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Cephalosporins 2 Flashcards

1
Q
  • extended activity of both gram pos and neg
  • shows greater resistance to beta lactamase
  • administered parenterally
  • often used against Pseudomonas, Streptococcus pneumonia and nonsocomial infections where stability to beta lactamses usually critical for success
  • still not active against MRSA or anaerobes/atypical intracellular organisms
A
  • 4th gen cephs (Cefepime)
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2
Q

brand name for cefepime gen 4 cef

A
  • Maxipime
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3
Q
  • features of gen 4 cephs chemical structure
A
  • beta lactamse stability
  • improved cell penetration
  • improved PK metabolically, stability and higher spectrum levels
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4
Q

antiobiotic map for cefepime

keep in mine it is broad spectrum often used in skin infections or sepsis

A
  • s. pnuemoniae (+)
  • strep pyogenes (+)
  • MSSA (+)
  • Proteus mirabilis
  • e. coli
  • klebsiella pneumonia
  • serratia
  • n. meningitdis
  • h. influenza
  • Enterobacter spp
  • Psuedomnas
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5
Q

applications for 4th gen cephs

A
  • UTI
  • skin and sking structureinfections
  • sepsis/bacteremia
  • meningitis
  • febrile neutropenia
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6
Q
  • unique agents active against MRSA

- designed to bind specific targets

A

gen 5 cephs such as

  • Ceftaroline
  • Ceftozolane
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7
Q
  • 5th gen ceph used to treat acute bacterial skin infections and community acquired bacterial pneumonia or SSSI or MRSA
  • parenteral agent
  • some ADR such a diarrhea, nauseam rash
A

Ceftaroline

- brand name Teflaro

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8
Q
  • 5th gen ceph developed to treat geam neg bacteria w resistance to developed convienent antibiotics
A

Ceftozolane

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9
Q

Ceftaroline antibiotic map coverage

A
  • S. pnuemoniae
  • Strep pyogenes
  • MSSA
  • MRSA
  • Proteus mirabilis (-)
  • E. coli (-)
  • Klebsiella pneumonia (-)
  • N meningitides (-)
  • H. influenza (-)
  • Serratia (-)
  • Enterobacter spp (-)
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10
Q
  • gen 5 cephs parenteral drug developed for gram neg organisms such as Psuedomonas and other gram negs that are resistant
  • trials emphasized for complicated intraabdominal infections, UTI and ventilator associated pneumonia
  • formulated w BLI agent tazobactem to decrease resistance
A
  • ceftolazane/tazobactam
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11
Q

cephalopsporins that are useful in treating meningitis

A
  • cefotaxime
  • ceftriaxone
  • cefepime
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12
Q

average half life of cephs in general excluding ceftriaxone

A
  • 0.5-2hrs
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13
Q
  • what to avoid with cefriaxone
A
  • IV calcium bc of chelating agents
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14
Q
  • coagulation issues w alcohol can be seen in these C2 and C3 agents
  • disulfiram like effect occurs which causes inhibition of enzyme aldehyde dehydrogenase
  • due to MTT group as R2 side chain
A
  • cefotetan (C2)

- cefoperazone (C3)

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15
Q
  • which generation?
  • activity is comparable lower than penicillins but possesses broader spectrum of activity more activity against gram pos and neg
A

1st gen

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16
Q
  • which generation?
  • have increased activity against gram neg but have some reduced against gram pos
  • many cross BBB
  • cephamycins have activity against anaerobi bacteria
17
Q
  • which generation?
  • better activity against gram neg, some have issue of reduced activity agains gram pos but have improved betalactamse resistance
  • some cross BBB
  • gram pos activity similar to gen 1
18
Q

which gen?

  • better gram neg activity
  • betalactamase resistance
  • some cross BBB
  • activity similar to gen 1
19
Q

which gen?

