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33 Cards in this Set
- Front
- Back
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carbapenems |
β-Lactam antibiotics |
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spectrum |
broad spectrum ___________________________ 1-Gram +ve 2-Gram -ve 3-anearobes
highly resistant to most β-lactamases |
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bacteria not covered by carbapenems |
intracellular bacteria (atypicals), such as the Chlamydiae |
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resistance |
carbapenemases producing bacteria
(((New Delhi metallo-β-lactamase, NDM-1))
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New Delhi metallo-beta-lactamase 1
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is an enzyme that makes bacteria resistant to a broad range of beta-lactam antibiotics. These include the antibiotics of the carbapenem family
mostly produced by :
1- Ecoli 2-klibsella |
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Approved carbapenems for clinical use |
Imipenem/cilastatin (Tienam)
meropenem
ertapenem (Invanz)
Doripenem |
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route |
only IV |
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mechanism of action |
cell wall membrane synthesis ((crosslinking))) |
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Ertaoenem generic |
Invanz |
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Ertapenem route
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IV route in 50 ml NS over 30 minutes
___________________________
IM with lidocain |
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Ertapenem mechanism |
inhibits cell wall synthesis by binding to penicillin binding protein
resistant to most beta-lactmases |
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Ertapenem peak in plasma |
= 2 hrs |
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Ertapenem elimination |
urine |
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Ertapenem half life |
4 hrs |
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Ertapenem caution / avoid in |
1-CNS disorders /seizure hx
2-never use with dextrose
3-adjust in renal impairment |
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Ertapenem side effects most common > 10 % |
diarrhea |
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Ertapenem side effects other |
increased LFT
nausea / abd. pain / vomiting/constipation
headach / altered mental /
increased plt count
fever
insomnia
edema / swelling
DRESS syndrome (rash / eosinophila)
rash / pruritis
eosinophilia
hypotension/ chest pain
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ertapenem
remember ...... remember S/E |
1- increased LFT
2-Increased plt
3-Dress syndrome
4-eiosinophiliae |
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ertapenem pregnancy |
B |
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Ertapenem serious interactions with |
1- BCG vaccinee
2-valproic acid (decreases VA ) |
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Ertapenem dosing of vial |
1 g |
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Ertapenem dosing |
1 g / day |
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Ertapenem dyration of ttt |
up to 14 days
may up to 4 wks in diebetic foot |
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Ertapenem dose in renal / adjustment <30 cr cl |
500 mg / day |
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Ertapenem dialysis |
500 mg less than 6 hrs before dailysis
then
150 after dialysis |
