Carbapenems and Monobactam Flashcards
What are the 4 Carbapenems?
Doripenem
Imipenem
Meropenem
Ertapenem
What are the chances a patient with a PCN allergy is also hypersensitive to Carbapenems?
10%
What is the mechanism of action for Carbapenems?
Binds to PBP resulting in cidal effect
Why would Meropenem be a good candidate for treating Meningitis?
Does not undrego renal degradation
Why is Imipenem often coupled with Cilastatin?
Why must this be done very carefully?
Cilastatin inhibits Imipenem’s renal degradation by competing for dehydropeptidase; lessening Imipenem elimination
SEIZURES: caused by too much imipenem; can use Meropenem instead
Why is Ertapenem often used on home health patients?
Long Half Life allows for once daily administration
T/F
In general, you must be careful when prescribing any Carbepenem (renal adjustment for insufficiency etc.) to avoid seizures.
TRUE
What adverse effects, besides hypersensitivity, are associated with Carbapenems?
Seizures
Anemia, Leukopenia, Thrombocytopenia
What bugs are covered by Imipenem, Meropenem, and Doripenem?
- Staph, Strep, Enterococcus
- SPACE
- Anaerobes
- ESBL organisms (PEK)-resistant bugs*
What bugs are covered by Ertapenem?
- Similar to Amp/Sulbactam (Unasyn) coverage but no Enterococcus coverage
- Staph/Strep
- Anaerobes
- ESBL organsims (PEK)
What adverse effects, besides VERY RARE hypersensitivity, are associated with Aztreonam?
Anemia, Leukopenia, Thrombocytopenia
What is Aztreonam usually reserved for?
Serious G– infections and patients with IgE-mediated hypersensitivity to PCNs
What bugs are covered by Ertapenem?
G– only to include SPACE (compare coverage to Ceftazidime)
Why is Aztreonam often used on patients with anaphylactic reactions to PCNs (Ace in the Hole)?
cross reactivity chances are so low
