FA carbapenem

Question 1

Carbapenems agents?

Answer 1

imipenem (combined with cilastatin), meropenem, ertapenem, doripenem

Question 2

Carbapenem administration?

Answer 2

i/v

Question 3

imipenem combined with what?

Answer 3

cilastatin

Question 4

why impenem used with cilastatin?

Answer 4

its inhibitor of renal dehydropeptidase I and therefore decr. inactivation of drug in renal tubules. (nesusidaro toksinis metabolitas)

Question 5

imipenem to beta-lactamases?

Answer 5

resistant

Question 6

what are newer carbapenems?

Answer 6

ertapenem and doripenem

Question 7

what enzyme breaks down imipenem?

Answer 7

human dehydropeptidase I

Question 8

meropenem to human dehydropeptidase I?

Answer 8

Meropenem is stable to dehydropeptidase I.

Question 9

when carbapenem are choice drugs?

Answer 9

Last-resort drugs (used only in life-threatening infections or after other antibiotics have failed) because of the significant adverse effects.

Question 10

meropenem to risk of seizures?

Answer 10

has decr. risk for seizures

Question 11

what covers carbapenems?

Answer 11

gram +, gram -, anaerobes (B. fragilis), enterokokai

Question 12

carbapenems - Broad-spectrum antibiotics with intrinsic beta-lactamase resistance.

Answer 12

.

Question 13

what gram + cocci are not coveredby carbapenems?

Answer 13

Gram-positive cocci (except for MRSA and Enterococcus faecalis and Enterococcus faecium, which are intrinsically resistant)

Question 14

carbapenems to pseudomonas?

Answer 14

covers, except ertapenem which has limited activity against Pseudomonas

Question 15

carbapenems adverse?

Answer 15

Secondary fungal infections
CNS toxicity: can lower seizure threshold at high serum concentrations
Highest risk: imipenem
Lowest risk: meropenem
Gastrointestinal upset
Rash
Thrombophlebitis

Question 16

what has highest risk for seizures?

Answer 16

imipenem

Question 17

what has lowest risk for seizures?

Answer 17

meropenem

Question 18

resistance mechanism?

Answer 18

Mechanism of resistance: inactivation by carbapenemase
(A type of β-lactamase); Produced by carbapenemase-producing Enterobacteriaceae (e.g., E. coli, K. pneumoniae, K. aerogenes)

Question 19

what m/os produce carbapenemases?

Answer 19

Produced by carbapenemase-producing Enterobacteriaceae (e.g., E. coli, K. pneumoniae, K. aerogenes)