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Pharmacology II > Cephalosporins > Flashcards

Cephalosporins Flashcards

1
Q

Are cephalosporins classified by structure or activity? Why?

A

Activity because structure is not related to activity

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2
Q

Name the 1st generation cephalosporins

A

Cefadroxil, Cephalexin, Cefapirin, Cefazolin

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3
Q

What is the spectrum of the first generation cephalosporins?

A

Mostly Gram +

Little gram -

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4
Q

How are the second generation CPs different from first generation?

A

Similar gram +
More gram -
Less activity againt Strep & staph
More activity against enterobacteriaceae

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5
Q

What are the third generation cephalosporins?

A

Cefpodoxime proxetil, cefotaxime, ceftazidine, ceftiofur Na, ceftiofur hydrochloride, Ceftiofur crystalline free acid, Cefovecin

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6
Q

What is the spectrum of third generation cephalosporins?

A

Much more gram -

Similar gram +

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7
Q

Which third generation cephalosporin is best for anaerobes?

A

Cefatoaxime

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8
Q

Which third generation cephalosporin is best for Pseudomonas?

A

Ceftazidime

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9
Q

Which third generation cephalosporin has the longest half-life?

A

Ceftriaxone

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10
Q

Name the fourth generation cephalosporin

A

Cefepime

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11
Q

Fourth generation cephalosporins were formed to overcome resistance by which bacteria?

A

Pseudomonas

Enterobacteriaceae

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12
Q

Which first generation cephalosproin has the best activity against gram -?

A

Cefazolin

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13
Q

What is the revised spectrum for 1st and 2nd generations?

A

Anerobes: +++++
Gram + Aerboes: +++++
Gram - aerobes: ++

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14
Q

What is the revised spectrum for 3rd generation?

A

Anaerobes: ++
Gram + Aerobes: ++
Gram - aerobes: +++++

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15
Q

Can you use ceftiofur for staph?

A

No

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16
Q

Would a staph that is methicillin resistant be resistant to 4th generation cephalosporins?

A

No

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17
Q

What is the revised spectrum for 4th generation cephalosporins?

A

Aerobes: +++++
Anaerobic Gram +: ++
Anaerobic gram -: none

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18
Q

Which bacteria are the main target of fourth generation cephalosporins?

A

Enterobacteriaceae

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19
Q

Are cephalosporins water soluble?

A

Very

Poor lipid solubility

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20
Q

What is the efficacy of cephalosporin most connected to?

A

Time above MIC in plasma

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21
Q

Are cephalosporins bactericidal or -static?

A

Bactericidal

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22
Q

What generation is cefovecin?

A

Third

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23
Q

Why does cefovecin have such a long half-life? What is this half-life?

A

High protein binding
133 hrs in dogs
166 hrs cats

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24
Q

Following a single administration of cefovecin in a dog, how long is there activity against Staph intermedius? Pasteurella multocida?

A

7 days against S. intermedius

14 days against P. multocida

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25
Q

What is the concern when administering Cefovecin concurrently with carprofen, furosemide, doxycycline, ketoconazole?

A

Competitive protein binding & increase free concentrations of these drugs

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26
Q

Does Cefovecin reach the MIC90 for E. coli, pseudomonas, enterococci?

A

No

27
Q

What are the indications for Naxcel (Ceftiofur Na) in cattle?

A

IM, SQ for BRD

Footrot (F. necrophorum, B. melaninogenicus

28
Q

What are the indications for Naxcel (Ceftiofur Na) in swine?

A

IM for swine bacterial pneumonia (Actinobaciullus pleuropneumonia, P. multocida, S. cholerasuis, S. suis)

29
Q

What are the indications for Naxcel (ceftiofur Na) in sheep?

A

IM

Sheep respiratory dz (P. haemolytica, P. multocida)

30
Q

What are the indications for Naxcel (ceftiofur nA) in Goats?

A

IM

Caprine respiratory dz (P. haemolytica & multocida)

31
Q

What are the indications for Naxcel (ceftiofur Na) in horses?

A

IM

Respiratory infections with S. zooepidemicus

32
Q

What are the indications of Naxcel (Ceftiofur Na) in dogs?

A

SQ

UTI from E. coli or P. mirabilis

33
Q

What are the indications of Naxcel (Ceftiofur Na) in day old chickens?

A

SQ

Control early mortality associated with E. coli

34
Q

What are the indications of Naxcel (Ceftiofur Na) in day old turkey poults?

