Anti-Infective – Carbapenems
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Outline
Overview
- Overview
- Not normally first-line antibiotics choice
- Bactericidal beta-lactam antibiotics
- Reserved for complicated/severe infections
- Escherichia coli
- Klebsiella pneumoniae
- Drug-induced seizure activity
- Types
- Imipenem-cilastatin
- Meropenem
- Ertapenem
- Doripenem
- Mechanism of action
- Inhibit the synthesis of bacterial cell wall
- Leads to cell death
- Ertapenem
- Indications
- Enterococcal spp
- Pseudomonas spp
- Indications
- Meropenem
- Indications
- Gram + organisms
- Enterobacteriaceae
- Pseudomonas aeruginosa
- Bacterial meningitis
- Indications
- Imipenem-cilastatin
- Indications
- Gram + / gram – aerobic and anaerobic bacteria
- Bone, joint, skin, and soft tissue infections
- Bacterial endocarditis caused by S. aureus
- Intraabdominal bacterial infections
- Pneumonia
- UTIs and pelvic infections
- Bacterial septicemia
- Gram + / gram – aerobic and anaerobic bacteria
- Interactions
- Cyclosporine
- Ganciclovir
- Probenecid
- Indications
- Contraindications
- Hypersensitivity
- Pediatric population with CNS infections
- Adverse Effects
- Seizures
- Ellderly
- Renally impaired
- Hypersensitivity
- Penicillin allergy
- Gastrointestinal
- Nausea
- Vomiting
- Diarrhea
- Dermatologic reactions
- Rash
- Phlebitis
- Seizures
Patient Education
Call your doctor if you experience any of the following:
- Seizures
- Hypersensitivity
- Penicillin allergy
- Gastrointestinal
- Nausea
- Vomiting
- Diarrhea
- Dermatologic reactions
- Rash
- 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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Concepts Covered:
- Suffixes
- Concepts of Pharmacology
- Test Taking Strategies
- Med Term Basic
- Prefixes
- Med Term Whole
- Bipolar Disorders
- Immunological Disorders
- Medication Administration
- Learning Pharmacology
- Cardiovascular
- Emergency Care of the Cardiac Patient
- Terminology
- Cardiac Disorders
- Circulatory System
- Dosage Calculations
- Nervous System
- Skeletal System
- Shock
- Shock
- Noninfectious Respiratory Disorder
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Disorders of the Thyroid & Parathyroid Glands
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- Adult
- Gastrointestinal
- Upper GI Disorders
- Liver & Gallbladder Disorders
- Newborn Complications
- Lower GI Disorders
- Multisystem
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- Hematologic Disorders
- Central Nervous System Disorders – Brain
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- Prenatal Concepts
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- Gastrointestinal Disorders
- Acute & Chronic Renal Disorders
- Disorders of the Adrenal Gland
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- Renal Disorders
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Study Plan Lessons
Medical Terminology Course Introduction
Pharmacology Course Introduction
12 Points to Answering Pharmacology Questions
12 Points to Answering Pharmacology Questions
01.01 CCRN Test Overview for CCRN Review
MedTerm Basic Word Structure
54 Common Medication Prefixes and Suffixes
54 Common Medication Prefixes and Suffixes
MedTerm Body as a Whole
MedTerm Suffixes
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
Essential NCLEX Meds by Class
Essential NCLEX Meds by Class
MedTerm Prefixes
6 Rights of Medication Administration
