cephalosporins Flashcards
what is the advantage of a cephalosporin
its more resistant to b lactamase- has broader spectrum of activity
ITS THE DRUG OF CHOICE FOR KLEBSIELLA INFECTIONS*
what is the only cephalosporin reactive to MRSA
5th gen: Ceftaroline fosamil***
what CANT cephalosporins tx
CANT TX LISTERIA OR C DIFF
- Tx with ampicillin/ penicillin G
first generation ceph
cephalexin
cefazolin
cefadroxil
second generation ceph
cefprozil
cefuroxime
cefoxitin
cefotetan
third generation ceph
ceftriaxone cefotaxime ceftadizime cefdinir cefixime
fourth gen ceph
cefepime
fifth gen ceph
ceftaroline fosamil
spectrum first gen
Gram + cocci ( staph, strep, pneumococci)
*
RESISTANT TO STAPHYLOCOCCAL PENICILLINS!
gram - bacilli ( proteus, E coli, Klebsiella)
most prescribed cephalosporin
cephalexin (1 egn)
cefazolin drug of choice for
surgical prophylaxis, orthopedic surgery and alternative for mild penicillin allergy that needs tx for bacterial endoxarditis
routes first gen ceph
cephalexin PO
cefazolin IV
cefadroxil PO
Second gen spectrum
1 gen
- Gram + cocci ( staph, strep, enterococci)
- gram - bacilli ( proteus, E coli, Klebsiella)
2 gen
- more gram - (moraxella, HIB)
which is most prescribed 2nd gen ceph
cefprozil
Cefoxitin
Cefotetan xtra bacteria
- bacteroides
- c. perfingens
- GONORRHEA (backup)
routes 2nd gen ceph
cefprozil PO
cefuroxime PO
ceflacor PO
cephamycins ( cefoxitin cefotetan) IV
Third gen spectrum
1 gen
- Gram + cocci ( staph, strep, enterococci)
- gram - bacilli ( proteus, E coli, Klebsiella)
2 gen
- more gram - (moraxella, HIB)
3 gen
- more gram - ( neisseria pseudomonas)
which third gen can cross bbb
ceftriaxone
cefotaxime
ceftaxidine
which third gen can tx step pneumo resistant to penicillin
ceftriazone
cefotaxime
ceftriaxone first line for
bacterial meningitis HIB** N. gonorrhea H. Ducrei-- Chanchroid typhoid fever- salmonella penicillin resistan strep pneumo
cefotaxime tx
bacterial meningitis HIB
n. gonorrhea
penicillin resistant strep pneumo
Importance of ceftazidime
only 3rd gen for pseudomonas***
+ metronidazole tx bacteroides
cefixime tx
n. gonorrhea
cefdinir
most common 3rd gen
community acquired pneumonia
strawberry susp
4th gen ceph tx
cefepime
BEST to tx enterobacter* due to increased resistant to b lactamase hydrolysis
also crosses CNS
4th gen bacteria
1 gen
- Gram + cocci ( staph, strep, enterococci)
- gram - bacilli ( proteus, E coli, Klebsiella)
2 gen
- more gram - (moraxella, HIB)
3 gen
- more gram - ( neisseria pseudomonas)
4 gen
- (enterobacter bacteroides serratia citrobacter?)
fifth generation
special?
ONLY B LACTAM THAT CAN TX MRSA
ONLY CEPH THAT CAN TX ENTEROCOCCI
VRSA MRSA VISA
Main mode of resistance for cephalosporins
enzymatic inactivation via cephalosporinase
pharmacokinetics
which ones tx meningitis
ceftriaxone cefotaxime ceftazidine (3rd)
cefepime (4th)
what prolings duration of activity of ceph
probenecid
which cephs not excreted by kidney***
ceftriaxone- excreted by bile
can be given in people with decreased renal function
adverse effect of cephs
cephotetan adverse effect
allergic and hypersensitivity rxn–
cefotetan-
- disulfiram reaction— inhibits metabolism of alcohol, causing buildup of aldehyde also metronidazole
use for first gen ceph
UTI
skin soft tissue infection
resp tract infection- strep throat
ceftriaxone combinations to tx
- meningitis
- penicillin resistnt strep pneumo
meningitis: ceftriaxone and ampicillin (listeria)
strep pneumo: ceftriaxone and vancomycin
