chapter 24-cephalosporins

Question 1

pharmacodynamics

Answer 1

• inhibit synthesis of cell wall by bacteria (similar to PCN)
• 1st generation: used against gram positive cocci-s. aureus, and s. epidermidis (excluding MRSA), used for skin and soft tissue infections
• 2nd generation: active against 1st generation PLUS klebsiellas, proteus, e.coli
• 3rd generation: broader spectrum, mostly for gram-negative bacteria
• 4th generation: resistant to beta-lactamase, used against gram-positive bacteria

Question 2

cephalosporins

Answer 2

• beta-lactam group of abx
• 4 generations based on activity-the higher the generation the more activity against gram-negative organisms and anaerobes and less against gram-positive organisims

Question 3

pharmacokinetics of cephalosporins

Answer 3

• PO absorbed by GI tract and widely distributed to tissue
• some may be bound to proteins
• some metabolized by less active compounds
• usually excreted by kidneys-in various degrees of unchanged drug

Question 4

ADRs of cephalosporins (G.I.A.N.T)

Answer 4

G: gi n/v/d
I: increased glucose
A: anaphylaxis/ETOH-will vomit
N: nephrotoxicity
T: thrompbocytopenia

Question 5

clinical uses of cephalosporins

Answer 5

• used for therapeutic failure of AOM
• 1st generation strep pharyngitis
• 2nd generation UTI (cephalexin, cefixime, cefpodoxime)
• can be used for chlamydia (ceftriaxone, cefixime), gonnorea
• community acquired pneumonia

Question 6

monitoring on cephalosporins

Answer 6

• diarrhea (e.coli)

- renal function-esp. on prolonged therapy