, citing various reasons, including an earthquake in China and other issues at the major production facility in 海正 (Hisun); increased demand; withdrawal of funding by a major pharmaceutical company. == References ==