Cephalosporins 2

Question 1

• extended activity of both gram pos and neg
• shows greater resistance to beta lactamase
• administered parenterally
• often used against Pseudomonas, Streptococcus pneumonia and nonsocomial infections where stability to beta lactamses usually critical for success
• still not active against MRSA or anaerobes/atypical intracellular organisms

Answer 1

• 4th gen cephs (Cefepime)

Question 2

brand name for cefepime gen 4 cef

Answer 2

• Maxipime

Question 3

• features of gen 4 cephs chemical structure

Answer 3

• beta lactamse stability
• improved cell penetration
• improved PK metabolically, stability and higher spectrum levels

Question 4

antiobiotic map for cefepime

keep in mine it is broad spectrum often used in skin infections or sepsis

Answer 4

• s. pnuemoniae (+)
• strep pyogenes (+)
• MSSA (+)
• Proteus mirabilis
• e. coli
• klebsiella pneumonia
• serratia
• n. meningitdis
• h. influenza
• Enterobacter spp
• Psuedomnas

Question 5

applications for 4th gen cephs

Answer 5

• UTI
• skin and sking structureinfections
• sepsis/bacteremia
• meningitis
• febrile neutropenia

Question 6

• unique agents active against MRSA

- designed to bind specific targets

Answer 6

gen 5 cephs such as

• Ceftaroline
• Ceftozolane

Question 7

• 5th gen ceph used to treat acute bacterial skin infections and community acquired bacterial pneumonia or SSSI or MRSA
• parenteral agent
• some ADR such a diarrhea, nauseam rash

Answer 7

Ceftaroline

- brand name Teflaro

Question 8

• 5th gen ceph developed to treat geam neg bacteria w resistance to developed convienent antibiotics

Answer 8

Ceftozolane

Question 9

Ceftaroline antibiotic map coverage

Answer 9

• S. pnuemoniae
• Strep pyogenes
• MSSA
• MRSA
• Proteus mirabilis (-)
• E. coli (-)
• Klebsiella pneumonia (-)
• N meningitides (-)
• H. influenza (-)
• Serratia (-)
• Enterobacter spp (-)

Question 10

• gen 5 cephs parenteral drug developed for gram neg organisms such as Psuedomonas and other gram negs that are resistant
• trials emphasized for complicated intraabdominal infections, UTI and ventilator associated pneumonia
• formulated w BLI agent tazobactem to decrease resistance

Answer 10

• ceftolazane/tazobactam

Question 11

cephalopsporins that are useful in treating meningitis

Answer 11

• cefotaxime
• ceftriaxone
• cefepime

Question 12

average half life of cephs in general excluding ceftriaxone

Answer 12

• 0.5-2hrs

Question 13

• what to avoid with cefriaxone

Answer 13

• IV calcium bc of chelating agents

Question 14

• coagulation issues w alcohol can be seen in these C2 and C3 agents
• disulfiram like effect occurs which causes inhibition of enzyme aldehyde dehydrogenase
• due to MTT group as R2 side chain

Answer 14

• cefotetan (C2)

- cefoperazone (C3)

Question 15

• which generation?
• activity is comparable lower than penicillins but possesses broader spectrum of activity more activity against gram pos and neg

Answer 15

1st gen

Question 16

• which generation?
• have increased activity against gram neg but have some reduced against gram pos
• many cross BBB
• cephamycins have activity against anaerobi bacteria

Answer 16

• 2nd gen

Question 17

• which generation?
• better activity against gram neg, some have issue of reduced activity agains gram pos but have improved betalactamse resistance
• some cross BBB
• gram pos activity similar to gen 1

Answer 17

• 3rd gen

Question 18

which gen?

• better gram neg activity
• betalactamase resistance
• some cross BBB
• activity similar to gen 1

Answer 18

• 4th gen

Question 19

which gen?

