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Pharm Exam 3 > Cephalosporins > Flashcards

Cephalosporins Flashcards

1
Q

What generation is
cefazolin
cephalexin

A

1st gen

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2
Q

what generation is
cefuroxime
cefotetan

A

2nd gen

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3
Q

What generation is
ceftriaxone (Rocephin)
Cefotaxime
Ceftazidime

A

3rd gen

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4
Q

what generation is

cefepime

A

4th generation

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5
Q

what generation is
ceftolozane/Tazobactam
ceftaroline

A

5th generation

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6
Q

what are the 2 main uses for a 1st gen cephalosporin?
Cefazolin
Cephalexin

A

good coverage for skin infections

Also this covers E.coli so good coverage for a uncomplicated UTI

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7
Q

What does the 2nd gen cephalosporins provide good coverage for

cefuroxime
cefotetan

A

intra-abdominal infections due to the anaerobic coverage

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8
Q

What does the 3rd generation cephalosporin provide good coverage for

ceftriaxone
cefotaxime
ceftazidime

A

lung infections

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9
Q

What cephalosporin would you use for community acquired pneumonia for someone who is not in a nursing home?

A

Ceftriaxone (Rocephin)

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10
Q

What does the 4th generation cephalosporin provide good coverage for
cefepime

A

Serious infections

This generation provides the gram positive coverage strength of the 1st gen plus the gram neg strength of the 3rd generation

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11
Q

what generation of cephalosporins provides anaerobic coverage

A

2nd gen

5th gen

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12
Q

what cephalosporin antibiotics cover pseudomonas

A

Ceftazidime (3rd gen)
Cefepime (4th gen)
Ceftolozane/Tazobactam - 5th gen and most potent

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13
Q

where is pseudomonas most commonly found?

who is highest risk

A

nursing homes

immune comprimised

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14
Q

what generation is destroyed by B lactamases

A

1st generation

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15
Q

As you progress from 1st gen to 5th, what changes

A

1) increasing activity against gram neg bacteria and anaerobes
2) increasing resistance to destruction by b lactamases
3) increase ability to reach CSF

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16
Q

what generations have access to CSF

A

3rd-5th

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17
Q

almost all cephalosporins are eliminated by _____ except _______

A

kidneys

ceftriaxone - liver

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18
Q

what cephalosporins can produce a disulfiram effect

A

Cefazolin

cefotetan

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19
Q

what cephalosporins can promote bleeding and should be avoided with anticoagulants, thrombolytics, NSAIDS, other antiplatelet agents

A

Cefotetan
Cefazolin
Ceftriaxone

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20
Q

is cephalosporin bactericidal or bacteriostatic

A

bacteriocidal

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21
Q

what gen is used in pt with mild pcn allergy and surgical prophylaxis

A

first gen

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22
Q

what gen is used to treat otitis, sinusitis, resp tract infections

A

2ng gen

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23
Q

what gen is used to treat meningitis

A

3rd gen

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24
Q

what gen is used to treat hospital acquired pneumonia and complicated intra-abdominal and UTI

A

4th gen

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25
Q

what gen is used to treat MRSA associated infections

A

5th gen

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26
Q

what gen covers staph or strep

A

1st gen

27
Q

what gen covers H. influenzae, Klebsiella, pneumococci, staph

A

2nd gen

28
Q

what gen covers pseudomonas aeruginosa, neisseria gonorrhoeae and Klebsiela, serratia

A

3rd gen

29
Q

what gen covers psudomonas aeruginosa

A

4th gen

30
Q

what gen covers MRSA

A

5th gen

31
Q

cephalosporins are contraindicated in pt

A

with history of severe allergy to PCN

32
Q

All cephalosporins can promote ______, what should be monitored

A

C. diff

report increase in stool frequency

33
Q

what are the 1st gen cephalosporins

A

cefadroxil
cefazolin
cephalexin

34
Q

2nd gen cephalosporins

A 
cefaclor
cefotetan
cefoxitin
cefprozil
cefuroxime
35
Q

3rd gen cephalosporin

A 
cefdinir
cefditoren
cefixime
cefotaxime
cefpodoxime
ceftazidime
ceftibuten
ceftriaxone
36
Q

4th gen cephalosporin

A

cefepime

ceftolozane

37
Q

5th gen cephalosporin

A

ceftaroline

38
Q

what gen is cefdinir

A

3rd gen cephalosporin

39
Q

what gen is cefixime

A

3rd gen cephalosporin

40
Q

what gen is cefotaxime

A

3rd gen cephalosporin

41
Q

what gen is ceftriaxone

A

3rd gen cephalosporin

42
Q

what do you treat C-diff with

A

oral Vancomycin

stop other abx

43
Q

What type of bugs does Vancomycin treat

A

only gram positive

esp active against S aureus and Staph epidermidis
including strains for both that are Methicillin resistant

other is strep, penicillin resistant pneumococci and c.diff

44
Q

major adverse effect of vanc

A

renal tox

45
Q

drug interaction with vanc

A

nephrotoxic drugs can increase risk of renal tox ->aminoglycosides, cyclosporine, NSAIDS)

46
Q

lab sign of kidney damage secondary to vanc

A

Serum creatinine increased by 50%

47
Q

Pt severe allergy to PCN, what do you give for c-diff

A

oral vancomycin - no b lactam ring

48
Q

c diff can lead to

A 
toxic megacolon
pseudomembranous colitis
colon perforation
sepsis
death
49
Q

alternate abx for c diff

A

flagyl

50
Q

what cephalosporins are responsible for promoting C-diff

A

second and third gen cephalosporins such as cipro and levaquin

51
Q

how is c-diff defined

A

3 or more unformed stools in 24 hours plus a positive stool test for c-diff

52
Q

what increases risk for c diff

A

gI surgery
serious illness
prolonged hospitalization
immunosuppression

53
Q

what antibiotic do you use in c.diff with leukocytosis with WBC of 15,000 or higher plus hypotension/shock, ileus or megacolon

A

add in Metronidazole (flagyl) with vancomycin

54
Q

what drug is reserved for treating vancomycin resistant infections? also an alternative to zyvox, daptomycin, tygacil.

what class?

A

Telavancin

lipoglycoproteins - active against gram positive bacteria

inhibits bacterial cell wall synthesis and disrupts membrane function

55
Q

adverse effects of Telavancin

A 
taste disturbance 
n/v
foamy urine
Red mans 
prolong QT
nephrotoxic
56
Q

who cannot have Televanciin

A

history of QT

GFR less than 50

57
Q 
flushing 
rash
pruritis
urticaria
tachycardia
hypotension
A

Red mans syndrome

58
Q

drug drug interaction televancin

A

NSAIDS
ACE inhibitors
aminoglycosides
(nephrotoxic)

59
Q

abx in monobactams

A

Aztreonam (single b lactam ring)

resistant to B lactamases

60
Q

Aztreonam is only active against

A

gram negative aerobic bacteria

61
Q

adverse effect Aztreonam

A

pain and thrombophlebitis at site of injection

62
Q

single dose therapy in women with uncomplicated UTI

A

Fosfomycin

63
Q

adverse effects Fosfomycin

A 
diarrhea
headache
vaginitis
nausea
abd pain
rhinitis
drowsiness
dizziness 
rash

Pharm Exam 3 (19 decks)

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