Carbapenems Flashcards
(T/F) - Carbapenems are among the most broad-spectrum antibacterials
TRUE
Name the drugs in the carbapenem class
- Imipenem/cilastatin
- Meropenem
- Doripenem
- Ertapenem
Which carbapenem has important spectrum deficiencies?
Ertapenem
(T/F) - Carbapenems share the same MOA of beta-lactams and possess a beta-lactam ring
TRUE
Are carbapenems different from PCNs and cephalosporins?
YES
Carbapenems have a good spectrum in which bacteria?
- MSSA
- Strep
- Anaerobes
- Enteric GNRs
- Pseudomonas
- Acinetobacter
- ESBL-producing GNRs
Which carbapenems should not be used for pseudomonas and acinetobacter?
Ertapenem
What adverse event could happen with the use of carbapenems? Especially which carbapenem?
Seizures; especially imipenem
How could the risk of seizures be minimized in patients?
- Avoid imipenem in pts w/ history of seizures or CNS infection
- Adjust doses in renally dysfunction pts
(T/F) - Imipenem, doripenem, and meropenem have a more broad spectrum activity than ertapenem
TRUE
(T/F) - Imipenem, doripenem, and meropenem should be used empirically for most community acquired infections
FALSE - should not
Which carbapenem is metabolized by the kidney to a nephrotoxic product? How can it be prevented?
Imipenem; cilastatin blocks the renal dihyropeptidase
Which carbapenem has a weaker activity over the other carbapenems?
Ertapenem
Which carbapenem is administered once a day being more convenient than the other carbapenems for home infusion therapy of susceptible infections?
Ertapenem
(T/F) - Carbapenems cannot elicit an allergic reaction in patients with a history of PCN allergy
FALSE - can elicit
What are the utilizations of all carbapenems?
- Mixed aerobic/anaerobic infections
- Intra-abdominal infections
- Infections caused by ESBL-producing organisms
What are the utilizations of imipenem, doripenem, meropenem?
- Nosocomial infections
- Febrile neutropenia
In renal dysfunction patients, what should be done before administration?
Check doses to minimize the risk of seizures
What is the name of the drug that falls in the class of carbapenem/beta-lactamase inhibitor?
Meropenem/vaborbactam
Carbapenem/beta-lactamase inhibitor has a good spectrum in which bacteria?
- Same as meropenem
- Resistant to meropenem due to certain beta-lactamases (Klebsiella pneumoniae carbapenemase [KPC])
What is carbapenem/beta-lactamase inhibitor FDA-approved of?
- Complicated UTIs
- Pyelonephritis caused by susceptible bacteria
What is the off-label use of carbapenem/beta-lactamase inhibitors?
Carbapenem-resistant Enterobacteriaceae