- compounds designed for specific targets of MRSA and Pseudomonas aeruginosa

Answer 19

• 5th gen

Question 20

• cefazolin antibiotic map coverage

Answer 20

• s. pnuemoniae (+)
• strep pyogenes (+)
• staph aureus MSSA (+)
• proteus mirabillis (-)
• e. colo (-)
• Klebsiella pneumonia (-)

Question 21

• cefuroxime antibiotic map coverage

Answer 21

• s. pnuemoniae (+)
• strep pyogenes (+)
• staph aureus MSSA (+)
• proteus mirabillis (-)
• e. coli (-)
• Klebsiella pneumonia (-)
• N. meningitides (-)
• H. influenza (-)

Question 22

• Cefoxitin/Cefotetan antibiotic map coverage

Answer 22

• s. pnuemoniae (+)
• strep pyogenes (+)
• staph aureus MSSA (+)
• proteus mirabillis (-)
• e. coli (-)
• Klebsiella pneumonia (-)
• N. meningitides (-)
• H. influenza (-)
• bacteriodes gragilis (-)**

Question 23

• cephtriaxone/cefotaxime antibiotic map coverage

Answer 23

• s. pnuemoniae (+)
• strep pyogenes (+)
• staph aureus MSSA (+)
• proteus mirabillis (-)
• e. coli (-)
• Klebsiella pneumonia (-)
• N. meningitides (-)
• H. influenza (-)
• Enterobacter spp (-)

Question 24

• ceftazidime antibiotic map coverage

Answer 24

• s. pnuemoniae (+)
• strep pyogenes (+)
• proteus mirabillis (-)
• e. coli (-)
• Klebsiella pneumonia (-)
• N. meningitides (-)
• H. influenza (-)
• Enterobacter spp (-)
• Serratia (-)
• Pseudomonas

Question 25

- cefepime antibiotic map coverage

Answer 25

- s. pnuemoniae (+) - strep pyogenes (+) - MSSA (+) - proteus mirabillis (-) - e. coli (-) - Klebsiella pneumonia (-) - N. meningitides (-) - H. influenza (-) - Enterobacter spp (-) - Serratia (-) - Pseudomonas

Question 26

- ceftaroline antibiotic map coverage

Answer 26

- s. pnuemoniae (+) - strep pyogenes (+) - MSSA (+) - MRSA (+)****** - proteus mirabillis (-) - e. coli (-) - Klebsiella pneumonia (-) - N. meningitides (-) - H. influenza (-) - Enterobacter spp (-) - Serratia (-)

Question 27

1st gen parenterals - strong action on gram pos aerobes - skin/soft tissue infections and prophylaxis

Answer 27

- Cefazolin

Question 28

1st gen oral agents - strong action on gram pos aerobes - skin/soft tissue infections and prophylaxis

Answer 28

- Cefadroxil | - Cephalexin

Question 29

2nd gen parenterals - modest action on aerobic gram pos, gram neg and some anaerobes - respiratory infections although 3rd gen may be better

Answer 29

- Cefotetan | - Cefoxitin

Question 30

2nd gen oral agents - modest action on aerobic gram pos, gram neg and some anaerobes - respiratory infections although 3rd gen may be better

Answer 30

- Cefaclor - Cefprozil - Loracarbef

Question 31

3rd gen parenterals - strong action against aerobic gram neg and moderate against aerobic gram pos - cefotaxime = strep pneumo - ceftriaxone = 1/day - ceftizoxime = anaerobes - ceftazidime = Psuedomonas

Answer 31

- Cefotaxime - Ceftriaxone - Ceftazidime - Ceftizoxime

Question 32

3rd gen oral agents - strong action against aerobic gram neg and moderate against aerobic gram pos - cefotaxime = strep pneumo - ceftriaxone = 1/day - ceftizoxime = anaerobes - ceftazidime = Psuedomonas

Answer 32

- cefdinir | - cefixime

Question 33

4th gen parenterals - strong action against gram neg aerobes better than C2 and C3 for gram pos - increase passage gram negs - increase affinity PBP - increase resistance to betalactamses - used for Pseudomonas

Answer 33

cefepime

Question 34

4th gen oral agents - strong action against gram neg aerobes better than C2 and C3 for gram pos - increase passage gram negs - increase affinity PBP - increase resistance to betalactamses - used for Pseudomonas

Answer 34

none!