CHEMO DRUGS HY

Question 1

cephalosporin classfication with examples of each group

Answer 1

Cephalosporins
First generation
Cephalexin, others

Spectrum
strong gram possitve coverage and some gram negative(kleibsela , proteus)

Second generation
Cefotetan
Cefoxitin
Cefuroxime CNS

SPECTRUM =
gram neg coverage inc anaerobes

Third generation(CNS)
Ceftriaxone
Cefotaxime
Ceftazidime

SPECTRUM
Emperic management of sepsis and meningitis
pneumonia and gonorrhea

Fourth generation(CNS)
Cefepime 
R
SPECTRUM
Broad activity,
beta-lactamase-stable

Question 2

Pharmakokinetics and AA of Cephalosporin

Answer 2

Renal elimination
dose modification in renal dysfunction
ceftriaxone eliminated via liver

3rd and 4rth gen ENTER CNS

l Side effects:
Hypersensitivity:Incidence: 2%
Wide range, but rashes and drug fever most common

Positive Coombs test, but rarely hemolysis

Assume complete cross-allergenicity between cephalosporins

partial cross-allergenicity with penicillins (about 5%)