APEH inhibitor
Acylpeptide hydrolase inhibitor
- A serine protease of protein turnover
- Blocks acylpeptide hydrolase
- ↓ hydrolysis of valproate glucuronide back to valproate → ↓ valproate levels
Drugs with this mechanism (3)
- Ertapenem — Once-daily carbapenem lacking Pseudomonas coverage; convenient for outpatient IV.
- Imipenem — Broad-spectrum carbapenem (with cilastatin); reserved for resistant infections.
- Meropenem — Broad-spectrum carbapenem with good CNS penetration; less seizure-prone than imipenem.
Self-check
- What valproate metabolite is normally hydrolyzed back to valproate by APEH?
Valproate glucuronide. - How does APEH inhibition affect valproate levels?
Decreases them.
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