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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Concepts Covered:

  • EENT Disorders
  • Oncology Disorders
  • Microbiology
  • Emergency Care of the Cardiac Patient
  • Vascular Disorders
  • Cardiac Disorders
  • Central Nervous System Disorders – Brain
  • Medication Administration
  • Labor Complications
  • Intraoperative Nursing
  • Musculoskeletal Trauma
  • Respiratory Disorders
  • Shock
  • Infectious Respiratory Disorder
  • Disorders of Pancreas
  • Pregnancy Risks
  • Male Reproductive Disorders
  • Adult
  • Basics of Chemistry
  • Emergency Care of the Respiratory Patient
  • Neonatal
  • Newborn Care
  • Hematologic Disorders
  • Cardiovascular Disorders
  • Sexually Transmitted Infections
  • Nervous System
  • Terminology
  • Disorders of the Thyroid & Parathyroid Glands
  • Learning Pharmacology
  • Integumentary Disorders
  • EENT Disorders
  • Liver & Gallbladder Disorders
  • Prenatal Concepts
  • Postpartum Complications
  • Labor and Delivery
  • Dosage Calculations
  • Concepts of Pharmacology
  • Depressive Disorders
  • Bipolar Disorders
  • Anxiety Disorders
  • Cognitive Disorders
  • Personality Disorders
  • Noninfectious Respiratory Disorder
  • Disorders of the Posterior Pituitary Gland
  • Upper GI Disorders
  • Urinary Disorders
  • Substance Abuse Disorders
  • Urinary System
  • Immunological Disorders
  • Prefixes
  • Suffixes
  • Test Taking Strategies

Study Plan Lessons

Acetaminophen (Tylenol) Nursing Considerations
Antineoplastics
Fungal Infections
Antiviral Agents for Treatment
Basics of Microbial Control
Pediatric Dosage Calculations
Hypertension (HTN) Concept Map
Coronary Artery Disease Concept Map
Interactive Practice Drip Calculations
Tension and Cluster Headaches
Migraines
Patient Controlled Analgesia (PCA)
Epidural
Anesthetic Agents
Barbiturates
Opioids
Bronchodilators
Anti-Infective – Glycopeptide
Anti-Infective – Antitubercular
Antidiabetic Agents
Anticonvulsants
Thrombolytics
Anti-Infective – Lincosamide
Anti-Infective – Antivirals
Anti-Infective – Antifungals
Anti-Infective – Sulfonamides
Anti-Infective – Fluoroquinolones
Anti-Infective – Macrolides
Anti-Infective – Carbapenems
Anti-Infective – Aminoglycosides
ACLS (Advanced cardiac life support) Drugs
Anesthetic Agents
Viruses & Fungi
Nuclear Chemistry
Rapid Sequence Intubation
CRNA
Bronchodilators
Anticonvulsants
Cardiopulmonary Arrest
Anti-Infective – Glycopeptide
Antidiabetic Agents
Bacteria
Nuclear Chemistry
Neonatal Resuscitation Program (NRP)
Thrombolytics
Anti-Infective – Lincosamide
Barbiturates
Prostaglandins in Pregnancy
Eye Prophylaxis for Newborn
Phytonadione (Vitamin K) for Newborn
Thrombin Inhibitors
Anti-Infective – Antitubercular
Chemical Equations
Chemical Bonds & Compounds
Betamethasone and Dexamethasone in Pregnancy
Sedatives-Hypnotics
Tocolytics
Sympatholytics (Alpha & Beta Blockers)
Opioids
Coumarins
Anti-Platelet Aggregate
Properties of Matter
Scientific Notation & Measurement
Chemical Reactions
Anti-Infective – Antivirals
Anti-Infective – Antifungals
Anti-Infective – Tetracyclines
Anti-Infective – Sulfonamides
Anti-Infective – Fluoroquinolones
Anti-Infective – Macrolides
Anti-Infective – Carbapenems
Anti-Infective – Aminoglycosides
Parasympathomimetics (Cholinergics) Nursing Considerations
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
ACLS (Advanced cardiac life support) Drugs
Psychiatry Terminology
Pharmacology Terminology
Nursing Care and Pathophysiology for Hashimoto’s Thyroiditis
The SOCK Method – Overview
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
The SOCK Method – S
Hanging an IV Piggyback
Spiking & Priming IV Bags
IV Push Medications
IM Injections
SubQ Injections
Insulin Mixing
Medications in Ampules
Drawing Up Meds
Topical Medications
EENT Medications
Pill Crushing & Cutting
NG Tube Med Administration (Nasogastric)
Hb (Hepatitis) Vaccine
Phytonadione (Vitamin K)
Eye Prophylaxis for Newborn (Erythromycin)
Lung Surfactant
Rh Immune Globulin (Rhogam)
Meds for PPH (postpartum hemorrhage)
Uterine Stimulants (Oxytocin, Pitocin)
Prostaglandins
Opioid Analgesics
Magnesium Sulfate
Betamethasone and Dexamethasone
Tocolytics
Complex Calculations (Dosage Calculations/Med Math)
IV Infusions (Solutions)
Injectable Medications
Oral Medications
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Basics of Calculations
Pharmacokinetics
Pharmacodynamics
Antidepressants
Mood Stabilizers
Antianxiety Meds
Meds for Alzheimers
Sedatives-Hypnotics
Antipsychotics
Heart (Cardiac) Failure Therapeutic Management
NG Tube Medication Administration
Disease Specific Medications
Vasopressin
TCAs
SSRIs
Proton Pump Inhibitors
Anti-Infective – Penicillins and Cephalosporins
Parasympatholytics (Anticholinergics) Nursing Considerations
NSAIDs
Nitro Compounds
MAOIs
Magnesium Sulfate
Insulin
HMG-CoA Reductase Inhibitors (Statins)
Hydralazine
Histamine 2 Receptor Blockers
Histamine 1 Receptor Blockers
Epoetin Alfa
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Corticosteroids
Cardiac Glycosides
Calcium Channel Blockers
Benzodiazepines
Autonomic Nervous System (ANS)
Atypical Antipsychotics
Angiotensin Receptor Blockers
ACE (angiotensin-converting enzyme) Inhibitors
Renin Angiotensin Aldosterone System
6 Rights of Medication Administration
Essential NCLEX Meds by Class
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
54 Common Medication Prefixes and Suffixes
12 Points to Answering Pharmacology Questions