Which carbapenem is associated with seizures at high doses and is given with cilastatin to protect the kidney?

Which carbapenem is associated with seizures at high doses and is given with cilastatin to protect the kidney?

• A. Meropenem
• B. Imipenem
• C. Doripenem
• D. Ertapenem

Answer: (B)

Imipenem can cause seizures at high doses because it may lower the seizure threshold through effects on GABA receptors. It is given with cilastatin to protect the kidney because cilastatin inhibits renal dehydropeptidase I, preventing imipenem’s breakdown in the proximal tubules and reducing nephrotoxicity while allowing the drug to remain effective. The other carbapenems have a lower risk of seizures and are not paired with cilastatin for this purpose, so the association described points to imipenem.

Imipenem can cause seizures at high doses because it may lower the seizure threshold through effects on GABA receptors. It is given with cilastatin to protect the kidney because cilastatin inhibits renal dehydropeptidase I, preventing imipenem’s breakdown in the proximal tubules and reducing nephrotoxicity while allowing the drug to remain effective. The other carbapenems have a lower risk of seizures and are not paired with cilastatin for this purpose, so the association described points to imipenem.