How does imipenem cause seizure & which patients have higher risk of it?

How does imipenem cause seizure & which patients have higher risk of it?

The mechanism of seizure provoca- tion by imipenem is undoubtedly multifactorial, related to the drug’s ability to reduce inhibition of epileptic dis- charges by blocking the -aminobutyric acid (GABA)A receptor; to its action on -amino-3-hydroxy-5-methyl- isoxazolepropionate (AMPA) and N-methyl-D-aspartate (NMDA) …

Why do carbapenems cause seizures?

Increased concentrations of carbapenem agents are more likely to precipitate seizure activity. This is secondary to the antagonism of the GABA receptor by these agents, whereby increased doses increase this antagonism and increase the risk of seizure.

Does ertapenem lower seizure threshold?

It is likely that the use of ertapenem lowers the seizure threshold in elderly patients with predisposing risk factors.

Which carbapenem has highest seizure risk?

In general, the incidence of seizures associated with carbapenems is as follows, in order of decreasing frequency: Meropenem (0.7%) [6], ertapenem (0.5%) [7], and imipenem (0.4%) [8], according to FDA-approved labeling; but compared to other carbapenems, the highest seizure rate has occurred with the use of imipenem ( …

Why do antibiotics cause seizures?

Numerous antibiotics may trigger epileptic seizures or status epilepticus by decreasing inhibitory transmission in the brain, thus lowering the seizure threshold. The most potent seizurogenic effect is exerted by penicillins, cephalosporins, fluorochinolons and carbapenems.

Which medication should be avoided in a patient with a history of seizures?

Pseudoephedrine – a decongestant that shrinks blood vessels in the nasal passages. This is the active ingredient in medications like Sudafed and any medications with “D” on the end (Zyrtec D, Claritin D or Mucinex D). Bupropion – also known as Wellbutrin, which is used for smoking cessation and as an anti-depressant.

Who should not take imipenem?

chronic kidney disease stage 3B (moderate) chronic kidney disease stage 4 (severe) chronic kidney disease stage 5 (failure) kidney disease with likely reduction in kidney function.