{"id":107,"date":"2019-09-22T17:51:38","date_gmt":"2019-09-22T17:51:38","guid":{"rendered":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/chapter\/3-7-carbapenems\/"},"modified":"2021-12-07T11:06:19","modified_gmt":"2021-12-07T11:06:19","slug":"3-7-carbapenems","status":"publish","type":"chapter","link":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/chapter\/3-7-carbapenems\/","title":{"raw":"3.7 Carbapenems","rendered":"3.7 Carbapenems"},"content":{"raw":"Carbapenems are a beta- lactam \u201ccousin\u201d to penicillins and cephalosporins.\n\nIndications:<\/strong> Carbapenems are useful for treating life-threatening, multidrug-resistant infections due to their broad spectrum of activity.[footnote]Papp-Wallace, K. M., Endimiani, A., Taracila, M. A., & Bonomo, R. A. (2011). Carbapenems: past, present, and future. Antimicrobial agents and chemotherapy, 55<\/em>(11), 4943\u20134960. https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3195018\/<\/a>[\/footnote]<\/sup> These antibiotics are effective in treating gram-positive and gram-negative infections. Because of their broad spectrum of activity, these medications can be especially useful for treating complex hospital-acquired infections or for patients who are immunocompromised.\n\nMechanism of Action:<\/strong> Carbapenems are typically bactericidal and work by inhibiting the synthesis of the bacterial cell wall.\n\nSpecific Administration Considerations:<\/strong> Carbapenems are similar to cephalosporins.\u00a0 Cross sensitivity may occur in patients allergic to pencillin or cephalosporins.\n\nPatient Teaching & Education:\u00a0 <\/strong>Patients should monitor for signs of superinfection and report any occurrence to the provider.\u00a0 If a patient experiences fever and bloody diarrhea, they should contact the provider immediately.\u00a0 The patient should also be advised that side effects can occur even weeks after the medication is discontinued.[footnote]uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a>[\/footnote]\n\nNow let's take a closer look at the medication grid\u00a0 for imipenem in Table 3.7.[footnote]Daily Med, https:\/\/dailymed.nlm.nih.gov\/dailymed\/index.cfm<\/a>, used for hyperlinked medications in this module. Retrieved June 27, 2019.[\/footnote]\n\nTable 3.7 Carbapenem Medication Grid\n\n\n\n\n
\n
Class\/Subclass<\/strong><\/h5>\n<\/th>\n
\n
Prototype\/Generic<\/strong><\/h5>\n<\/th>\n
\n
Administration Considerations<\/strong><\/h5>\n<\/th>\n
\n
Therapeutic Effects<\/strong><\/h5>\n<\/th>\n
\n
Side\/Adverse Effects<\/strong><\/h5>\n<\/th>\n<\/tr>\n
Carbapenems<\/th>\nimipenem<\/a><\/td>\nRoute: IV\n\nCheck for allergies, including penicillin and cephalosporins\n\nDosage adjustment if renal impairment\n\nUse with caution with seizure disorder or renal dysfunction<\/td>\nMonitor for systemic signs\u00a0of infection:\n\n-WBCs\n\n-Fever\n\nMonitor actual site of infection\n\nMonitor culture results, if obtained<\/td>\nSimilar to cephalosporins<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n \n

Critical Thinking Activity 3.7a<\/strong><\/span><\/h2>\nUsing the above grid information, consider the following clinical scenario question:<\/strong><\/span>\n\nJohn Smith was admitted to the hospital with a serious abdominal infection. The nurse notices that this patient is allergic to penicillin as he prepares to administer the first dose of imipenem medication. What is the nurse\u2019s next best action?<\/span>\n\nNote: Answers to the Critical Thinking activities can be found in the \"Answer Key\" sections at the end of the book.","rendered":"

Carbapenems are a beta- lactam \u201ccousin\u201d to penicillins and cephalosporins.<\/p>\n

