Updated: 9/16/2017

Carbapenems

Topic
Review Topic
0
0
Introduction
  • Classification
    • antibiotic
      • penicillin-family (β-lactam)
        • carbapenems
  • Drugs
    • imipenem (+ cilastatin)
    • meropenem
    • doripenem
    • ertapenem
Mechanism
  • Action
    • see Penicillin 
    • β-lactamase resistant
    • normal kidneys break down imipenem with a dihydropeptidase
      • cilastatin, a selective dihydropeptidase inhibitor, is always given with imipenem
        • inhibits renal dihydropeptidase I, thereby decreasing inactivation of drug in renal tubules
      • cilastatin not needed for meropenem
  • Resistance
    • some bacteria can hydrolyze carbapenems
    • some bacteria have decreased the size of their porins, preventing entry of the drug
Uses
  • Imipenem has the broadest activity of any known antibiotic
    • effective against
      • Gram-positives
      • Gram-negatives
        • including most Pseudomonas
        • used for Enterobacter
      • anaerobes
    • NOT effective against
      • MRSA
      • bacteria without peptidoglycan cell walls
        • e.g. Mycoplasma
      • some Pseudomonas spp.
  • Other carbapenems provide similar broad spectrum coverage
    • however, ertapenem does not cover Pseudomonas
Adverse effects
  • Significant adverse effects limit use of these drugs
    • seizures
      • meropenem has reduced risk of seizures
    • nausea, vomiting, GI upset
    • skin rash
  • Allergy
    • 5-10% of patients with penicillin allergy are also allergic to carbapenems
Pharmacology
  • Given IV or IM
  • Renal excretion
 

Please rate topic.

Average 4.8 of 4 Ratings

Thank you for rating! Please vote below and help us build the most advanced adaptive learning platform in medicine

The complexity of this topic is appropriate for?
How important is this topic for board examinations?
How important is this topic for clinical practice?
Topic COMMENTS (4)
Private Note