cephalosporins are beta lactams - binds to PBP - activate autolytic enzymes

Antimicrobials 2 Flashcards by Sime Maharaj

What are the cell wall synthesis inhibitors?

fosfomycin, beta lactams, bacitracin, daptomycin, vancomycin

How well did you know this?

Not at all

Perfectly

cephalosporins MOA?

cephalosporins are beta lactams

binds to PBP
activate autolytic enzymes

How well did you know this?

Not at all

Perfectly

cephalosporins spectrum?

generation 1 –> 3
increasing activity against gram negative
decreasing activity against gram positive

generation 4 = broad
generation 5 = similar to gen 3 plus effective against MRSA

IMPORTANT: INACTIVE against CLAME
chlamydia, listeria, legionella, actinobacter, mycoplasma, enterococci

How well did you know this?

Not at all

Perfectly

cephalosporins vs penicillins? (beta lactamase resistant? bacteriocidal?

more resistant to beta lactamases
ie. next step

beta lactams so yes bacteriocidal

How well did you know this?

Not at all

Perfectly

cephalosporins resistance mech?

modify PBPs

How well did you know this?

Not at all

Perfectly

1st gen cephalosporins? used for?

cephalexin, cefazolin

Used as a penicillin G subsitute because they are still effective against organisms with penicillinase (a beta lactamase) ie. s. aureus

How well did you know this?

Not at all

Perfectly

Cefazolin DOC

surgical prophylaxis

How well did you know this?

Not at all

Perfectly

1st gen cephalosporins used to treat?

gram positive
E coli
Klebsiella pneumoniae
P. mirabilis (proteus)

How well did you know this?

Not at all

Perfectly

2nd gen cephalosporins? what are they? active against what organisms?

more gram negatives, less gram positives

H. influenza
Enterobacter
Neisseria

2nd gen:
aman is eating a dole cup and suddenly he HEARS something and he thinks it’s an OX coming IN, but no sadly its just an ACTOR

cefamandole
cefotetan
cefoxitin
cefaclor

How well did you know this?

Not at all

Perfectly

which 2nd generations treat abd and pelvic cavity infections?

Cefotetan
Cefoxitin

both ones with Os
O looks like a belly

How well did you know this?

Not at all

Perfectly

what are the 3rd generation cephalosporins? what are they active against?

cef-triaxone
cef-operazone
-cef-otaxime
-cef-tazidime
-cef-fixime

active against same 2nd gen (HEN) -
H. influenza
Enterobacter
Neisseria

active against more gram negatives, and less gram postiives

How well did you know this?

Not at all

Perfectly

Which cephalosporins are active against pneumococci?

3rd generation: all the T ones

cef triaxone
cefo taximine
cef tazidime

*recall penicillin G also active against pneumococci

How well did you know this?

Not at all

Perfectly

Which cephalosporins are active against pseudomonas?

3rd gen: cefoperazone and ceftazidime

also active against pseudomonas: antipseudomal penicilins

How well did you know this?

Not at all

Perfectly

4th generation cephalosporins?

cefipime

parenteral only

wide spectrum:
Hemophilus, enterobacter, neisseria (HEN), (2nd and 3rd)
E Coli, P mirabilis (1st)
Pseudomonas aeruginosa (3rd: operazone, tazidime)
Pneumococcus: (3rd: Ts: triaxone, taxidime, taximime)

How well did you know this?

Not at all

Perfectly

cefipime treats?

4th gen

mixed infections - broad spec

complicated UTIs
complicated intra abd infections
febrile neutropenia

How well did you know this?

Not at all

Perfectly

5th gen cephalosporin?

ceftaroline
Parenteral only

MRSA!!!!!!!!

similar spectrum to generation 3

cephalosporins admin?

most = paraenteral
except

cephalexin, ceflacor, cefixime

do cephalosporins get to CSF?

only 3rd gen

cephalosporins elimination?

kidneys

EXCEPTION: bile: ceftriazone and cefoperazone

which beta lactams cause disulfiram like side effects? what other side effect is caused by these drugs ?

cephalosporins:
cefamandole
cefotetan
cefoperazone

*also cause low prothrombin

If allergic to penicillin, can you prescribe cephalosporins?

minor allergy: go tru

severe: no

What are some AE of cephalosporins?

kernicterus: ceftriaxone binds albumin
allergic reactions
pain at infection site

SUPERINFECTIONS - CLOSTRIDIUM DIFICILE

Carbapenems? Beta lactamase resisitent? MRSA resistant?

Yes. resistant against beta lacatmase (so are monobactams) (as you go down the list of beta lactams, more resistant)

Not MRSA resistant

Carbapenems ?

doripenem
ertapenem
imipenem (AMY in sketchy)
meropenem

Carbapenems spectrum?

very broad spectrum gram pos gram neg aerobes anaerobes ``` Pseudomonas aeruginosa (except ertapenem) remember em rata is skinny ie less broad ```

Carbapenem AE?

partial cross sensitivity with penicilins High IMIPENEM: seizures

Which carbapenem has to be given with something else in order to prevent it's degradation?

imipenem cilastatin (keep it lastin with cilastin) cilastin : dehydropeptidase inhibitor if not, imipenem is degraded by dehydropeptidase 1

When are carbapenems prescribed?

usually restricted to avoid resistance only given for LIFE THREATENING infections that req beta lactamase activity

Monobactams? names? resistant to beta lactamases?

aztreonam yes resistant

can you give monobactam to patients with penicillin allergies?

yes. monobactam is the most structurally different one of the Beta lactams - little cross hypersensitivity

monobactam spectrum?

narrow only give to aerobic, gram negative rods pseudomonas *weird because most drugs treat gram postive

monobactams active against pseudomonas?

yes

when are monobactams prescribed?

gram negative infections (already hard to treat) in patients allerfic to penicillin UTIs, intraabdominal, gynceological infections, etc

monobactams rote of admin?

IV, IM, can even be inhaled for cystic fibrosis patients

monobactam penetrate CSF? excretion?

yes, when inflamed excreted via urine