Indications:<\/strong> Carbapenems are useful for treating life-threatening, multidrug-resistant infections due to their broad spectrum of activity.[1]<\/sup><\/a><\/sup> These antibiotics are effective in treating gram-positive and gram-negative infections. Because of their broad spectrum of activity, these medications can be especially useful for treating complex hospital-acquired infections or for patients who are immunocompromised.<\/p>\n

Mechanism of Action:<\/strong> Carbapenems are typically bactericidal and work by inhibiting the synthesis of the bacterial cell wall.<\/p>\n

Specific Administration Considerations:<\/strong> Carbapenems are similar to cephalosporins.\u00a0 Cross sensitivity may occur in patients allergic to pencillin or cephalosporins.<\/p>\n

Patient Teaching & Education:\u00a0 <\/strong>Patients should monitor for signs of superinfection and report any occurrence to the provider.\u00a0 If a patient experiences fever and bloody diarrhea, they should contact the provider immediately.\u00a0 The patient should also be advised that side effects can occur even weeks after the medication is discontinued.[2]<\/sup><\/a><\/p>\n

Now let’s take a closer look at the medication grid\u00a0 for imipenem in Table 3.7.[3]<\/sup><\/a><\/p>\n

Table 3.7 Carbapenem Medication Grid<\/p>\n\n\n\n\n
\n
Class\/Subclass<\/strong><\/h5>\n<\/th>\n
\n
Prototype\/Generic<\/strong><\/h5>\n<\/th>\n
\n
Administration Considerations<\/strong><\/h5>\n<\/th>\n
\n
Therapeutic Effects<\/strong><\/h5>\n<\/th>\n
\n
Side\/Adverse Effects<\/strong><\/h5>\n<\/th>\n<\/tr>\n
Carbapenems<\/th>\nimipenem<\/a><\/td>\nRoute: IV<\/p>\n

Check for allergies, including penicillin and cephalosporins<\/p>\n

Dosage adjustment if renal impairment<\/p>\n

Use with caution with seizure disorder or renal dysfunction<\/td>\n

Monitor for systemic signs\u00a0of infection:<\/p>\n

-WBCs<\/p>\n

-Fever<\/p>\n

Monitor actual site of infection<\/p>\n

Monitor culture results, if obtained<\/td>\n

Similar to cephalosporins<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

Critical Thinking Activity 3.7a<\/strong><\/span><\/h2>\n

Using the above grid information, consider the following clinical scenario question:<\/strong><\/span><\/p>\n

John Smith was admitted to the hospital with a serious abdominal infection. The nurse notices that this patient is allergic to penicillin as he prepares to administer the first dose of imipenem medication. What is the nurse\u2019s next best action?<\/span><\/p>\n

Note: Answers to the Critical Thinking activities can be found in the “Answer Key” sections at the end of the book.<\/p>\n

  1. Papp-Wallace, K. M., Endimiani, A., Taracila, M. A., & Bonomo, R. A. (2011). Carbapenems: past, present, and future. Antimicrobial agents and chemotherapy, 55<\/em>(11), 4943\u20134960. https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3195018\/<\/a> ↵<\/a><\/li>
  2. uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a> ↵<\/a><\/li>
  3. Daily Med, https:\/\/dailymed.nlm.nih.gov\/dailymed\/index.cfm<\/a>, used for hyperlinked medications in this module. Retrieved June 27, 2019. ↵<\/a><\/li><\/ol><\/div>","protected":false},"author":2,"menu_order":7,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":"cc-by"},"chapter-type":[49],"contributor":[],"license":[53],"class_list":["post-107","chapter","type-chapter","status-publish","hentry","chapter-type-numberless","license-cc-by"],"part":84,"_links":{"self":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/107","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/users\/2"}],"version-history":[{"count":1,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/107\/revisions"}],"predecessor-version":[{"id":108,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/107\/revisions\/108"}],"part":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/parts\/84"}],"metadata":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/107\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/media?parent=107"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapter-type?post=107"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/contributor?post=107"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/license?post=107"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}