Cephalosporins Flashcards
what are the gram positive bugs
staph
strep
enterococcus
what are 3 categories for gram negative bugs
Piddly
Fence
Space
Where are space bugs normally seen
hospitals/nursing homes
name 3 atypical bugs
chlamidya
mycoplasma
Legionella
what atypical drug refers to a STD
chlamidya
What atypical drug refers to walking pneumonia
mycoplasma
What atypical drug is water born
legionella
what are the anaerobe drugs
poststrepococcus
bacteriods
clostridium
Where are the anaerobe drugs located
poststreptococcus : mouth
bacteriods: gut/small instestines
clostridium: large intestines
What drug works on the DNA gyrase
FQN
What drug works on the 30S ribosome
aminoglycosides
cephalosproins: how do bacterial cell walls cross-link different peptidoglycan
- amino group of pentaglycine reacts with peptide b/w D-ala residues
- one D-alanine forms bond with glycine
- one D-alanine released
cephalosproins: cross-linking reaction is catalyzed by who
- glycopeptide transpeptidase
- penicillin-binding proteins (PBP)
cephalosproins: how do they block bacterial cell wall synthesis
- act as the D-ala-Dala
- bind to transpeptidase
- irreversbile covalent bond with serine
what type of drug is cephalosproins
cidal
ifficiacy of a particular cephalosproins is related to what
its affinity for PBPs
cephalosproins: the beta-lactam ring acts how in acid medium
unstable
how are orally administered cephalosporins absorbed
rapidly and thoroughly
oral cephalosporins are available as what type of compounds
- prodrug ester
- nonesterified compounds
where are prodrug esters of cephalosproins activated? and what enhances absorption
hydrolyzed in intestines
food enhances absorption
how well is cephalosproins distributed
well distributed
third generation cephalosporins are good for what
penetrate well into CSF especially with inflammed meninges
what cephalosproins drug is usually used for meningitis
caftriaxone
how are most cephalosproins excreted
renal
which cephalosproins are excreted through hepatic
ceftriaxone and cefoperaxone
following an IV infusion of 5th generation, Ceftaroline fosamil (prodrug), what does it get convert to and by who?
ceftaroline
by plasma phosphateases
cephalosprorins have a cross sensitivity with what other drug
10% with penicillin
on non-IgE mediated (anaphylaxis) pencillin allergic patients, however what should you use first
Aztreonam
hypoprothrombinemia
disturbance in vitamin K dependent clotting factors by blocking the vitamin K epoxide reductase
cephalosporins that have a methylthiotetrazole side (NMTT) chain is associated with what adverse effect? why does this occur
bleeding
-hypoprothrombinemia
cefoperazone and ceftriaxone have what GI adverse effect and why?
diarrhea due to primary biliary excretion
what renal adverse effect does cephalosporins have
interstitial nephritis
cefamandole and cefeperazone have an NMTT side chain, what adverse effect does this have
disulfiram-like intolerance (prevents breakdown of alcohol)
Cefaclor has what adverse effect in children
serum sickness
what interaction does Warfin and cephalosporins have together
potentiation of anticoagulant effects
what interaction does probenecid and cephalosporins have together
prolongs excretion in cephalosporins that bave tubular secretions
first generation common oral product
Cephalexin
first generation common IV
Cefazolin
Second generation common oral product
cefuroxime axetil
second generation common parenteral product
Cefuroxime
second generation (cephamycins) common parenteral products
cefoxitin
cefotetan
third generation common parenteral product
ceftriaxone
thrid generation (antipseudomonal) common parenteral product
ceftazidime
fourth generation common parenteral products
cefeprime
fifth generation common parenteral products
ceftaroline
as cephalosporin generation increases what coverage increases
gram negative
generally cephalosporins do not cover
enterococcus
atypicals
MRSA
listeria monocytogenes
what are the atypical drugs
legionella
mycoplasma
chlamydia
what cephalosporins cover MRSA and enterococcus
ceftaroline
which generation covers both strap and strep
1 2 2(cephamycins) 3 ( antipseudomonal) 4 5
what gram positive does third generation cover
strep
what gram positive bacteria does 5th generation cover
strap, strep, enterococcus
which cephalosporin are abaerobes
cefoxitin
cefotetan
which cover just space bugs
third antipseudomonal
fourth
what gram negative bugs does third generation cover
SACE
what gram negative bugs does fifth generation cover
SCE
pseudomonas
what gram negative bugs does second generation and second cephamycins cover
H.flu
M. cat
PEK
what do you use for community acquired pneumonia
third generation- ceftriaxone, cefotaxime
what do you use for nosocomial pneumonia
third generation- ceftazidime
fourth generation - cefepime
what do you use for meningitis
third generation cephalosporins ( higher doses)
what do you use for skin/soft tissue
- first generation cephalosporins (staph/strep)
- fifth generation
what do you use for severe infections like diabetic foot
cephamycins, 3/4 generation ceph in combo with other agents
what do you use for surgical prophylaxis?
cefaxolin (longer 1/2 life)
cephaymycins (abdominal/GI surgies)
how do you treat endocarditis
depends on organsism
how do you treat febrile neutropenia
ceftazidime or cefepime +/- vancomycin
What is used prior to surgery to prevent S. aureus?
Cefazolin
