Carbapenems Flashcards
Carbapenems
greatest spectrum of B lactams, G+, G-, anaerobes
What are carbapenems reserved for?
resistant infections
What does Cilastatin inhibit?
dehydropeptidase (not B- lactamase) in kidney tubules that metabolize imipenem
What does inhibiting dehydropeptidase do?
increases the levels of imipenem and prevents nephrotoxic metabolite
Side effects of impipenem?
resists most b lactamase; vomiting ad nausea, increase risk of c. difficile; seizures
Merpopenem
not metabolized by dehydropeptidase; fewer seizures
Ertapenem
once a day dose
Doripenem
injection for complicated UTI and intra abdominal infections
not to be used for any type of pnemonia (increase risk of death/ decrease risk of cure)
CARBAPENEM GENERAL USES
- Urinary tract infectionss - Lower respiratory tract infections; Bone, joint & skin infections
Intra-abdominal & gynecological infections, bacterial septicemia
Why did cilastatin have to be paired up with Imipenem?
Imipenem couldnt achieve levels sufficient enough in the urinary tract to treat urinary infections because dehydropeptidase would break it down
CRKP
deadly; is emerging in long-term care facilities and nursing homes, particularly in patients on ventilators, where elderly are most affected.
Overall effect
Seizures
