Cephalosporins

Question 1

what are the gram positive bugs

Answer 1

staph
strep
enterococcus

Question 2

what are 3 categories for gram negative bugs

Answer 2

Piddly
Fence
Space

Question 3

Where are space bugs normally seen

Answer 3

hospitals/nursing homes

Question 4

name 3 atypical bugs

Answer 4

chlamidya
mycoplasma
Legionella

Question 5

what atypical drug refers to a STD

Answer 5

chlamidya

Question 6

What atypical drug refers to walking pneumonia

Answer 6

mycoplasma

Question 7

What atypical drug is water born

Answer 7

legionella

Question 8

what are the anaerobe drugs

Answer 8

poststrepococcus
bacteriods
clostridium

Question 9

Where are the anaerobe drugs located

Answer 9

poststreptococcus : mouth

bacteriods: gut/small instestines
clostridium: large intestines

Question 10

What drug works on the DNA gyrase

Answer 10

FQN

Question 11

What drug works on the 30S ribosome

Answer 11

aminoglycosides

Question 12

cephalosproins: how do bacterial cell walls cross-link different peptidoglycan

Answer 12

• amino group of pentaglycine reacts with peptide b/w D-ala residues
• one D-alanine forms bond with glycine
• one D-alanine released

Question 13

cephalosproins: cross-linking reaction is catalyzed by who

Answer 13

• glycopeptide transpeptidase

- penicillin-binding proteins (PBP)

Question 14

cephalosproins: how do they block bacterial cell wall synthesis

Answer 14

• act as the D-ala-Dala
• bind to transpeptidase
• irreversbile covalent bond with serine

Question 15

what type of drug is cephalosproins

Answer 15

cidal

Question 16

ifficiacy of a particular cephalosproins is related to what

Answer 16

its affinity for PBPs

Question 17

cephalosproins: the beta-lactam ring acts how in acid medium

Answer 17

unstable

Question 18

how are orally administered cephalosporins absorbed

Answer 18

rapidly and thoroughly

Question 19

oral cephalosporins are available as what type of compounds

Answer 19

• prodrug ester

- nonesterified compounds

Question 20

where are prodrug esters of cephalosproins activated? and what enhances absorption

Answer 20

hydrolyzed in intestines

food enhances absorption

Question 21

how well is cephalosproins distributed

Answer 21

well distributed

Question 22

third generation cephalosporins are good for what

Answer 22

penetrate well into CSF especially with inflammed meninges

Question 23

what cephalosproins drug is usually used for meningitis

Answer 23

caftriaxone

Question 24

how are most cephalosproins excreted

Answer 24

renal

Question 25

which cephalosproins are excreted through hepatic

Answer 25

ceftriaxone and cefoperaxone

Question 26

following an IV infusion of 5th generation, Ceftaroline fosamil (prodrug), what does it get convert to and by who?

Answer 26

ceftaroline | by plasma phosphateases

Question 27

cephalosprorins have a cross sensitivity with what other drug

Answer 27

10% with penicillin

Question 28

on non-IgE mediated (anaphylaxis) pencillin allergic patients, however what should you use first

Answer 28

Aztreonam

Question 29

hypoprothrombinemia

Answer 29

disturbance in vitamin K dependent clotting factors by blocking the vitamin K epoxide reductase

Question 30

cephalosporins that have a methylthiotetrazole side (NMTT) chain is associated with what adverse effect? why does this occur

Answer 30

bleeding | -hypoprothrombinemia

Question 31

cefoperazone and ceftriaxone have what GI adverse effect and why?

Answer 31

diarrhea due to primary biliary excretion

Question 32

what renal adverse effect does cephalosporins have

Answer 32

interstitial nephritis

Question 33

cefamandole and cefeperazone have an NMTT side chain, what adverse effect does this have

Answer 33

disulfiram-like intolerance (prevents breakdown of alcohol)

Question 34

Cefaclor has what adverse effect in children

Answer 34

serum sickness

Question 35

what interaction does Warfin and cephalosporins have together

Answer 35

potentiation of anticoagulant effects

Question 36

what interaction does probenecid and cephalosporins have together

Answer 36

prolongs excretion in cephalosporins that bave tubular secretions

Question 37

first generation common oral product

Answer 37

Cephalexin

Question 38

first generation common IV

Answer 38

Cefazolin

Question 39

Second generation common oral product

Answer 39

cefuroxime axetil

Question 40

second generation common parenteral product

Answer 40

Cefuroxime

Question 41

second generation (cephamycins) common parenteral products

Answer 41

cefoxitin | cefotetan

Question 42

third generation common parenteral product

Answer 42

ceftriaxone

Question 43

thrid generation (antipseudomonal) common parenteral product

Answer 43

ceftazidime

Question 44

fourth generation common parenteral products

Answer 44

cefeprime

Question 45

fifth generation common parenteral products

Answer 45

ceftaroline

Question 46

as cephalosporin generation increases what coverage increases

Answer 46

gram negative

Question 47

generally cephalosporins do not cover

Answer 47

enterococcus atypicals MRSA listeria monocytogenes

Question 48

what are the atypical drugs

Answer 48

legionella mycoplasma chlamydia

Question 49

what cephalosporins cover MRSA and enterococcus

Answer 49

ceftaroline

Question 50

which generation covers both strap and strep

Answer 50

``` 1 2 2(cephamycins) 3 ( antipseudomonal) 4 5 ```

Question 51

what gram positive does third generation cover

Answer 51

strep

Question 52

what gram positive bacteria does 5th generation cover

Answer 52

strap, strep, enterococcus

Question 53

which cephalosporin are abaerobes

Answer 53

cefoxitin | cefotetan

Question 54

which cover just space bugs

Answer 54

third antipseudomonal | fourth

Question 55

what gram negative bugs does third generation cover

Answer 55

SACE

Question 56

what gram negative bugs does fifth generation cover

Answer 56

SCE | pseudomonas

Question 57

what gram negative bugs does second generation and second cephamycins cover

Answer 57

H.flu M. cat PEK

Question 58

what do you use for community acquired pneumonia

Answer 58

third generation- ceftriaxone, cefotaxime

Question 59

what do you use for nosocomial pneumonia

Answer 59

third generation- ceftazidime | fourth generation - cefepime

Question 60

what do you use for meningitis

Answer 60

third generation cephalosporins ( higher doses)

Question 61

what do you use for skin/soft tissue

Answer 61

- first generation cephalosporins (staph/strep) | - fifth generation

Question 62

what do you use for severe infections like diabetic foot

Answer 62

cephamycins, 3/4 generation ceph in combo with other agents

Question 63

what do you use for surgical prophylaxis?

Answer 63

cefaxolin (longer 1/2 life) | cephaymycins (abdominal/GI surgies)

Question 64

how do you treat endocarditis

Answer 64

depends on organsism

Question 65

how do you treat febrile neutropenia

Answer 65

ceftazidime or cefepime +/- vancomycin

Question 66

What is used prior to surgery to prevent S. aureus?

Answer 66

Cefazolin