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152 > Antibiotics (rest of beta lactams > Flashcards

Antibiotics (rest of beta lactams Flashcards

1
Q

What is the similar structure between cephalosporins

A
  • 7-aminocephalosporonic acid
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2
Q

What is the difference between cephalosporins and cephamycin’s (cefoxitin)

A
  • An O where the S is
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3
Q

What is the MOA of cephalosporins

A
  • Same as penicillins, bactericidal
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4
Q

How does resistance for cephalosporins occur

A
  • Lack of PBP or altered PBP with reduced affinity
    • Beta lactamase production
    • Resistant to beta- lactamase produced by staph aureas and common gnb
    • Efflux
    • Inability of drug to penetrate
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5
Q

What are the adverse effects of cephalosporins

A
  • Considered safe drugs
    • Hypersensitivity
    • Allergic
    • Skin rash
    • Diarrhea
    • Fever, granulocytopenia, hemolytic anemia
    • Biliary pseudolithiasis (ceftriaxone)
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6
Q

Why can ceftriaxone cause biliary pseudolithiasis

A
  • Ceftriaxone eliminated by the billiard system so a long half life
    - Only have to give once a day
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7
Q

What is biliary pseudolithiasis

A
  • Mimics gallstones
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8
Q

What are the first generation cephalosporins

A

a) Oral:
- Cephalexin
- Cefadroxil
b) IV/IM
Cefazolin

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9
Q

What are first generation cephalosporins active against

A
  • Active against gpc (gram positive cocci)
    • Some gram negative bacilli (gnb) E.coli, proteus and klebsiella
    • Not active against enterococci or MRSA
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10
Q

Are first generation cephalosporins the DOC for any infections

A
  • No except cefazolin is for surgical prophylaxis
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11
Q

Do first generation cephalosporins penetrate the CNS

A

No

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12
Q

What are the second generation cephalosporins

A

a) Oral
- Cefuroxime axetil
- Cefprozil (cefaclor)
b) IV/ IM
- Cefuroxime
c) Cephamycin: cefoxitin

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13
Q

What are second generation cephalosporins active against

A
  • Same activity as first generation but greater coverage of gnb (not pseudomonas aeruginosa)
    • Active against gpc (gram positive cocci)
    • Some gram negative bacilli (gnb) E.coli, proteus and klebsiella
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14
Q

What are cephamycin’s used for

A
  • Used in mixed aerobic/ anaerobic infections (good in gut, diabetic gout infections as there Is both aerobic and anaerobic)
    • Better anaerobic function
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15
Q

What are the third generation cephalosporins

A

a) Cefotaxime, ceftriaxone
- IV/IM
- Don’t cover Ps. Aeruginosa
b) Ceftazidime
- IV/IM
- Reserved for Ps. Aeruginosa (still has a lot of gp effectiveness)
c) Cefixime
- Oral agent

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16
Q

Third generation cephalosporins activity

A
  • Enhanced activity against gnb
    • Decreased activity against gpc except Strep pneumoniae
17
Q

Can third generation cephalosporins penetrate the CNS

A

Yes

18
Q

What are the fourth generation cephalosporins

A
  • Cefepime
    • Reserved for hospital cause such broad spectrum
19
Q

What are the fourth generations activity

A
  • Fourth gen cephalosporins
    • Enhanced activity enterobacter and citrobacter
    • Active against Ps. Aeruginosa
20
Q

What are the fifth generation cephalosporins and what are they active against

A
  • Ceftaroline and ceftobiprole
    • Activity against MRSA, ampicillin sensitive E. faecalis and penicillin resistant S. pneumoniae
21
Q

Carbapenems

A

Structurally related to beta lactams

22
Q

What are the carbapenems

A
  • Imipenem-cilastatin, meropenem, ertapenem (very broad spectrum agents)
23
Q

What is imipenem combined with

A
  • Cilastatin (a renal di-petidase inhibitor)
24
Q

What is the activity of carbapenems (imipenem and meropenem)

A

Gram positive, gram negative including pseudomonas and anaerobic organisms

25
Q

What makes ertapenem different then the other carbapenems

A
  • Long half life (once daily)
    • Poor activity against enterococcus sp and P. aeruginosa
26
Q

monobactams

A
  • mono cyclic beta lactam ring
    • Resistant to beta lactamases
    • Aztreonam (not available in canada)
    • Active against gnb including Ps. aeruginosa
    • Not active against ESBL or AmpC producers

152 (8 decks)

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