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29.03 Anti-Infective – Carbapenems

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Overview

  1. Overview
    1. Not normally first-line antibiotics choice
    2. Bactericidal beta-lactam antibiotics
    3. Reserved for complicated/severe infections
      1. Escherichia coli
      2. Klebsiella pneumoniae
    4. Drug-induced seizure activity
  2. Types
    1. Imipenem-cilastatin
    2. Meropenem
    3. Ertapenem
    4. Doripenem
  3. Mechanism of action
    1. Inhibit the synthesis of bacterial cell wall
    2. Leads to cell death
  4.  Ertapenem
    1. Indications
      1. Enterococcal spp
      2. Pseudomonas spp
  5.  Meropenem
    1. Indications
      1. Gram + organisms
      2. Enterobacteriaceae
      3. Pseudomonas aeruginosa
      4. Bacterial meningitis
  6.  Imipenem-cilastatin
    1.  Indications
      1. Gram + / gram – aerobic and anaerobic bacteria
        1. Bone, joint, skin, and soft tissue infections
        2. Bacterial endocarditis caused by S. aureus
        3. Intraabdominal bacterial infections
        4. Pneumonia
        5. UTIs and pelvic infections
        6. Bacterial septicemia
    2. Interactions
      1. Cyclosporine
      2. Ganciclovir
      3. Probenecid
  7. Contraindications
    1. Hypersensitivity
    2. Pediatric population with CNS infections
  8. Adverse Effects
    1.  Seizures
      1. Ellderly
      2. Renally impaired
    2. Hypersensitivity
      1. Penicillin allergy
    3. Gastrointestinal
      1. Nausea
      2. Vomiting
      3. Diarrhea
    4. Dermatologic reactions
      1. Rash
      2. Phlebitis
    1.  

Patient Education

Call your doctor if you experience any of the following:

  1.  Seizures
  2. Hypersensitivity
    1. Penicillin allergy
  3. Gastrointestinal
    1. Nausea
    2. Vomiting
    3. Diarrhea
  4. Dermatologic reactions
    1. Rash
    2. Phlebitis

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Video Transcript

Hello and welcome. Today we’re going to discuss carbapenems  and the must-know information regarding these antibiotics.

Carbapenems are usually not first-line antibiotics due to their side effect profile. This class of antibiotics are bacterial beta-lactams and reserved for complicated infections like e. coli and klebsiella pneumoniae. One major side effect of carbapenems use is drug-induced seizures.

Now, carbapenems have various brand names put their generic names end in -PENEM. Carbapenems = penem ending.

The mechanism of action with carbapenems revolves around it’s inhibition of bacterial cell wall synthesis. Which leads to bacterial cell suppression and death Regardless of cellular structures, the wall synthesis impairs and destroys cellular function.

Ertapenem, is indicated in enterococcus and pseudomonas infections.

Meropenem is a well-known drug in the ICU setting and used from various complicated infections, such as pseudomonas. It’s the only carbapenem that treats bacterial meningitis.

Imipenem-cilastatin is another carbapenem used for the various well know ICU infections. If you’re patient has soft tissue infections, UTIs or bacterial septicemia, you have probably heard of this drug before.

Carbapenems potentiate the CNS effect, such as seizures when used in conjunction with medication such as cyclosporine, ganciclovir, probenecid.

Carbapenems have an extended list of adverse effects: It can cause seizures, gastrointestinal symptoms, dermatologic reactions and hypersensitivity in patients with PCN allergies. When you think of the adverse effects think of SGHD.

Nursing concepts for carbapenems include pharmacology and infection control.

Okay let’s recap – carbapenems are beta-lactam antibiotics, with ending -PENEM. These antibiotics are used to treat various infections and include profile with many side effects ( seizures, gastrointestinal symptoms, dermatologic reactions and hypersensitivity in patients with PCN allergies). One well-known important side effect is seizures and should be used with caution in children and the elderly.

You know now the important details regarding carbapenems. Now, go out and be your best self today and as always, Happy Nursing!

 
Module 0 – Pharmacology Course Introduction
Module 3 – Disease Specific Medications

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