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Pharmacology > Cephalosporins > Flashcards

Cephalosporins Flashcards

1
Q

Cephalosporins are useful because?

A

Greater gram negative activity

Some with less gram positive activity (in 2nd and 3rd generation)

Cephalosporinase-resistant (especially 4th generation– cefepime)

Less toxic to patient

Better distribution (especially to CNS)

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2
Q

First generation drugs are?

A

Cefazolin (parenteral)

Cephalexin (oral)

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3
Q

Cefazolin (parenteral) and Cephalexin (oral)

A

are used for cellulitis in staph and strep, and surgical prophylaxis.

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4
Q

What are second generation drugs?

A

Cefoxitin
Cefotetan
Cefuroxime

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5
Q

What are third generation drugs?

A 
Ceftizoxime
Cefoperazone
Ceftriaxone
Ceftazimide
Cefotaxime
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6
Q

What are 4th generation drugs?

A

Cefepime

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7
Q

Ceftazidime, cefoperazone are useful in

A

Activity against Pseudomonas aeruginosa

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8
Q

Many third-generation cephalosporins that penetrate into the CNS (-ax drugs) are useful in?

A

empirical treatment of meningitis

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9
Q

4th generation Cefepime is used in?

A

reserve for situations which are very life threatening or caused by organisms that are resistant to primary line of antibiotics

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10
Q

Cephalosporins do no work against?

A

L- Listeria (Penicillins used)

A- Atypical Bacteria (No Cell wall i.e Chlamydia, Mycoplasma best treated with Macrolides/Tetracycline

M- MRSA FQ/Vancomycin/Linezolide/Pristinamycin/Tigecill ine)

E- Enterococcus {treated with (Penicillin + Aminoglycoside combination) OR vancomycin)

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11
Q

Vancomycin is a Non –beta Lactam and works by?

A

Does not bind to PBP or interfere with transpeptidation.

Binds to D-ala-dala peptide, blocks transglycosylation which is the elongation of the peptidoglycan cell wall

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12
Q

Adverse affects of cephalosporins?

A

Renal toxicity, except cefoperazone and ceftriaxone
Disulfiram effect
Bleeding
Hypersensitivity– 6 - 16% cross-reactivity with penicillins

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13
Q

Disulfiram effect is seen with which drugs?

A

Cefuroxime,Cefotetan & cefoperazone

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14
Q

If the patient is allergic to both penicillin and cephalosporins, then give

A
  • Gm+ve organism with Macrolide

- Gm –ve organism with Aztreonam

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15
Q

Beta lactam drugs

A

Cephalosporin

Penicillin

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16
Q

When is Aztreonam useful?

A

Only gram negative ROD activity, no gram positive activity.

For penicillin allergic patients, and those with renal insufficiency who can’t tolerate aminoglycosides.

17
Q

Aztreonam’s toxicity

A

vertigo, occasional GI upset

18
Q

Carbapenems

A

Most effective

Imipenem, Meropenem & Ertapenem

*Used for nosocomial infections.

19
Q

Imipenem DOC for?

A

Enterobacter
Gram positive and negative rods, and anaerobes
Cross-sensitivity in patients with penicillin allergies

20
Q

Renal dihdropeptidase I inactivates

A

Imipenem

21
Q

You should co-administer imipenem with and why?

A

Cilastatin, which is given to prevent the patients kidney from metabolizing imipenem too quickly

22
Q

Imipenem toxicity

A

CNS toxicity

Seizure in 1 out of 2 patient treated with this drug

23
Q

Meropenem & Ertapenem

A

dipeptidase-resistant carbapenem: don’t need cilastatin, has ↓ risk of seizures

24
Q

Vancomycin adverse affects?

A
  1. Red man syndrome - strong vasodilation due to histamine release (type 1 hypersensitivity)
  2. Ototoxicity,
  3. Nephrotoxicity (↑ risk with concomitant aminoglycoside)
25
Q

Bacitracin

A

It inhibits cell wall synthesis

by blocking peptidoglycan proteins from entering.

26
Q

Bacitracin is a topical drug that is combined with?

A

Polymyxin or Neomycin in ointments and creams. ( Triple Antibiotic)

27
Q

Mechanism of action of triple antibiotic cream?

A

CWSI – bacitracin
AG – Neomycin
CMD (cytoplasmic membrane disruptor) – Polymyxin B

28
Q

Fosfomycin is approved for

A

Uncomplicated UTI due to E. coli or Enterococcus faecalis in women
Safe during pregnancy.

29
Q

Difference between Carbapenems and Penicillin and Cephalosporin?

A

Resistant to beta-lactamases

30
Q

Vancomycin is used against

A

MRSA

31
Q

Vancomycin resistance is carried by bacteria by

A

switching the D-ala, to a d-ala lactase, therefore the drug cannot recognize and bind.

32
Q

What drugs can you give for VRSA and VRE resistant bacteria?

A

Linezolid and Streptogrammins

Pharmacology (8 decks)

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