Cephalosporins Flashcards
How many generations of Cephalosporins are there?
4
Name two drugs that are 1st generation Cephalosporins.
- Cefalexin
2. Cefadroxil
Name two drugs that are 2nd generation Cephalosporins.
- Cefuroxime
2. Cefamandole
Name two drugs that are 3rd generation Cephalosporins.
- Cefotaxime
2. Ceftriaxone
Name two drugs that are 4th generation Cephalosporins.
- Cefepime
2. Cefpirome
How are 1st generation Cephalosporins administered?
- Oral
How are 2nd generation Cephalosporins administered?
Cefuroxime: - Oral - IV - IM Cefamandole: - IV
How are 3rd generation Cephalosporins administered?
- IV
- IM
How are 4th generation Cephalosporins adminstered?
Cefepime: - IV - IM Cefpirome: - IV
What is the MOA of a 1st generation Cephalosporin (include elimination)?
- Similar to Penicillin
- Variable half-life (increased by Probenecid)
- Excreted via kidney
What is the MOA of a 2nd generation Cephalosporin (include elimination)?
- Similar to Penicillin
- Variable half-life (increased by Probenecid)
- Excreted via kidney
What is the MOA of a 3rd generation Cephalosporin (include elimination)?
- Similar to Penicillin
- Penetrated well into CSF
- 40% hepatic elimination
What is the MOA of a 4th generation Cephalosporin (include elimination)?
- Similar to Penicillin
- B-lactamase resistant
What spectrum are 1st generation Cephalosporins?
- Streptococci
- Staphylococci
- Most effective against Gram +ve
What spectrum are 2nd generation Cephalosporins?
- Streptococci and Staphylococci (same as 1st)
- E.coli
- Klebsiella
- Proteus
- H.influenza
- Enterobacter
What spectrum are 3rd generation Cephalosporins?
- Gram +ve (and H.influenza)
- N.gonorrheae
- Salmonella
- P.aeruginosa
What spectrum are 4th generation Cephalosporins?
- Gram +ve and -ve (same as 1st, 2nd and 3rd gen.)
- Especially: P.aeruginosa
When is Ceftriaxone contra-indicated?
- Neonates
- Increased calcium solution
What drug interactions occur with Ceftriaxone?
- Alcohol
- Warfarin
- NSAIDs
- COCP
- Probenecid
- Cephalosporins
- Aminoglycosides (inactivate)
What main side effect is caused by Cefamandole?
- Alcohol intolerance
What are the general side effects of Cephalosporins?
- Hypersensitivity reactions
- Cross-hypersensitivity (patients may tolerate)
- Decreased effect of COCP
- Nephrotoxic (with vancomycin or aminoglycosides)
- Neurotoxin (high dose or renal impairment)
- IV administration = phlebitis and erythema