6 Rights of Medication Administration
Pharmacodynamics
Pharmacokinetics
The SOCK Method – Overview
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method – S
The SOCK Method – O
The SOCK Method – O
The SOCK Method – C
The SOCK Method – C
The SOCK Method – K
The SOCK Method – K
Basics of Calculations
Basics of Calculations
02.01 Hypertensive Crisis for CCRN Review
Neuro Terminology
Cardiac Terminology
02.02 Cardiomyopathy for CCRN Review
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Oral Medications
Oral Medications
Respiratory Terminology
02.03 Swan-Ganz Catheters for CCRN Review
Digestive Terminology
Injectable Medications
Injectable Medications
02.04 Pulmonary Artery Wedge Pressure (PAWP) for CCRN Review
02.05 Calculating PAWP on PEEP for CCRN Review
IV Infusions (Solutions)
IV Infusions (Solutions)
Urinary Terminology
Complex Calculations (Dosage Calculations/Med Math)
Complex Calculations (Dosage Calculations/Med Math)
02.06 Heart Murmurs for CCRN Review
Reproductive Terminology
Interactive Pharmacology Practice
Musculoskeletal Terminology
02.07 Reading “A, C, V Waves” & PAWP Waveforms for CCRN Review
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
Interactive Practice Drip Calculations
Metabolic & Endocrine Terminology
02.09 12 Lead EKG- Leads 1, 2, 3, aVL, and aVF for CCRN Review
Hematology Oncology & Immunology Terminology
Pediatric Dosage Calculations
02.10 12 Lead EKG- Lead V1-V6 for CCRN Review
Integumentary (Skin) Terminology
02.11 12 Lead EKG- Injuries for CCRN Review
02.12 Myocardial Infarction- Inferior Wall for CCRN Review
02.13 Myocardial Infarction – Anterior Septal Wall for CCRN Review
02.14 Shock Stages for CCRN Review
02.15 Hypovolemic Shock for CCRN Review
02.16 Cardiogenic Shock for CCRN Review
02.17 Septic Shock for CCRN Review
02.18 Cardiovascular Practice Questions for CCRN Review
Disease Specific Medications
Sensory Terminology
03.01 Syndrome of Inappropriate Antidiuretic hormone (SIADH) for CCRN Review
03.02 Diabetes Insipidus for CCRN Review
Pharmacology Terminology
03.03 Hypoglycemia for CCRN Review
Psychiatry Terminology
Diagnostics Terminology
03.04 DKA vs HHNK for CCRN Review
03.05 Endocrine Practice Questions for CCRN Review
Procedural Terminology
Antianxiety Meds
04.01 Hematology for CCRN Review
Benzodiazepines
Benzodiazepines
04.02 Hematology Review Questions for CCRN Review
ACLS (Advanced cardiac life support) Drugs
05.01 Pancreatitis and Large Bowel Obstruction for CCRN Review
05.02 Liver Overview and Disease for CCRN Review
05.03 Jaundice for CCRN Review
05.04 Ruptured Spleen for CCRN Review
05.05 GI Practice Questions for CCRN Review
Anti-Platelet Aggregate
06.01 Organ Failure, Dysfunction & Trauma for CCRN Review
NG Tube Medication Administration
06.02 Poisoning for CCRN Review
Coumarins
06.03 Multi-System CCRN Important Points for CCRN Review
06.04 Differentiating Ectopy and Aberrancy for CCRN Review
Thrombin Inhibitors
06.05 Wide Complex Tachycardia for CCRN Review
Thrombolytics
Anticonvulsants
07.01 CVA (Cerebrovascular Accident/Stroke) for CCRN Review
07.02 Neuro Anatomy for CCRN Review
07.03 Uncal Herniation for CCRN Review
07.04 Supratentorial Herniation and Glasgow Coma Scale for CCRN Review
07.05 Supratentorial Herniation: Cushings Triad for CCRN Review
07.06 Increased Intracranial Pressure (ICP) for CCRN Review
07.07 Cerebral Perfusion Pressure for CCRN Review
07.08 Basilar Skull Fracture for CCRN Review
07.09 Meningitis for CCRN Review