A

SQ

Control of early mortality associated with E. coli

35
Q

Can you use Naxcel (Ceftiofur Na) in lactating dairy cattle/sheep/goats?

A

Yes

36
Q

Compare and contrast IM vs IV injection of Ceftiofur in cattle

A

Cmax IM is 4 vs IV 7
Tmax IM is .75 vs IV .3
T1/2 is similar

37
Q

What is the MIC90 for Salmonella & E. coli in swine/cattle?

A

1.0 ug/mL

38
Q

Why is Ceftiofur hydrochloride (excenel) considered RTU and Ceftiofur Na is not?

A

Ceftiofur hydrochloride comes in cottonseed oil suspension, Ceftiofur Na is sterile powder

39
Q

Are indications between Ceftiofur Na and Ceftiofur hydrochloride very different?

A

No. still primarily respiratory disease & footrot

Excenel also for metritis

40
Q

Are the Cmax & T1/2 similar between IM Naxcel and SQ/IM Excenel?

A

Yes. There is no reason to use IM Ceftiofur

41
Q

Where is Ceftiofur CFA (Excede) labeled for injection use in cattle?

A

SQ under skin of ear and at base of ear

42
Q

Why do you never inject Excede SQ in the neck of cattle?

A

Drastically extended slaughter withdrawal time

43
Q

What are the indications of using CCFA (Excede) in cattle?

A

SQ in ear

BRD & for prophylaxis of BRD

44
Q

What are the indications in swine for Excede? (CCFA)

A

IM in neck

Respiratory disease

45
Q

What are the indications for Excede (CCFA) in horses?

A

SQ in ear

Lower respiratory infections (S. zooepidemicus)

46
Q

What is the half-life of an SQ injection of excede in the ear of cattle?

A

62 hours

47
Q

What is the half-life of IM injection of Excede (CCFA) in neck of swine?

A

49 hours

48
Q

What is the indication for Simplicef (Cefpodoxime proxetil)?

A

Oral tablets for dogs with skin infections by S. intermedius, S. aureus, Streptococcus canis, E. coli, P. multocida, P. mirabilis

49
Q

Does Simplicef (Cefpodoxime proxetil) work against Pseudomonas?

A

No

50
Q

What is the half-life of Simplicef (Cefpodoxime proxetil) in dogs?

A

5 hours

51
Q

Which strains of Salmonella are resistant to cephalosporins? Which animal species are these linked to?

A 
Salmonella Heidelberg (poultry)
Salmonella Newport & Salmonella typhimurium in dairy cattle
52
Q

Which cephalosporins can reach therapeutic levels in the CNS of humans?

A

Ceftazidine, Ceftriaxone, Cefipime, Cefotaxime

53
Q

Which cephalosporins have CLSI approved veterinary breakpoints?

A

Ceftiofur, cefpodoxime

54
Q

What is ceftiofur rapidly metabolized to? Are these compounds equipotent?

A

desfuroylceftiofur. Yes except for staph (MIC90 for ceftiofur is 1 ug/mL, MIC90 for desfuroylceftiofur is 4 ug/mL)

55
Q

Is there cross-reactivity between penicillins and cephalosporins in veterinary species?

A

Unknown but estimated at 15% in humans

56
Q

What is the main organ to which cephalosporins are most toxic?

A

Kidney (nephrotoxicity)

57
Q

Can you use cephalosporins in a healthy patient? CKD patient?

A

Yes

No

58
Q

Which other class of antibiotics may increase nephrotoxicity of cephalosporins if administered concurrently?

A

Aminoglycosides

59
Q

Very high doses or prolonged doses of cephalosporin can lead to complications with what system?

A

Immune system

Hepatitis, agranulocytosis, thrombocytopenia

60
Q

Administration of oral cephalosporins can lead to what?

A

Anorexia, vomiting, diarrhea

61
Q

What issues are we concerned with in horses & cephalosporins? Which administration route are we most worried?

A

Clostridium difficile enterocolitis with equine diarrhea especially if given IV

62
Q

Is Ceftiofur Na labeled for IV administration in horses?

A

No, IM

63
Q

If a dog is well titrated on phenobarbital, what is the issue with administration of cephalosporin?

A

Cephalexin will decrease seizure threshold

64
Q

Can you use cephalosporins extra-label in food animals?

A

Only if route, duration, dose and everything else is followed (revoked 2012) and NO HUMAN CEPHALOSPORINS

Pharmacology II (15 decks)

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