Cell Wall Inhibitors- Carbapenems

Question 1

imipenem (Primaxin®)

Coverage

Answer 1

• GP except MRSA
• GN including Pseudomonas + Enterobacter, ESBLs, anaerobes

Question 2

imipenem (Primaxin®)

MOA

Answer 2

β-lactam inhibits PBP and prevents cross-linking of peptidoglycan

Question 3

imipenem (Primaxin®)

Adverse Effects

Answer 3

• Penicillin allergy cross-reactivity
• Seizures

Question 4

imipenem (Primaxin®)

Indications

Answer 4

• Treatment of infections caused by GNB producing extended- spectrum β-lactamases
• serious infections caused by susceptible organisms

Question 5

imipenem (Primaxin®)

Contraindicationns

Answer 5

• Hypersensitivity to imipenem
• Lowers seizure threshold compared to carbapenems

Question 6

meropenem (Merrem®)

Coverage

Answer 6

• GP except MRSA
• GN including Pseudomonas, ESBLs, anaerobes

NOTE: same as imipenem except that it does not cover enterococcus like enterobacter

NOTE: same MOA, adverse effects and indications as imipenem

Question 7

meropenem (Merrem®)

Contraindications

Answer 7

Hypersensitivity to β-lactams

Question 8

ertapenem (Invanz®)

coverage

Answer 8

• GP except Enterococcus, MRSA
• GN including Enterobacter (but not Pseudomonas), anaerobes

NOTE: same MOA, adverse effects, indications as imipenem

NOTE:

Question 9

ertapenem (Invanz®)

Contraindications

Answer 9

Hypersensitivity to β-lactams