Cephalosporins/Carbapenems Flashcards
A disulfiram effect can occur with the use of alcohol and which cephalosporins?
cefazolin and cefotetan
Increased risk of bleeding occurs with which cephalosporins and why?
- cefazolin, cefotetan and ceftriaxone
- they interfere with vitamin K metabolism which can inhibit the formation of clotting factors
1st generation cephalosporins are use to treat which organisms?
- gram positive
- staphylococci
- streptococci
2nd generation cephalosporins are use to treat which organisms?
- gram pos/neg organisms
- h. influenzae
- klebsiella
- pneumococci
- staphylococci
3rd generation cephalosporins are use to treat which organisms?
- gram neg organisms
- P. aeruginosa
- neisseria gonorrhoeae
- klebsiella
- serratia
4th generation cephalosporins are use to treat which organisms?
gram neg organism (p. aeruginosa)
5th generation cephalosporins are use to treat which organisms?
MRSA
What organisms are Imipenem use to treat?
- gram neg cocci
- gram neg bacilli
- anaerobic bacteria
Why is cilastatin combined imipenem?
it prevents imipenem breakdown by the kidneys
What drug is combined with imipenem to prevent renal breakdown?
cilastatin
What organisms are Vancomycin used to treat?
- gram positive bacteria only
- staphylococcus aureas
- staphylococcus epidermidis
- MRSA strains of the S. aureas and epidermidis
- streptococci
- PCN resistant pneumococci
- Clostridium difficile
What type of organism is Clostridium Difficile?
- gram positive, spore forming anaerobic bacillus
What are the mild symptoms of C. Difficile infection?
- abdominal discomfort
- nausea
- fever
- diarrhea
What are the severe complications of C. Difficile infection?
- dehydration
- e-lyte disturbances
- toxic megacolon
- pseudomembranous colitis
- colon perforation
- renal failure
- sepsis
- death
What antibiotics are used to treat the initial occurrence of C. Difficile infection?
- PO vancomycin (Vancocin)
- PO fidaxomicin
Which antibiotics most likely to lead to C. Diff infection?
- Clindamycin
- second and third generation cephalosporins
- fluoroquinolones
What is the main risk factor for C. Difficile infection?
antibiotic use
A fulminant C. Diff infection is characterized by the presence of what conditions?
- shock
- toxic megacolon
- hypotension
What are alternative treatments to vanco and fidaxomicin for C. Diff infection?
- Rifaximin – approve to treat diarrhea caused by E. Coli, can reduce recurrence of infection following tx with vanco
- Bezlotoxumab - Monoclonal Antibodies directed against C. diff. toxins A and B, reduce recurrence when given concurrently with metronidazole or vancomycin
What are the 1st generation cephalosporins?
- cefadroxil
- cefazolin
- cephalexin
What are the 2nd generation cephalosporins?
- cefaclor
- cefotetan
- cefoxitin
- cefprozil
- cefuroxime
What are the 3rd generation cephalosporins?
- cefdinir
- cefditoren
- cefixime
- cefotaxime
- cefpodoxime
- ceftazidime
- ceftibuten
- ceftriaxone
What are the 4th generation cephalosporins?
- cefepime
- ceftolozane
What are the 5th generation cephalosporins?
- ceftaroline
cefadroxil is what type of drug?
1st generation cephalosporin
cefazolin is what type of drug?
1st generation cephalosporin
cephalexin is what type of drug?
1st generation cephalosporin
cefaclor is what type of drug?
2nd generation cephalosporin
cefotetan is what type of drug?
2nd generation cephalosporin
cefoxitin is what type of drug?
2nd generation cephalosporin
cefprozil is what type of drug?
2nd generation cephalosporin
cefuroxime is what type of drug?
2nd generation cephalosporin
cefdinir is what type of drug?
3rd generation cephalosporin
cefixime is what type of drug?
3rd generation cephalosporin
cefotaxime is what type of drug?
3rd generation cephalosporin
cefpodoxime is what type of drug?
3rd generation cephalosporin
ceftazidime is what type of drug?
3rd generation cephalosporin
ceftibuten is what type of drug?
3rd generation cephalosporin
ceftriaxone is what type of drug?
3rd generation cephalosporin
cefepime is what type of drug?
4th generation cephalosporin
ceftolozane is what type of drug?
4th generation cephalosporin
ceftaroline is what type of drug?
5th generation cephalosporin
Which cephalosporin generation is the preferred treatment for patients with mild PCN allergies and for surgical prophylaxis?
1st generation
Which cephalosporin generation is the preferred treatment for otitis, sinusitis, and URI?
2nd generation
Which cephalosporin generation is the preferred treatment for meningitis?
3rd generation
Which cephalosporin generation is the preferred treatment for hospital acquired pneumonia and complicated intra-abdominal and urinary tract infections?
4th generation
Which cephalosporin generation is the preferred treatment for methicillin resistant Staphylococcus aureus?
5th generation
What type of drug should be combined with imipenem when used to treat pseudomonas aeruginosa?
an antipseudonomal drug
Imipenem is used to treat which organisms?
- gram positive cocci
- gram negative cocci
- gram negative bacilli
- anaerobes
What are the names of the carbapenems?
- doripenem
- ertapenem
- imipenem/cilastatin
- meropenem
- meropenem/vaborbactam
What are the AE of imipenem?
- nausea
- vomiting
- diarrhea
- rarely: seizures and superinfections
What affect does imipenem have on valproate?
reduces valproate blood levels, allowing breakthrough seizures to occur
What type of drug is valproate?
antiseizure drug
