Question

Carbapenem which has tendency to cause maximum seizures?

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

Answer 1

The Correct Option is A

Step 1: The question asks which beta-lactam of the carbapenem class is most epileptogenic. Seizures from this class arise because the drug competitively blocks inhibitory $GABA_A$ signalling in neurons.
Step 2: Imipenem stands out because its side chain gives it the strongest binding to the $GABA_A$ receptor, so even at standard doses it carries a measurable convulsant liability, worsened when renal clearance falls.
Step 3: The newer agents - meropenem, ertapenem and doripenem - were designed with side chains that bind the receptor weakly, so their seizure incidence is far lower; meropenem is the carbapenem of choice for CNS infection for this very reason.
Step 4: Putting this together, the agent with the maximum tendency to provoke seizures is imipenem.
\[\boxed{\text{Imipenem}}\]