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Pharm Unit 6: AntiMicrobials > Cephalosporins > Flashcards

Cephalosporins Flashcards

1
Q

What are the general characteristics of cephalosporins?

A
  1. More resistant to Beta lactamase than PCNs
  2. Lack activity against MRSA and enterococcus: except ceftaroline 5th gen
  3. Cause hypersensitivty rxns like PCN: cross reactivity likely 1%
  4. Lack activity against B. fragilis
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2
Q

What are the first generation cephalosporins?

A
  1. Cefazolin

2. Cephalexin (keflex)

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3
Q

What is the route for Cefazolin and cephalexin?

A
  1. Cefazolin: IV

2. Cephalexin (keflex): PO

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4
Q

What is the gram positive spectrum of activity for Cefazolin and cephalexin?

A
  1. MSSA

2. Streptococci

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5
Q

What enteric gram negative rods are Cefazolin and cephalexin effective against?

A
  1. Enterobacteriaceae: unpredictable
  2. Klebsiella pnuemoniae
  3. E. coli
  4. Proteus Mirabilis
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6
Q

What anaerobes are Cefazolin and cephalexin not effective against?

A

B. fragilis

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7
Q

What are the clinical uses for Cefazolin and cephalexin?

A
  1. Cefazolin:
    A. Surgical prophylaxis, 24 hrs prior, Add metronidazole (flagyl) for colon surgery
    B. MSSA bacteremia and endocarditis
  2. Skin and soft tissue infection
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8
Q

What are the SE for Cefazolin and cephalexin?

A

Allergic rxn

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9
Q

What are the second generation cephalosporins?

A
  1. True cephalosporins: good ability to cross BBB
    A. Cefuroxime (ceftin)
  2. Cephamycins
    A. cefoxitin (mefoxin)
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10
Q

What is the route of administration for Cefuroxime (ceftin) and cefoxitin (mefoxin)?

A
  1. Cefuroxime (ceftin): IV, PO

2. cefoxitin (mefoxin): IV

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11
Q

What gram positive bacteria are Cefuroxime (ceftin) and cefoxitin (mefoxin) effective against?

A
  1. Strep pneumonieae

A. Cefoxitin less active

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12
Q

What gram negative bacteria is Cefuroxime (ceftin) effective against?

A
  1. H. influenza
  2. N. gonorhea
  3. M. Catarrhalis
  4. some enterobacteria
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13
Q

What gram negative bacteria is cefoxitin (mefoxin) effective against?

A
  1. E. coli
  2. Klebsiella
  3. Less active against H. influenza
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14
Q

What anaerobes is cefoxitin (mefoxin) effective against?

A
  1. B. fragilis
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15
Q

What are the clinical uses for Cefuroxime (Ceftin)?

A
  1. Community acquired resp tract infections
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16
Q

What are the clinical uses for Cefoxitin (Mefoxin)?

A
  1. Intra-abominal infections, pelvic/Gyn infections
  2. Mixed aerobe/anaerobe soft tissue infections
  3. Surgical propylaxis in colon surgery
17
Q

What are the SE for second generation cephalosporins?

A

Allergic rxns

18
Q

What are the third generation cephalosporins?

A
  1. Ceftazadime (fortaz)
  2. cefpodoxime (vantin)
  3. ceftriaxone (rocephin)
19
Q

What is the spectrum of activity for Ceftazadime (fortaz); cefpodoxime (vantin); ceftriaxone (rocephin)?

A
  1. Enteric gram negative bacteria
  2. Streptococci: Strep pneumo
  3. Pseudomonas: ONLY Ceftazidime
  4. MSSA: Ceftazidime poor activty
20
Q

What bacteria do Ceftazadime (fortaz); cefpodoxime (vantin); ceftriaxone (rocephin) have poor or limited activity against?

A
  1. No activity for enterococci, MRSA, Listeria, stenotrophomonas
  2. Anaerobes: no activity against B. fragilis
    3.
21
Q

What is the route of administration for Ceftazadime (fortaz); cefpodoxime (vantin); ceftriaxone (rocephin)?

A
  1. Ceftazadime (fortaz): IV
  2. cefpodoxime (vantin): PO
  3. ceftriaxone (rocephin): IV
22
Q

What are the clinical uses for Ceftazadime (fortaz); cefpodoxime (vantin); ceftriaxone (rocephin)?

A
  1. Ceftazadime (fortaz): pseudomonal infections, post neurosurgical meningitis, NOT community acquired meningitis
  2. ceftriaxone (rocephin): Community acquired pneumonia, complicated UTIs, community acquired meningitis, CSF lyme disease, strep endocarditis, gonococcal infections, PID, intra-abdominal infections with metronidazole
23
Q

What are the SE of 3rd gen cephalosporins?

A
  1. Greater correlation of C. difficile infection

2. Ceftriaxone: biliary sludging esp in neonates, dose related

24
Q

What are the 4th generation cephalosporins?

A
  1. Cefepime
25
Q

What is the route for cefepime?

A

IV, IM

26
Q

What gram negative bacteria is cefepime effective against?

A
  1. Aerobic gram negatives
  2. enterobacteriaceae
  3. Pseudomonas
27
Q

What gram positive bacteria is cefepime effective against?

A
  1. MSSA

2. Strep. pneumo

28
Q

What bacteria is cefepime NOT effective against?

A
  1. B. fragilis
  2. MRSA
  3. Listeria
29
Q

What are the clinical uses for cefepime?

A
  1. Neutropenic fever
  2. Meningitis
  3. Ceftazidime-resistant enterobacteriae
30
Q

What are the fifth generation cephalosporins?

A

Ceftaroline

31
Q

What is the route for Ceftaroline?

A

IV

32
Q

What gram positive bacteria is ceftaroline effective against?

A
  1. MRSA
  2. MSSA
  3. Streptococci
  4. E. caecalis
33
Q

What gram negative bacteria is ceftaroline effective against?

A
  1. Enterobacteriae
  2. H. influenza
  3. M. catarrhalis
34
Q

What bacteria is ceftaroline NOT effective against?

A
  1. Pseudomonas

2. Anaerobes

35
Q

What are the clinical indications for ceftaroline?

A

Complicate skin and soft tissue infection

Pharm Unit 6: AntiMicrobials (15 decks)

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