Carbapenems and aztreonam

Carbapenems and aztreonam

Drug monograph · NCLEX study reference
Therapeutic class	Antibacterial
Pharmacologic class	Beta-lactams (carbapenems; aztreonam is a monobactam)
Onset / peak / duration	Rapid; IV every 6 to 8 hours (ertapenem once daily).
Half-life / level	Short; no routine level.
Routes	IV
High-alert (ISMP)	No
Black box warning	None
Antidote / reversal	Supportive care.
Pregnancy / lactation	Use if clearly needed.

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Carbapenems and aztreonam — Antibacterial; Beta-lactams (carbapenems; aztreonam is a monobactam).

Identification

• Therapeutic class: Antibacterial.
• Pharmacologic class: Beta-lactams (carbapenems; aztreonam is a monobactam).

Pharmacology

• Mechanism of action: Inhibit cell wall synthesis with very broad coverage; carbapenems reserved for serious and resistant infections.
• Onset / peak / duration: Rapid; IV every 6 to 8 hours (ertapenem once daily).
• Half-life / therapeutic level: Short; no routine level.

Clinical use

• Indications: Serious gram-negative and mixed infections, resistant organisms; aztreonam useful in severe penicillin allergy (no cross-reactivity).
• Usual dose, route, frequency: IV; ertapenem once daily.
• Maximum dose / adjustments: Reduce in renal impairment.

Safety

• Contraindications: Carbapenem hypersensitivity; caution in penicillin allergy (carbapenems), but aztreonam is safe in penicillin allergy.
• Black box warning: None.
• Interactions: Valproate (carbapenems sharply lower valproate levels and risk seizures), probenecid.
• Pregnancy / lactation: Use if clearly needed.
• High-alert: No.

Adverse effects

• Common side effects: Diarrhea, nausea, injection-site reactions.
• Serious effects to report: Seizures (especially imipenem in renal impairment), anaphylaxis, C. difficile colitis.
• Antidote / reversal: Supportive care.

Nursing process

• Assessment before administration: Allergy history, renal function, seizure history, valproate use.
• Interventions during therapy: Avoid carbapenems with valproate; adjust for renal function.
• Monitor: Renal function, neuro status, infection resolution.
• Evaluation / expected outcome: Resolution of serious infection.

Patient teaching

• Patient teaching: These are reserved for serious infections; report any rash or new symptoms.
• Notify provider if: Rash, breathing difficulty, twitching or seizures, severe diarrhea.
• Administration tips: IV per protocol; aztreonam an option for penicillin-allergic patients.