- compounds designed for specific targets of MRSA and Pseudomonas aeruginosa

20
Q
  • cefazolin antibiotic map coverage
A
  • s. pnuemoniae (+)
  • strep pyogenes (+)
  • staph aureus MSSA (+)
  • proteus mirabillis (-)
  • e. colo (-)
  • Klebsiella pneumonia (-)
21
Q
  • cefuroxime antibiotic map coverage
A
  • s. pnuemoniae (+)
  • strep pyogenes (+)
  • staph aureus MSSA (+)
  • proteus mirabillis (-)
  • e. coli (-)
  • Klebsiella pneumonia (-)
  • N. meningitides (-)
  • H. influenza (-)
22
Q
  • Cefoxitin/Cefotetan antibiotic map coverage
A
  • s. pnuemoniae (+)
  • strep pyogenes (+)
  • staph aureus MSSA (+)
  • proteus mirabillis (-)
  • e. coli (-)
  • Klebsiella pneumonia (-)
  • N. meningitides (-)
  • H. influenza (-)
  • bacteriodes gragilis (-)**
23
Q
  • cephtriaxone/cefotaxime antibiotic map coverage
A
  • s. pnuemoniae (+)
  • strep pyogenes (+)
  • staph aureus MSSA (+)
  • proteus mirabillis (-)
  • e. coli (-)
  • Klebsiella pneumonia (-)
  • N. meningitides (-)
  • H. influenza (-)
  • Enterobacter spp (-)
24
Q
  • ceftazidime antibiotic map coverage
A
  • s. pnuemoniae (+)
  • strep pyogenes (+)
  • proteus mirabillis (-)
  • e. coli (-)
  • Klebsiella pneumonia (-)
  • N. meningitides (-)
  • H. influenza (-)
  • Enterobacter spp (-)
  • Serratia (-)
  • Pseudomonas
25
Q
  • cefepime antibiotic map coverage
A
  • s. pnuemoniae (+)
  • strep pyogenes (+)
  • MSSA (+)
  • proteus mirabillis (-)
  • e. coli (-)
  • Klebsiella pneumonia (-)
  • N. meningitides (-)
  • H. influenza (-)
  • Enterobacter spp (-)
  • Serratia (-)
  • Pseudomonas
26
Q
  • ceftaroline antibiotic map coverage
A
  • s. pnuemoniae (+)
  • strep pyogenes (+)
  • MSSA (+)
  • MRSA (+)****
  • proteus mirabillis (-)
  • e. coli (-)
  • Klebsiella pneumonia (-)
  • N. meningitides (-)
  • H. influenza (-)
  • Enterobacter spp (-)
  • Serratia (-)
27
Q

1st gen parenterals

  • strong action on gram pos aerobes
  • skin/soft tissue infections and prophylaxis
28
Q

1st gen oral agents

  • strong action on gram pos aerobes
  • skin/soft tissue infections and prophylaxis
A
  • Cefadroxil

- Cephalexin

29
Q

2nd gen parenterals

  • modest action on aerobic gram pos, gram neg and some anaerobes
  • respiratory infections although 3rd gen may be better
A
  • Cefotetan

- Cefoxitin

30
Q

2nd gen oral agents

  • modest action on aerobic gram pos, gram neg and some anaerobes
  • respiratory infections although 3rd gen may be better
A
  • Cefaclor
  • Cefprozil
  • Loracarbef
31
Q

3rd gen parenterals

  • strong action against aerobic gram neg and moderate against aerobic gram pos
  • cefotaxime = strep pneumo
  • ceftriaxone = 1/day
  • ceftizoxime = anaerobes
  • ceftazidime = Psuedomonas
A
  • Cefotaxime
  • Ceftriaxone
  • Ceftazidime
  • Ceftizoxime
32
Q

3rd gen oral agents

  • strong action against aerobic gram neg and moderate against aerobic gram pos
  • cefotaxime = strep pneumo
  • ceftriaxone = 1/day
  • ceftizoxime = anaerobes
  • ceftazidime = Psuedomonas
A
  • cefdinir

- cefixime

33
Q

4th gen parenterals

  • strong action against gram neg aerobes better than C2 and C3 for gram pos
  • increase passage gram negs
  • increase affinity PBP
  • increase resistance to betalactamses
  • used for Pseudomonas
34
Q

4th gen oral agents

  • strong action against gram neg aerobes better than C2 and C3 for gram pos
  • increase passage gram negs
  • increase affinity PBP
  • increase resistance to betalactamses
  • used for Pseudomonas

ID (14 decks)

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