Cephalospororins

Question 0

Methyl thiol tetrazole (MTT)

Answer 0

5 membered, 4 nitrogen containing ring with methyl and thiol substituents
Bleeding risk. Can cause hypoprothrombinemia: avoid anti coagulants and heparin
Disulfiram reaction: disulfur+alcohol causes flushing, diarrhea, vomiting. Avoid alcohol use while taking cephalosporins that contain (MTT)

Question 1

Cephalosporins beta Lactam ring is fused to…

Answer 1

Dihydrothiazine ring (6 membered ring)
Beta Lactam ring + dihydrothiazine ring = Cefem structure

Question 2

First generation cephalosporins

Answer 2

Primarily Gram (+), some gram (-)
Cefazolin (Ancef). Parenteral
Cephlaxin (Keflex). Oral

Question 3

Second generation cephalosporins

Answer 3

Some gram (+), many gram (-) and activity against haemophilus and influenzae
Cefuroxime (Ceftin). Parenteral
Cefuroxime axetil. Oral
Cefprozil (Cefzil). Oral

Question 4

Third generation cephalosporins

Answer 4

Primarily gram (-), less active against gram (+)
Cefotaxime (Claforan). Parenteral. Penetrate CNS
Ceftriaxone (Rocephin). Parenteral. Penetrate CNS
Cefdinir (Omnicef). Oral
Cefpodoxime (Vantin). Oral

Question 5

Fourth generation cephalosporins

Answer 5

Broad spectrum, active against gram (+) and gram (-)
Cefepime (Maxipime). Parenteral
Nosocomial infections
Activity against strep., staph.(MSSA), and gram (-)

Question 6

Fifth generation cephalosporins

Answer 6

Gram(+) and gram (-)
Ceftobiprol
Ceftatroline
Effective against MRSA

Question 7

Cephalosporin Abx used for meningitis b/c it can penetrate CSF

Answer 7

Cefotaxime, ceftriaxone, cefepime
Other drugs not in cephalosporin class but mentioned: Nafcillin

Question 8

Cross allergenicity of PCN with cephalosporins is more likely with…

Answer 8

First and second generation cephalosporins