Anti-Infective – Carbapenems

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Outline

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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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!

 

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Pediatric

Concepts Covered:

  • EENT Disorders
  • Immunological Disorders
  • Intraoperative Nursing
  • Shock
  • Gastrointestinal Disorders
  • Lower GI Disorders
  • Postpartum Care
  • Basic
  • Respiratory Disorders
  • Endocrine and Metabolic Disorders
  • Developmental Considerations
  • Childhood Growth and Development
  • Prenatal and Neonatal Growth and Development
  • Cardiac Disorders
  • Emergency Care of the Cardiac Patient
  • Musculoskeletal Disorders
  • Fundamentals of Emergency Nursing
  • Adult
  • Concepts of Population Health
  • Factors Influencing Community Health
  • Renal and Urinary Disorders
  • Renal Disorders
  • Noninfectious Respiratory Disorder
  • Integumentary Disorders
  • Urinary Disorders
  • Central Nervous System Disorders – Brain
  • Neurologic and Cognitive Disorders
  • Newborn Complications
  • Musculoskeletal Trauma
  • Infectious Disease Disorders
  • Newborn Care
  • Disorders of Pancreas
  • Pregnancy Risks
  • Communication
  • Neurological Emergencies
  • Pediatric
  • Oncologic Disorders
  • Preoperative Nursing
  • Acute & Chronic Renal Disorders
  • Developmental Theories
  • Emergency Care of the Neurological Patient
  • Medication Administration
  • Perioperative Nursing Roles

Study Plan Lessons

Acute Otitis Media (AOM)
Anaphylaxis Nursing Interventions for Certified Perioperative Nurse (CNOR)
Anti-Infective – Carbapenems
Appendicitis
Bismuth Subsalicylate (Pepto-Bismol) Nursing Considerations
Breastfeeding
Brief CPR (Cardiopulmonary Resuscitation) Overview
Care of the Pediatric Patient
Celiac Disease
Cleft Lip and Palate
Conjunctivitis
Constipation and Encopresis (Incontinence)
Day in the Life of a Peds (Pediatric) Nurse
Dehydration
Developmental Considerations for the Hospitalized Individual
Developmental Stages and Milestones
Dysrhythmias for Certified Emergency Nursing (CEN)
Fever Case Study (Pediatric) (30 min)
Flight Nurse
Forensic Nurse
Growth & Development – Infants
Hypoxia – Signs and Symptoms (in Pediatrics) Nursing Mnemonic (FINES)
Immunizations (Vaccinations)
Imperforate Anus
Intussusception
Intussusception for Certified Emergency Nursing (CEN)
Life Support Review Course Introduction
Malnutrition (Failure to Thrive, Malabsorption Disorders) for Progressive Care Certified Nurse (PCCN)
Nephrotic Syndrome Case Study (Peds) (45 min)
Nursing Care Plan (NCP) for Asthma
Nursing Care Plan (NCP) for Asthma / Childhood Asthma
Nursing Care Plan (NCP) for Cleft Lip / Cleft Palate
Nursing Care Plan (NCP) for Clubfoot
Nursing Care Plan (NCP) for Cystic Fibrosis
Nursing Care Plan (NCP) for Dehydration & Fever
Nursing Care Plan (NCP) for Eczema (Infantile or Childhood) / Atopic Dermatitis
Nursing Care Plan (NCP) for Enuresis / Bedwetting
Nursing Care Plan (NCP) for Epiglottitis
Nursing Care Plan (NCP) for Hydrocephalus
Nursing Care Plan (NCP) for Imperforate Anus
Nursing Care Plan (NCP) for Infective Conjunctivitis / Pink Eye
Nursing Care Plan (NCP) for Intussusception
Nursing Care Plan (NCP) for Marfan Syndrome
Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia
Nursing Care Plan (NCP) for Neural Tube Defect, Spina Bifida
Nursing Care Plan (NCP) for Otitis Media / Acute Otitis Media (AOM)
Nursing Care Plan (NCP) for Phenylketonuria (PKU)
Nursing Care Plan (NCP) for Scoliosis
Nursing Care Plan (NCP) for Skull Fractures
Nursing Care Plan (NCP) for Transient Tachypnea of Newborn
Nursing Care Plan (NCP) for Varicella / Chickenpox
Nursing Care Plan (NCP) for Vomiting / Diarrhea
Nursing Care Plan for Newborn Reflexes
Nursing Case Study for Pediatric Asthma
Nursing Case Study for Type 1 Diabetes
Nutrition Assessments
Nutritional Requirements
Omphalocele
Oncology nurse
Pain Management and Procedural Sedation for Certified Emergency Nursing (CEN)
Patients with Communication Difficulties
Pediatric Advanced Life Support (PALS)
Pediatric Bronchiolitis Labs
Pediatric Dosage Calculations
Pediatric Gastrointestinal Dysfunction – Diarrhea
Pediatric Oncology Basics
Pediatric Vital Signs (VS)
Pediatrics Course Introduction
Perioperative Education Documentation for Certified Perioperative Nurse (CNOR)
Peritoneal Dialysis (PD)
Piaget’s Theory of Cognitive Development
Product Evaluation and Selection for Certified Perioperative Nurse (CNOR)
RN to MSN
Seizure Disorders for Certified Emergency Nursing (CEN)
Seizure Management in the ER
Tips & Advice for Pediatric IV
Tonsillitis
Umbilical Hernia
Visitor Supervision for Certified Perioperative Nurse (CNOR)
Vitals (VS) and Assessment
Vomiting