Now we're going to move on to another
of the drugs in the beta-lactam family,
Imipenem, meropenem, ertapenem, and doripenem.
Those are just 4 examples
of the generic names
in the carbapenem family.
Remember, carbapenems have the
same mechanism of action.
They weaken the bacterial cell wall
and you'll see that icon on the slide.
And they are part of the beta-lactam family
because they also have a beta-lactam ring.
Now, carbapenems are very broad spectrum.
I always like to think of this
as a car wreck
that would be majorly traumatic,
and that's why they treat very broad
spectrum. So, carbapenems
are very, very broad-spectrum drugs.
They're not active against MRSA. That
would be awesome if they were,
we have already been introduced to
a drug that can treat MRSA
in the fifth generation cephalosporins.
Now, the adverse effects for carbapenems --
no drug is without some type
of adverse effect,
GI distress and possible allergic reaction.
Those are pretty consistent
across the board,
and I know you've heard me say that before,
but I want to help you recognize if
you're thinking about antibiotics,
pretty much, any of them
can cause GI distress
and you're at risk for an allergic reaction.
Now, carbapenems, because they
are so broad spectrum,
can put your patient at risk
for a superinfection.
Now, superinfection is not super good.
In fact, it's super bad.
Because it's broad spectrum,
it knocks out lots of different
kinds of bacteria.
Sometimes, it knocks out the good bacteria,
so you may be treating a
patient for 1 infection,
but a superinfection is another
infection that develops
because of the antibiotics we
gave you. See, when you
knock out too many bacteria,
now, all of a sudden, there's
lots of resources available
for the bad bugs that don't help us.
And that's what a superinfection is called.
So, 1 example you may be familiar with.
If you are a female or you know
a female, sometimes when they
take an antibiotic, they end up
with a yeast infection
in a very personal space.
That's an example of a superinfection.
Now, there's a low risk of a cross
allergy to penicillins,
but because carbapenems also
have a beta-lactam ring,
you still have a low risk of a cross
allergy to penicillin.
Cross allergy to penicillin means
if I'm allergic to penicillin,
there's a small chance that I will also
have an allergy to carbapenems
because it's called a cross allergy,
and the beta-lactam ring structure
that they share.
Now let's take a look at monobactams.
Monobactams, in comparison to carbapenems,
are much more narrow spectrum.
They only go against gram-negative
Hey, why is that super cool? Well, remember,
gram-positive is slower, kinder, gentler
kind of bugs. We can kill them easier.
Gram-negative are tougher to kill.
So monobactams are great at
but it has to be given IV
or IM because it's not absorbed
in the GI tract.
Now, here's another tip I would give you.
As you're studying for pharmacology,
whenever you see something that
says it has to be given IV or IM,
you should almost start a
separate list in your notes
to make sure you have that listed there.
That's a good way to group or
chunk information together.
Now, the adverse effects for monobactams
are similar to another drug
we've just discussed,
thrombophlebitis, or pain
at the injection site.
Now does it happen very often? Usually, no.
But it's something -- if you have any patient
that's receiving an IV medication,
it's part of excellent nursing care to
frequently check that IV site,
make sure that you don't see any pain
or swelling or tenderness at the site
because any drug or medication or fluid
that we're giving in an IV site has
the potential to either
slide out of the vein or be caustic
to the tissue around it.
So, if you assess a site, it
shouldn't feel warm,
and if you touch it, the patient should
not feel any significant pain.
If either 1 of those 2 things are present,
then you're going to need to reassess
that site, and possibly start a new IV.