07.10 Neurologic Review questions for CCRN Review
Antidepressants
08.01 Psychological Review for CCRN Review
MAOIs
MAOIs
SSRIs
SSRIs
TCAs
TCAs
09.01 Acute Renal Failure Overview for CCRN Review
Antidiabetic Agents
09.02 Acute Tubular Necrosis for CCRN Review
09.03 Acute Renal (Pre-Renal vs Renal) Failure for CCRN Review
09.04 Continuous Renal Replacement Therapy for CCRN Review
Insulin
Insulin
09.05 Chronic Renal Failure for CCRN Review
09.06 Renal Practice Questions for CCRN Review
Insulin – Mixtures (70/30)
10.01 Arterial Blood Gas (ABG) Interpretation for CCRN Review
Histamine 1 Receptor Blockers
Histamine 1 Receptor Blockers
10.02 Breath Sounds for CCRN Review
10.03 Acute Respiratory Failure for CCRN Review
Histamine 2 Receptor Blockers
Histamine 2 Receptor Blockers
10.04 Pulmonary Question Review for CCRN Review
Renin Angiotensin Aldosterone System
Renin Angiotensin Aldosterone System
Sympatholytics (Alpha & Beta Blockers)
ACE (angiotensin-converting enzyme) Inhibitors
ACE (angiotensin-converting enzyme) Inhibitors
Angiotensin Receptor Blockers
Angiotensin Receptor Blockers
Calcium Channel Blockers
Calcium Channel Blockers
Cardiac Glycosides
Cardiac Glycosides
Anti-Infective – Aminoglycosides
Anti-Infective – Antifungals
Metronidazole (Flagyl) Nursing Considerations
Anti-Infective – Antitubercular
Anti-Infective – Antivirals
Anti-Infective – Carbapenems
Anti-Infective – Fluoroquinolones
Ciprofloxacin (Cipro) Nursing Considerations
Anti-Infective – Glycopeptide
Vancomycin (Vancocin) Nursing Considerations
Anti-Infective – Lincosamide
Anti-Infective – Macrolides
Anti-Infective – Penicillins and Cephalosporins
Anti-Infective – Penicillins and Cephalosporins
Anti-Infective – Sulfonamides
Anti-Infective – Tetracyclines
Atypical Antipsychotics
Atypical Antipsychotics
Antipsychotics
Autonomic Nervous System (ANS)
Autonomic Nervous System (ANS)
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Parasympathomimetics (Cholinergics) Nursing Considerations
Parasympatholytics (Anticholinergics) Nursing Considerations
Bronchodilators
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Proton Pump Inhibitors
Epoetin Alfa
Epoetin Alfa
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HMG-CoA Reductase Inhibitors (Statins)
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Hydralazine
Hydralazine (Apresoline) Nursing Considerations
Nitro Compounds
Nitro Compounds
Vasopressin
Vasopressin
ACLS (Advanced cardiac life support) Drugs
Anti-Infective – Aminoglycosides
Anti-Infective – Carbapenems
Anti-Infective – Macrolides
Anti-Infective – Fluoroquinolones
Anti-Infective – Sulfonamides
Anti-Infective – Tetracyclines
Anti-Infective – Antifungals
Anti-Infective – Antivirals
Anti-Infective – Lincosamide
Thrombolytics
Anticonvulsants
Antidiabetic Agents
Sympatholytics (Alpha & Beta Blockers)
Anti-Infective – Antitubercular
Anti-Infective – Glycopeptide
Bronchodilators
Opioids
Barbiturates
Anesthetic Agents
Antineoplastics
Alkylating Agents
Antimetabolites
Anti Tumor Antibiotics
Plant Alkaloids Topoisomerase and Mitotic Inhibitors
Patient Controlled Analgesia (PCA)
Epidural
Insulin Drips
ABG (Arterial Blood Gas) Interpretation-The Basics
ABG (Arterial Blood Gas) Oxygenation
ABG Course (Arterial Blood Gas) Introduction
ABGs Nursing Normal Lab Values
ABGs Tic-Tac-Toe interpretation Method
Acetaminophen (Tylenol) Nursing Considerations
Acyclovir (Zovirax) Nursing Considerations
