{"id":99,"date":"2019-09-22T17:51:38","date_gmt":"2019-09-22T21:51:38","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/chapter\/3-7-carbapenems\/"},"modified":"2022-03-16T12:50:41","modified_gmt":"2022-03-16T16:50:41","slug":"3-7-carbapenems","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/chapter\/3-7-carbapenems\/","title":{"raw":"3.8 Carbapenems","rendered":"3.8 Carbapenems"},"content":{"raw":"Carbapenems are a beta-lactam \u201ccousin\u201d to penicillins and cephalosporins.\r\n\r\nIndications for Use:<\/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 clients who are immunocompromised.\r\n\r\nMechanism of Action:<\/strong> Carbapenems are typically bactericidal and work by inhibiting the synthesis of the bacterial cell wall.\r\n\r\nNursing Considerations Across the Lifespan:\u00a0<\/strong> Some carbapenems (eg. meropenem) are considered safe for use in pediatrics. Dose adjustments are required based on renal dysfunction in older adults. Information related to carbapenems in pregnancy is limited.\r\n\r\nSpecific Administration Considerations:<\/strong> Carbapenems are similar to cephalosporins.\u00a0 Cross sensitivity may occur in clients allergic to pencillin or cephalosporins.\r\n\r\nClient Teaching & Education:\u00a0 <\/strong>Clients should monitor for signs of superinfection and report any occurrence to the provider.\u00a0 If a client experiences fever and bloody diarrhoea, they should contact the provider immediately.\u00a0 The client 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]\r\n\r\nNow let's take a closer look at the medication card for Carbapenems 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][footnote]UpToDate (2021). Meropenem<\/em>. https:\/\/www.uptodate.com\/contents\/search<\/a>[\/footnote] Because information about medication is constantly changing, nurses should always consult evidence-based resources to review current recommendations before administering specific medication.\r\n\r\nTable 3.7 Carbapenem Medication Card\r\n\r\nClass:\u00a0 Carbapenems <\/strong>(prototypes: imipenem<\/a> and meropenem<\/a>)\r\n\r\n\"Carbapenems\r\n
\r\n

Clinical Reasoning and Decision-Making Activity 3.7a<\/strong><\/p>\r\n\r\n<\/header>\r\n

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

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

Indications for Use:<\/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 clients 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

Nursing Considerations Across the Lifespan:\u00a0<\/strong> Some carbapenems (eg. meropenem) are considered safe for use in pediatrics. Dose adjustments are required based on renal dysfunction in older adults. Information related to carbapenems in pregnancy is limited.<\/p>\n

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

Client Teaching & Education:\u00a0 <\/strong>Clients should monitor for signs of superinfection and report any occurrence to the provider.\u00a0 If a client experiences fever and bloody diarrhoea, they should contact the provider immediately.\u00a0 The client 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 card for Carbapenems in Table 3.7.[3]<\/sup><\/a>[4]<\/sup><\/a> Because information about medication is constantly changing, nurses should always consult evidence-based resources to review current recommendations before administering specific medication.<\/p>\n

Table 3.7 Carbapenem Medication Card<\/p>\n

Class:\u00a0 Carbapenems <\/strong>(prototypes: imipenem<\/a> and meropenem<\/a>)<\/p>\n

\"Carbapenems<\/p>\n

\n
\n

Clinical Reasoning and Decision-Making Activity 3.7a<\/strong><\/p>\n<\/header>\n

\n

Using the above 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 client 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 activities can be found in the “Answer Key<\/a>” sections at the end of the book.<\/p>\n<\/div>\n<\/div>\n

 <\/p>\n

Media Attributions<\/h2>