Cell Wall Inhibitors (Cephalosporins )

Question 1

Features of Cephalosporins :

Answer 1

1) B- lactams
2) More resistant to B-lactamases
3) Semisynthetic
4) Structurally and functionally related to Penicillins

Question 2

Cephalosporins Generations :

Answer 2

First,Second,third,fourth and advanced

Question 3

First Generation of cephalosporins:

Answer 3

1) Cefazolin
2) Cephalexin
3) Cefadroxil

Question 4

Antibacterial spectrum of first generation of cephalosporins :

Answer 4

They are resistant to Staphylococcal penicillinase ; Including MSSA but Not MRSA

Question 5

First generation of Cephalosporins are …………….

Answer 5

Penicillin G substitutes

Question 6

What are Second-generation of cephalosporins :

Answer 6

1) Cefotetan
2) Cefuroxime
3) Cefoxitin
4) Cefprozil

Question 7

Anti-bacterial spectrum of second-generation of cephalosporins :

Answer 7

Wider to gram-negative spectrum :
1) H.influenza
2) Klebsiella
3) Neisseria app
4) Proteus
5) Moraxella catarrhalis

Question 8

Second-generation of cephalosporins are ………………. Due to increasing in resistance

Answer 8

Nor first line

Question 9

Third-generation of cephalosporins:

Answer 9

1) Cefotaxime
2) Ceftriaxone
3) Ceftazidime
4) Cefdinir

Question 10

Antibacterial Spectrum of third-generation of cephalosporins :

Answer 10

Greater activity against gram-negative bacilli

Question 11

The third-generation of cephalosporins are ………………. , there must be a caution of …………

Answer 11

Broad-Spectrum // Collateral damage

Question 12

The third-generation of cephalosporins are drugs of choice for ……………

Answer 12

Meningitis

Question 13

Fourth-generation Cephalosporins is :

Answer 13

Cefepime

Question 14

Anti-bacterial spectrum of fourth-generation of cephalosporins :

Answer 14

1) effective against Strep and Staph species but not MRSA
2) Aerobic gram-negative bacilli including P.aeurogenosa

Question 15

Fourth-generation of cephalosporins are ………………… anti-biotics

Answer 15

Broad-spectrum

Question 16

What is the advanced-generation cephalosporins drug :

Answer 16

Ceftaroline

Question 17

Anti-bacterial spectrum of advanced-generation cephalosporins:

Answer 17

Only B-lactam that is effective against MRSA

Question 18

Advanced-generation of cephalosporins are ………………. Antibiotic that is indicated against …………

Answer 18

B-road-spectrum antibiotic / complicated skin MRSA infection & pneumonia

Question 19

The limitation of using Ceftaroline :

Answer 19

Twice-daily dosing regimen

Question 20

MOR of cephalosporins :

Answer 20

1) B-lactamases ( hydrolysis of the beta-lactam ring )
2) decreasing affinity of PBPs

Question 21

Cephalosporins are susceptible to :

Answer 21

1) Penicillinase as Staph
2) Extended-spectrum beta lactamse ESBL as E.coli and klebsiella

Question 22

What are ESBL ?

Answer 22

Plasmid-mediated,diverse, complex and rapidly evolving enzymes that share the ability to hydrolyse third-generation of cephalosporins and aztreonam

Question 23

Administration of cephalosporins :

Answer 23

Either IV or IM , poor oral absorption

Question 24

Oral cephalosporins as exceptions :

Answer 24

1)Cephalixen
2)Cefdinir
3) Cefixime

Question 25

Distribution of cephalosporins :

Answer 25

Cephalosporins distribute well in body fluids , their distribution is limited in CSF

Question 26

Therapeutic levels in CSF of cephalosporins :

Answer 26

Ceftriaxone and Cefotaxime are effective in the treatment of neonatal meningitis caused by haemophilus influenza.

Question 27

The cephalosporins that can penetrate the bone :

Answer 27

Cefazolin and ceftriaxone

Question 28

Elimination of cephalosporins :

Answer 28

Renal tubular Secretion
= doses must be adjusted to avoid toxicity in renal dysfunction

Question 29

Exception of the elimination of cephalosporins:

Answer 29

Ceftriaxone is eliminated in bile

Question 30

Adverse effects of Cephalosporins :

Answer 30

1) Hypersensitivity reaction ; it has highest rate of allergic cross-sensitivity with penicillin especially the first generation
2) Superinfections as they are broad-spectrum antibiotics

Question 31

Cephalosporins and B-lactamase inhibitors :

Answer 31

1) Ceftolozane & tazobactam
2) Ceftazidime & avibactam

Question 32

The combination of ceftalozane and tazobactam :

Answer 32

Multi-drug resistant P.aeruginosa and some ESBLs-producing bacteria

Question 33

Ceftazidime and avibactam combination :

Answer 33

ESBL-producing bacteria

Question 34

Both combinations are indicated for ………… and caused by ………….. :

Answer 34

The management of complicated intra-abdominal and UTIs / Multi-drug resistant bacteria