Adenosine (Adenocard) Nursing Considerations
Albuterol (Ventolin) Nursing Considerations
Alendronate (Fosamax) Nursing Considerations
Alprazolam (Xanax) Nursing Considerations
Alteplase (tPA, Activase) Nursing Considerations
Amiodarone (Pacerone) Nursing Considerations
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Ampicillin (Omnipen) Nursing Considerations
ASA (Aspirin) Nursing Considerations
Atenolol (Tenormin) Nursing Considerations
Atorvastatin (Lipitor) Nursing Considerations
Atropine (Atropen) Nursing Considerations
Azithromycin (Zithromax) Nursing Considerations
Base Excess & Deficit
Benztropine (Cogentin) Nursing Considerations
Bisacodyl (Dulcolax) Nursing Considerations
Bismuth Subsalicylate (Pepto-Bismol) Nursing Considerations
Bupropion (Wellbutrin) Nursing Considerations
Buspirone (Buspar) Nursing Considerations
Butorphanol (Stadol) Nursing Considerations
Calcium Acetate (PhosLo) Nursing Considerations
Calcium Carbonate (Tums) Nursing Considerations
Captopril (Capoten) Nursing Considerations
Carbamazepine (Tegretol) Nursing Considerations
Carbidopa-Levodopa (Sinemet) Nursing Considerations
Cefaclor (Ceclor) Nursing Considerations
Cefdinir (Omnicef) Nursing Considerations
Celecoxib (Celebrex) Nursing Considerations
Cephalexin (Keflex) Nursing Considerations
Chlorpromazine (Thorazine) Nursing Considerations
Cimetidine (Tagamet) Nursing Considerations
Ciprofloxacin (Cipro) Nursing Considerations
Clindamycin (Cleocin) Nursing Considerations
Clopidogrel (Plavix) Nursing Considerations
Codeine (Paveral) Nursing Considerations
Cortisone (Cortone) Nursing Considerations
Cyclosporine (Sandimmune) Nursing Considerations
Dexamethasone (Decadron) Nursing Considerations
Diazepam (Valium) Nursing Considerations
Digoxin (Lanoxin) Nursing Considerations
Diltiazem (Cardizem) Nursing Considerations
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Diphenhydramine (Benadryl) Nursing Considerations
Diphenoxylate-Atropine (Lomotil) Nursing Considerations
Divalproex (Depakote) Nursing Considerations
Dobutamine (Dobutrex) Nursing Considerations
Dopamine (Inotropin) Nursing Considerations
Enalapril (Vasotec) Nursing Considerations
Enoxaparin (Lovenox) Nursing Considerations
Epinephrine (EpiPen) Nursing Considerations
Epoetin (Epogen) Nursing Considerations
Erythromycin (Erythrocin) Nursing Considerations
Escitalopram (Lexapro) Nursing Considerations
Famotidine (Pepcid) Nursing Considerations
Fentanyl (Duragesic) Nursing Considerations
Ferrous Sulfate (Iron) Nursing Considerations
Fluoxetine (Prozac) Nursing Considerations
Fluticasone (Flonase) Nursing Considerations
Furosemide (Lasix) Nursing Considerations
Gabapentin (Neurontin) Nursing Considerations
Gentamicin (Garamycin) Nursing Considerations
Glipizide (Glucotrol) Nursing Considerations
Glucagon (GlucaGen) Nursing Considerations
Guaifenesin (Mucinex) Nursing Considerations
Haloperidol (Haldol) Nursing Considerations
Heparin (Hep-Lock) Nursing Considerations
Hepatitis B Vaccine for Newborns
Hydralazine (Apresoline) Nursing Considerations
Hydrochlorothiazide (Hydrodiuril) Nursing Considerations
Hydrocodone-Acetaminophen (Vicodin, Lortab) Nursing Considerations
Hydromorphone (Dilaudid) Nursing Considerations
Ibuprofen (Motrin) Nursing Considerations
Indomethacin (Indocin) Nursing Considerations
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Insulin – Short Acting (Regular) Nursing Considerations
Iodine Nursing Considerations
