Carbapenems Flashcards
What is the risk of carbapenems?
Loss of sensitivity to cephalosproins (3rd and 4th gen)
What are the two groups of carbapenems?
Imipenem/Meropenem
Ertapenem
Which group has the longest half life?
carbapenems
Ertapenem
What is Cilastatin added to? What does it do?
How is it different from the effect of Tazobactem?
added to Imipenem
prevents renal metabolism
Cilastatin does not provide additional coverage
What is the process of metabolism for Imipenem
extensive renal metabolism - brush border enzyme dehydropeptidase-1
(prevented by Cilstatin)
Adverse effects
carbapenems
seizures
cross allergenicity with PCN (cephalosporin)
Hematologic: anemia, leukopenia, thrombocytopenia
What is necessary in order to keep seizures under control?
Reduce dose/ renal adjustment necessary
Which group covers enterococcus and SPACE bugs?
carbapenems
Imipenem, Meropenem
What makes Ertapenem different from Imipenem/Meropenem?
No enterococcus coverage
No SPACE bugs
What group is not covered by Carbapenem?
Atypicals
What is the unique coverage by carbapenem?
ESBL organisms
What are the reserved uses for Carbapenem?
Serious/life threatening illness
multi-organism infections
acute necrotizing pancreatitis
ESBL organisms
