Carbapenems

Question 1

(T/F) - Carbapenems are among the most broad-spectrum antibacterials

Answer 1

TRUE

Question 2

Name the drugs in the carbapenem class

Answer 2

• Imipenem/cilastatin
• Meropenem
• Doripenem
• Ertapenem

Question 3

Which carbapenem has important spectrum deficiencies?

Answer 3

Ertapenem

Question 4

(T/F) - Carbapenems share the same MOA of beta-lactams and possess a beta-lactam ring

Answer 4

TRUE

Question 5

Are carbapenems different from PCNs and cephalosporins?

Answer 5

YES

Question 6

Carbapenems have a good spectrum in which bacteria?

Answer 6

• MSSA
• Strep
• Anaerobes
• Enteric GNRs
• Pseudomonas
• Acinetobacter
• ESBL-producing GNRs

Question 7

Which carbapenems should not be used for pseudomonas and acinetobacter?

Answer 7

Ertapenem

Question 8

What adverse event could happen with the use of carbapenems? Especially which carbapenem?

Answer 8

Seizures; especially imipenem

Question 9

How could the risk of seizures be minimized in patients?

Answer 9

• Avoid imipenem in pts w/ history of seizures or CNS infection
• Adjust doses in renally dysfunction pts

Question 10

(T/F) - Imipenem, doripenem, and meropenem have a more broad spectrum activity than ertapenem

Answer 10

TRUE

Question 11

(T/F) - Imipenem, doripenem, and meropenem should be used empirically for most community acquired infections

Answer 11

FALSE - should not

Question 12

Which carbapenem is metabolized by the kidney to a nephrotoxic product? How can it be prevented?

Answer 12

Imipenem; cilastatin blocks the renal dihyropeptidase

Question 13

Which carbapenem has a weaker activity over the other carbapenems?

Answer 13

Ertapenem

Question 14

Which carbapenem is administered once a day being more convenient than the other carbapenems for home infusion therapy of susceptible infections?

Answer 14

Ertapenem

Question 15

(T/F) - Carbapenems cannot elicit an allergic reaction in patients with a history of PCN allergy

Answer 15

FALSE - can elicit

Question 16

What are the utilizations of all carbapenems?

Answer 16

• Mixed aerobic/anaerobic infections
• Intra-abdominal infections
• Infections caused by ESBL-producing organisms

Question 17

What are the utilizations of imipenem, doripenem, meropenem?

Answer 17

• Nosocomial infections

- Febrile neutropenia

Question 18

In renal dysfunction patients, what should be done before administration?

Answer 18

Check doses to minimize the risk of seizures

Question 19

What is the name of the drug that falls in the class of carbapenem/beta-lactamase inhibitor?

Answer 19

Meropenem/vaborbactam

Question 20

Carbapenem/beta-lactamase inhibitor has a good spectrum in which bacteria?

Answer 20

• Same as meropenem

- Resistant to meropenem due to certain beta-lactamases (Klebsiella pneumoniae carbapenemase [KPC])

Question 21

What is carbapenem/beta-lactamase inhibitor FDA-approved of?

Answer 21

• Complicated UTIs

- Pyelonephritis caused by susceptible bacteria

Question 22

What is the off-label use of carbapenem/beta-lactamase inhibitors?

Answer 22

Carbapenem-resistant Enterobacteriaceae