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Paper II — 2021 February (Supplementary) (2010 Scheme) — Q9

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Paper II
2021 February (Supplementary) (2010 Scheme)

Question

Imipenem and cilastatin

Q91 marksShort Answers

Answer

Imipenem, a carbapenem antibiotic, is extensively metabolized by the renal enzyme dehydropeptidase-I, which rapidly degrades it, resulting in low urinary concentrations and potentially nephrotoxic metabolites if given alone. Cilastatin is a specific inhibitor of dehydropeptidase-I; combining it with imipenem blocks this renal degradation, increasing imipenem’s plasma half-life, improving urinary concentrations, and reducing the risk of nephrotoxic metabolite formation — making the combination necessary for effective and safe clinical use.

  1. 1Pharmacokinetics

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