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Pharm III > Cephalosporins, Carbapenems, & Monobactams > Flashcards

Cephalosporins, Carbapenems, & Monobactams Flashcards

1
Q

Cephalosporins MOA

A

Interfere with PBP in bacterial cell walls

Are bactericidal

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2
Q

Cephalosporins MOR

A

Produce Beta lactamase enzymes

Alter PBP (MRSA, PRSP)

Alteration of outer membrane to decrease the penetration of the cephalosporin

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3
Q

Organisms that produce beta lactamase enzymes

A

Gram +:
Penicillin Resistant S. Aureus

Gram -:
Haemophilus Influenzae, Klebsiella, Moraxiella, E. Coli, Enterobacter, Nisseria gonorrhoeae

Anaerobe:
Bacteroides

8 species

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4
Q

Cephalosporins are NOT active against?

A 
MRSA (except fifth generation)
C. Diff
Enterococcus
Listeria monocytogenes
Legionella

M-CELL

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5
Q

Cefazoline

A

First generation

MSSA*
PSSP
Streptococci
PEK (Proteus Mirabilis, E. Coli, Klebsiella)

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6
Q

Cephalexin

A

First generation

MSSA*
PSSP
Streptococci
PEK (Proteus Mirabilis, E. Coli, Klebsiella)

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7
Q

Cefuroxime

A

Second Generation

MSSA*
PSSP
Streptococci
HENPEK (H. Influenzae, Enterobacter, Nisseria Spp., Proteus Mirabilis, E. Coli, Klebsiella)

B. Fragilis (Prophalaxis for abdominal surgery)

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8
Q

Cefoxitin

A

Second generation

MSSA*
PSSP
Streptococci
HENPEK (H. Influenzae, Enterobacter, Nisseria Spp., Proteus Mirabilis, E. Coli, Klebsiella)

B. Fragilis (Prophalaxis for abdominal surgery)

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9
Q

Ceftotetan

A

Second Generation

MSSA*
PSSP
Streptococci
HENPEK (H. Influenzae, Enterobacter, Nisseria Spp, Proteus Mirabilis, E. Coli, Klebsiella

B. Fragilis (Prophalaxis for abdominal surgery)

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10
Q

Cefprozil

A

Second Generation

MSSA*
PSSP
Streptococci
HENPEK (H. Influenzae, Enterobacter, Nisseria Spp, Proteus Mirabilis, Enterobacter, Klebsiella)

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11
Q

Ceftriaxone

A

Third generation

PSSP*
HENPEKSSS (H. Influenzae, Enterobacter, Nisseria Spp. Proteus Mirabilis, E. Coli, Klebsiella, Serratia, Salmonella, Shigella

** Not good for P. Aeruginosa**

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12
Q

Ceftazidime

A

Third Generation

PSSP

HENPEKSSS (H. Influenzae, Enterobacter, Nisseria, Proteus Mirabilis, E. Coli, Klebsiella, Serratia, Salmonella, Shigella)

GOOD FOR P. Aeruginosa

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13
Q

Cefpodoxime

A

Third Generation

PSSP
HENPEKSSS

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14
Q

Cefepime

A

Fourth Generation

Similar to Ceftazidime + Enterobacter

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15
Q

Ceftaroline

A

Fifth generation

Strep Pneumo
MRSA

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16
Q

Cephalosporin Absorption

A

Oral are well obsorbed- Food decreases absorption of cefaclor and loracarbef

17
Q

Cephalosporin Distribution

A

CSF:

2nd generation parenteral Cefuroxime
3rd and 4th generations (good for meningitis)

18
Q

Cephalosporin Elimination

A

Primarily eliminated by the kidney
Short half lives EXCEPT Ceftriaxone (8hrs)

EXCEPT:

  • Ceftriaxone (Biliary)
  • Cefoperazone (Liver)
19
Q

Cephalosporin Adverse Effects

A
  • Hypersensitivity
  • MTT side chain issues (cefoperazone, cefotetan)
    • Hypoprothrombinemia- due to inhibition of vit K
    • Ethanol intolerance
  • IV calclium and ceftriaxone precipitates
20
Q

Carbapenem MOA

A

Inhibitors of Cell wall synthesis by inhibiting PBPs; primary target is PBP-2

21
Q

Carbapenem MOR

A

Beta lactamase production, alteration to PBP, decreased permeability

22
Q

Carbapenems NOT active against:

A
  • MRSA
  • PRSP
  • VRE
  • Coag neg staph (epidirmidids/saprophiticus)
  • C. Diff
  • Atypical bacteria
  • Stenotrophomonal maltophilia
23
Q

Carbapenem Distribution

A

CSF Penetration- meropenem is the best

24
Q

Carbapenem Elimination

A

Primarily by kidney

Short half lives (Ertapenem 4 hours)

Imipenem undergoes hydrolysis by dihydropeptidase enzyme so used with cilastatin a DHP inhibitor

25
Q

Carbapenems Side Effects

A
  • Hypersensitivity

* CNS: Risk factor for seizures

26
Q

Monobactam (Aztreonam) MOA

A

Inhibits cell wall syntehsis by binding to PBP-3

27
Q

Monobactam Distribution

A

Penetrates CSF in the presence of Inflamed meninges

Only available IV

28
Q

Monobactam Elmination

A

Excreted in the urine

Short elimination half-life

29
Q

Monobactam Side Effects

A

No cross-reactivity with penicillins so can be used in penicillin allergic patients

30
Q

Carbapenem coverage

A

Large spectrum

Imipenem & Doripenem best for  gram + Aerobes
MSSA
PSSA
Streptococci
E. Faecalis

Meropenem & Doripenem best for gram - Aerobes
HENPEK + Moraxella

Gram + Anaerobes
Gram - Anaerobes (Bacteroides)

P. Aeruginosa covered by all except Ertapenem

31
Q

Aztreonam

A

No Gram + Coverage

Gram - Aerobe coverage (HENPEKSSS)

Pseudomonas Aeruginosa

Pharm III (8 decks)

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