Isoniazid (Niazid) Nursing Considerations
Ketorolac (Toradol) Nursing Considerations
Lactic Acid
Lactulose (Generlac) Nursing Considerations
Lamotrigine (Lamictal) Nursing Considerations
Levetiracetam (Keppra) Nursing Considerations
Levofloxacin (Levaquin) Nursing Considerations
Lidocaine (Xylocaine) Nursing Considerations
Lisinopril (Prinivil) Nursing Considerations
Lithium (Lithonate) Nursing Considerations
Loperamide (Imodium) Nursing Considerations
Lorazepam (Ativan) Nursing Considerations
Losartan (Cozaar) Nursing Considerations
Magnesium Sulfate (MgSO4) Nursing Considerations
Mannitol (Osmitrol) Nursing Considerations
Meperidine (Demerol) Nursing Considerations
Meropenem (Merrem) Nursing Considerations
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
Metformin (Glucophage) Nursing Considerations
Methadone (Methadose) Nursing Considerations
Methylergonovine (Methergine) Nursing Considerations
Methylphenidate (Concerta) Nursing Considerations
Methylprednisolone (Solu-Medrol) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Metoprolol (Toprol XL) Nursing Considerations
Metronidazole (Flagyl) Nursing Considerations
Midazolam (Versed) Nursing Considerations
Montelukast (Singulair) Nursing Considerations
Morphine (MS Contin) Nursing Considerations
Nalbuphine (Nubain) Nursing Considerations
Naproxen (Aleve) Nursing Considerations
Neostigmine (Prostigmin) Nursing Considerations
Nifedipine (Procardia) Nursing Considerations
Nitroglycerin (Nitrostat) Nursing Considerations
Nitroprusside (Nitropress) Nursing Considerations
Norepinephrine (Levophed) Nursing Considerations
Nystatin (Mycostatin) Nursing Considerations
Olanzapine (Zyprexa) Nursing Considerations
Omeprazole (Prilosec) Nursing Considerations
Ondansetron (Zofran) Nursing Considerations
Oxycodone (OxyContin) Nursing Considerations
Oxytocin (Pitocin) Nursing Considerations
Pancrelipase (Pancreaze) Nursing Considerations
Pantoprazole (Protonix) Nursing Considerations
Parasympatholytics (Anticholinergics) Nursing Considerations
Parasympathomimetics (Cholinergics) Nursing Considerations
Paroxetine (Paxil) Nursing Considerations
Pentobarbital (Nembutal) Nursing Considerations
Phenazopyridine (Pyridium) Nursing Considerations
Phenobarbital (Luminal) Nursing Considerations
Phenytoin (Dilantin) Nursing Considerations
Procainamide (Pronestyl) Nursing Considerations
Promethazine (Phenergan) Nursing Considerations
Propofol (Diprivan) Nursing Considerations
Propranolol (Inderal) Nursing Considerations
Propylthiouracil (PTU) Nursing Considerations
Proton Pump Inhibitors
Quetiapine (Seroquel) Nursing Considerations
Ranitidine (Zantac) Nursing Considerations
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Rifampin (Rifadin) Nursing Considerations
ROME – ABG (Arterial Blood Gas) Interpretation
Salmeterol (Serevent) Nursing Considerations
Selegiline (Eldepyrl) Nursing Considerations
Sertraline (Zoloft) Nursing Considerations
Spironolactone (Aldactone) Nursing Considerations
Streptokinase (Streptase) Nursing Considerations
Sucralfate (Carafate) Nursing Considerations
Terbutaline (Brethine) Nursing Considerations
Tetracycline (Panmycin) Nursing Considerations
Trimethoprim-Sulfamethoxazole (Bactrim) Nursing Considerations
Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations
Vancomycin (Vancocin) Nursing Considerations
Vasopressin (Pitressin) Nursing Considerations
Verapamil (Calan) Nursing Considerations
Warfarin (Coumadin) Nursing Considerations