C/9. Cephalosporins

Question 1

Cephalosporins

Pharmacokinetics/dynamic properties

Answer 1

Parenteral administation mostly
Some oral (cephalexin, cefixime)
Renal excretion
Biliary clearance (ceftriaxone, cefoperazone)
1st and 2nd gen do not enter CNS
3th and 4th gen can cross BBB

Question 2

Drugs need to know in this topic

Answer 2

Cefazolin
Cephalexin

Cefoxitin
Cefuroxime

Ceftriaxone
Cefotaxime
Cefixime
Ceftazidime

Cefepime

Ceftaroline fosamil
Ceftolozane/tazobactam

Question 3

1st gen

Answer 3

Cefazolin
Cephalexin

Gram-positive cocci (staph, Strep)
UTI’s caused by gram - (Proteus, E. Coli, Klebsiella)
Surgical prophylaxis

Hypersensitivity/allergic reaction; fever, urticaria, pruritus, joint swelling, anaphylaxis
Pain at IM injection site
Phlebitis following IV administration

Question 4

2nd gen

Answer 4

Cefoxitin
Cefuroxime

Extented gram -
Bacteroide fragilis
Sinus, ear, and respiratory infection caused by H. Influenza, M. Catarrhalis

Hypersensitivity/allergic reaction; fever, urticaria, pruritus, joint swelling, anaphylaxis
Pain at IM injection site
Phlebitis following IV administration

Question 5

3nd gen

Answer 5

Ceftriaxone
Cefotaxime
Cefixime
Ceftazidime

Increased activity against gram -
Empiric tx of bacterial meningitis and sepsis
Community and hospital-acquired pneumonia
Pseudomonas, B fragilis, B. Burgdoferi
N. Gonorrhea
Endocarditis caused by S. Viridans

Hypersensitivity/allergic reaction; fever, urticaria, pruritus, joint swelling, anaphylaxis
Pain at IM injection site
Phlebitis following IV administration

Question 6

4th gen

Answer 6

Cefepime

Broad-spectrum resistant to most beta-lactamase
Enterobacter, Hemophilus, Neisseria, Pneumococci, Pseudomonas

Hypersensitivity/allergic reaction; fever, urticaria, pruritus, joint swelling, anaphylaxis
Pain at IM injection site
Phlebitis following IV administration

Question 7

5th gen

Answer 7

Ceftaroline fosamil
Ceftolozane/tazobactam

Broad-spectrum, including MRSA strains
Complicated UTI’s, abdominal infections

Hypersensitivity/allergic reaction; fever, urticaria, pruritus, joint swelling, anaphylaxis
Pain at IM injection site
Phlebitis following IV administration

Question 8

Not covered by cephalosporine

Answer 8

LAME
Listeria
Atypical(chlamydia, mycoplasma)
MRSA
Enterococci