Cephalosporins/Carbapenems Flashcards

1
Q

A disulfiram effect can occur with the use of alcohol and which cephalosporins?

A

cefazolin and cefotetan

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2
Q

Increased risk of bleeding occurs with which cephalosporins and why?

A
  • cefazolin, cefotetan and ceftriaxone

- they interfere with vitamin K metabolism which can inhibit the formation of clotting factors

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3
Q

1st generation cephalosporins are use to treat which organisms?

A
  • gram positive
  • staphylococci
  • streptococci
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4
Q

2nd generation cephalosporins are use to treat which organisms?

A
  • gram pos/neg organisms
  • h. influenzae
  • klebsiella
  • pneumococci
  • staphylococci
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5
Q

3rd generation cephalosporins are use to treat which organisms?

A
  • gram neg organisms
  • P. aeruginosa
  • neisseria gonorrhoeae
  • klebsiella
  • serratia
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6
Q

4th generation cephalosporins are use to treat which organisms?

A

gram neg organism (p. aeruginosa)

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7
Q

5th generation cephalosporins are use to treat which organisms?

A

MRSA

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8
Q

What organisms are Imipenem use to treat?

A
  • gram neg cocci
  • gram neg bacilli
  • anaerobic bacteria
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9
Q

Why is cilastatin combined imipenem?

A

it prevents imipenem breakdown by the kidneys

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10
Q

What drug is combined with imipenem to prevent renal breakdown?

A

cilastatin

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11
Q

What organisms are Vancomycin used to treat?

A
  • gram positive bacteria only
  • staphylococcus aureas
  • staphylococcus epidermidis
  • MRSA strains of the S. aureas and epidermidis
  • streptococci
  • PCN resistant pneumococci
  • Clostridium difficile
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12
Q

What type of organism is Clostridium Difficile?

A
  • gram positive, spore forming anaerobic bacillus
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13
Q

What are the mild symptoms of C. Difficile infection?

A
  • abdominal discomfort
  • nausea
  • fever
  • diarrhea
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14
Q

What are the severe complications of C. Difficile infection?

A
  • dehydration
  • e-lyte disturbances
  • toxic megacolon
  • pseudomembranous colitis
  • colon perforation
  • renal failure
  • sepsis
  • death
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15
Q

What antibiotics are used to treat the initial occurrence of C. Difficile infection?

A
  • PO vancomycin (Vancocin)

- PO fidaxomicin

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16
Q

Which antibiotics most likely to lead to C. Diff infection?

A
  • Clindamycin
  • second and third generation cephalosporins
  • fluoroquinolones
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17
Q

What is the main risk factor for C. Difficile infection?

A

antibiotic use

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18
Q

A fulminant C. Diff infection is characterized by the presence of what conditions?

A
  • shock
  • toxic megacolon
  • hypotension
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19
Q

What are alternative treatments to vanco and fidaxomicin for C. Diff infection?

A
  • 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
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20
Q

What are the 1st generation cephalosporins?

A
  • cefadroxil
  • cefazolin
  • cephalexin
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21
Q

What are the 2nd generation cephalosporins?

A
  • cefaclor
  • cefotetan
  • cefoxitin
  • cefprozil
  • cefuroxime
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22
Q

What are the 3rd generation cephalosporins?

A
  • cefdinir
  • cefditoren
  • cefixime
  • cefotaxime
  • cefpodoxime
  • ceftazidime
  • ceftibuten
  • ceftriaxone
23
Q

What are the 4th generation cephalosporins?

A
  • cefepime

- ceftolozane

24
Q

What are the 5th generation cephalosporins?

A
  • ceftaroline
25
cefadroxil is what type of drug?
1st generation cephalosporin
26
cefazolin is what type of drug?
1st generation cephalosporin
27
cephalexin is what type of drug?
1st generation cephalosporin
28
cefaclor is what type of drug?
2nd generation cephalosporin
29
cefotetan is what type of drug?
2nd generation cephalosporin
30
cefoxitin is what type of drug?
2nd generation cephalosporin
31
cefprozil is what type of drug?
2nd generation cephalosporin
32
cefuroxime is what type of drug?
2nd generation cephalosporin
33
cefdinir is what type of drug?
3rd generation cephalosporin
34
cefixime is what type of drug?
3rd generation cephalosporin
35
cefotaxime is what type of drug?
3rd generation cephalosporin
36
cefpodoxime is what type of drug?
3rd generation cephalosporin
37
ceftazidime is what type of drug?
3rd generation cephalosporin
38
ceftibuten is what type of drug?
3rd generation cephalosporin
39
ceftriaxone is what type of drug?
3rd generation cephalosporin
40
cefepime is what type of drug?
4th generation cephalosporin
41
ceftolozane is what type of drug?
4th generation cephalosporin
42
ceftaroline is what type of drug?
5th generation cephalosporin
43
Which cephalosporin generation is the preferred treatment for patients with mild PCN allergies and for surgical prophylaxis?
1st generation
44
Which cephalosporin generation is the preferred treatment for otitis, sinusitis, and URI?
2nd generation
45
Which cephalosporin generation is the preferred treatment for meningitis?
3rd generation
46
Which cephalosporin generation is the preferred treatment for hospital acquired pneumonia and complicated intra-abdominal and urinary tract infections?
4th generation
47
Which cephalosporin generation is the preferred treatment for methicillin resistant Staphylococcus aureus?
5th generation
48
What type of drug should be combined with imipenem when used to treat pseudomonas aeruginosa?
an antipseudonomal drug
49
Imipenem is used to treat which organisms?
- gram positive cocci - gram negative cocci - gram negative bacilli - anaerobes
50
What are the names of the carbapenems?
- doripenem - ertapenem - imipenem/cilastatin - meropenem - meropenem/vaborbactam
51
What are the AE of imipenem?
- nausea - vomiting - diarrhea - rarely: seizures and superinfections
52
What affect does imipenem have on valproate?
reduces valproate blood levels, allowing breakthrough seizures to occur
53
What type of drug is valproate?
antiseizure drug