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Cephalosporins Flashcards

1
Q

What adverse event occurs if cephalosporin dosage isn’t adjusted in the presence renal impairment?

A

Induction of seizure activity

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2
Q

What are some clinical uses for cephalosporins?

A

Respiratory pathogens that cause acute otitis media, sinusitis, group A streptococcal pharyngitis, pneumonia, chronic bronchitis.

Also for UTI’s

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3
Q

Describe how Cephalosporins absorbed through the GI?

A

Oral formulations are well-absorbed

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4
Q

Is hepatic metabolism significant in cephalosporins?

A

No

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5
Q

How are cephalosporins excreted?

A

Via the kidneys as unchanged drug

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6
Q

Aside from renal toxicity, Cephalosporins can also cause:

A

Hematological/Coagulation abnormalities

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7
Q

Are cephalosporin’s stable in the presence of penicillinase produced by S. aureus?

A

Yes

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8
Q

What lab values signifies a renal dosing adjustment is needed for cephalosporins?

A

Recommended when GFR is less than 30mL/min

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9
Q

What is the MOA of Cephalosporins?

A

Inhibit mucopeptide synthesis in the bacterial cell wall

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10
Q

What are the first generation cephalosporins?

A

Cephalexin & Cefazolin

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11
Q

Can oral cephalosporins be taken with food?

A

Yes. Food or milk is okay

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12
Q

Staphylococcal skin infections often respond to which generation of cephalosporins?

A

First-generation (Cephalexin)

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13
Q

Cephalosporin Monitoring

A

Renal function
Signs of allergic reaction
Liver function
Coagulation abnormalities

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14
Q

Cephalosporin ADRs

A

Severe allergic reactions, including anaphylaxis

Clostridium difficile-associated diarrhea

Coagulation abnormalities

Seizure activity

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15
Q

Who are at risk for coagulation abnormalities from cephalosporin admin?

A

those with impaired renal function, cancer, Vit K synthesis, Low Vit K stores, or malnutrition

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16
Q

Are cephalosporins Bacteriostatic or Bactericidal?

A

Bactericidal

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17
Q

Describe the use of cephalosporins in pregnancy:

A

Generally safe in pregnancy
Cross the placenta & are excreted in breast milk
Shorter half lives

18
Q

What are the most common mechanisms of resistance to cephalosporins?

A

Beta-lactamase production and altered target sites.

19
Q

Cefazolin Adsorption

A

Not absorbed in GI tract

20
Q

Cefazolin Distribution

A

Various tissues and body fluids, including skin, bones, joints, gallbladder, and bile

Protein binding 80%

21
Q

Cephalexin Distribution

A

Widely throughout body, bone, bile, synovial fluid, pleural fluid

10-15% bound to plasma proteins

22
Q

Second Generation Cephalosporin:

A

Cefuroxime

23
Q

What are unique considerations for Cefuroxime?

A

Interacts with H-2 blockers
Increased activity against H.Influenza

24
Q

What is unique about Cefuroxime PO:

A

Oral prodrug (cefuroxime axetil): absorbed well in GI tract, hydrolyzed to active form.

25
Q

What are the third generation cephalosporins?

A

Cefdinir
Cefpodoxime
Ceftriaxone (IM/IV)

26
Q

Ceftriaxone should be avoided in this population?

A

Neonates at risk for hyperbilirubenemia

27
Q

Ceftriaxone (IM) is the recommended treatment for which STI?

A

Gonorrhea

28
Q

What instructions should you give to the patient when taking PO Cefdinir?

A

Take 2 hours before or 2 hours after antacids that contain magnesium or aluminum. Same for iron supplements

29
Q

What are the major drug interactions with Cephalosporins?

A

Probenecid
Loop diuretics
Warfarin

30
Q

Do 3rd generation cephalosporins cross the BBB?

A

Yes, parenteral form is used to treat meningitis.

31
Q

What type of dosing is required when using cephalosporins?

A

Renal dosing

32
Q

Are cephalosporins bactericidal or bacteriostatic?

A

Bactericidal

33
Q

Which cephalosporin has good tissue penetration & is the drug of choice for surgical prophylaxis?

A

Cefazolin (1st generation)

34
Q

Describe this relationship:

A

1st generation are more effective against gram + coverage, less against gram -, & they have poor CSF penetration. As the generations increase, there is less gram + coverage, more gram -, & more CSF penetration

35
Q

What instruction should be given to patient when taking PO Cefpodoxime?

A

Should be taken with food to enhance absorption

36
Q

What is similar about Cepodoxime and Cefuroxoime?

A

Both prodrugs

37
Q

Cefpodoxime is the most active oral agent against:

A

N. Gonorrhea

38
Q

How is Ceftriaxone distributed?

A

Highly bound to protein

39
Q

Monitoring for Ceftriaxone includes:

A

hepatic dysfunction as it can extend half-life & excretion

40
Q

Ceftriaxone is contraindicated in:

A

Neonates younger than 28 days

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