Cephalosporins Exam 1 Drug list

Question 1

Need to know Cephalosporins

Answer 1

First gen (Cephalexin and Cefazolin(IV/IM)

Second gen (Cefuroxime)

Third gen (Cefdinir, Cefpodoxime, Ceftriaxone (IM/IV))

Question 2

Cephalosporins are similar to

Answer 2

Penicillin’s chemically and structurally

Question 3

What adverse event occurs if cephalosporin dosage isn’t adjusted in the presence renal impairment?

Answer 3

Induction of seizure activity

Question 4

Cephalosporins most effective against

Answer 4

Rapidly growing organisms forming cell walls when antibiotic concentrations exceed the pathogen’s MIC for at least 50% of the dosing interval

Question 5

What are some clinical uses for cephalosporins

Answer 5

Active against respiratory pathogens
Acute otitis media, sinusitis, group A streptococcal pharyngitis, pneumonia, chronic bronchitis, and UTIs

Question 6

how well are cephalosporins absorbed through the GI?

Answer 6

Oral formulations are well-absorbed

Question 7

Is hepatic metabolism significant in cephalosporins?

Answer 7

No

Question 8

How are cephalosporins excreted?

Answer 8

Via the kidneys as unchanged drug

Renal impairment significantly extends half-life

Question 9

What species are intrinsically resistant to cephalosproins?

Answer 9

Enterococcus species

Question 10

Are cephalosporin’s stable in the presence of penicillinase produced by S. aureus?

Answer 10

Yes

Question 11

What lab values signifies a renal dosing adjustment is needed for cephalosporins?

Answer 11

Recommended when GFR is less than 30mL/min

Question 12

Cephalosporins MOA

Answer 12

Inhibit mucopeptide synthesis in the bacterial cell wall

Make bacterium osmotically unstable

Question 13

Cephalexin and Cefazolin are active against

Answer 13

Gram-positive cocci, S. aureus, s. epidermidis, and most streptococci

ex. E.coli, proteus mirabilis, klebsiella pneumoniae

Question 14

Cephalexin and Cefazolin Common Side Effects

Answer 14

Gastrointestinal upset (nausea, vomiting, diarrhea)
Rash
Allergic reactions, including anaphylaxis (rare)

Question 15

Staphylococcal skin infections often respond to which generation of cephalosporins?

Answer 15

First-generation (Cephalexin)

Question 16

Cephalosporin Monitoring

Answer 16

Renal function especially in patients with renal impairment (BUN and CrCl)

Signs of allergic reaction, such as rash, itching, swelling, and respiratory difficulties

Periodic liver function tests during prolonged therapy (tiredness, weakness, and jaundice)

Question 17

Cephalosporin ADRs

Answer 17

Severe allergic reactions, including anaphylaxis

Clostridium difficile-associated diarrhea

Coagulation abnormalities

Seizure activity

Question 18

Who are at risk for coagulation abnormalities from cephalosporin admin?

Answer 18

those with impaired renal function, cancer, Vit K synthesis, Low Vit K stores, or malnutrition

Question 19

Are cephalosporins Bacteriostatic or Bactericidal?

Answer 19

Bactericidal

Question 20

Do 1st and 2nd generations cross the BBB, placenta, and breast milk?

Answer 20

Don’t enter CSF

Generally safe in pregnancy

Cross the placenta

Small amounts in milk

Question 21

What are the most common mechanisms of resistance to cephalosporins?

Answer 21

Beta-lactamase production and altered target sites.

Question 22

Cefazolin Adsorption

Answer 22

Not absorbed in GI tract

Question 23

Cefazolin Distribution

Answer 23

Various tissues and body fluids, including skin, bones, joints, gallbladder, and bile

Protein binding 80%

Question 24

Cephalexin Distribution

Answer 24

Widely throughout body, bone, bile, synovial fluid, pleural fluid

10-15% bound to plasma proteins

Question 25

Second Generation Cephalosporin

Answer 25

Cefuroxime

Question 26

Cefuroxime Indications

Answer 26

Same as first gens, but increased activity against H. influenzae, limited activity against anaerobes (Bacteroides fragilis)

Question 27

Second generation require?

Answer 27

susceptibility tests do to different spectrum of activity.

Question 28

Cefuroxime common side effects

Answer 28

GI upset Rash Hypersensitivity reactions superinfections (ex candida overgrowth)

Question 29

Cefuroxime ADRs

Answer 29

Severe hypersensitivity reactions (e.g., anaphylaxis) Clostridioides difficile-associated diarrhea Hemolytic anemia Nephrotoxicity

Question 30

Is cefuroxime bacteriostatic or bactericidal?

Answer 30

Bactericidal

Question 31

Cefuroxime adsorption

Answer 31

Oral prodrug (cefuroxime axetil) absorbed well in GI tract, hydrolyzed to active form.

Question 32

Cefuroxime distribution

Answer 32

Widely in the body, tissues and fluids (lungs, pleural fluid, and bile)

Question 33

Third Generation Cephalosporins

Answer 33

Cefdinir Cefpodoxime Ceftriaxone (IM/IV)

Question 34

Third Generation cephalosporins are active against?

Answer 34

Streptococcal species, streptococcus pneumoniae, MSSA, H. Influenzae, Moraxella, N gonorrheae, N meningitis, E. coli, klebsiella, proteus, salmonella

Question 35

No 3rd gen cephalosporins are reliable against?

Answer 35

Anaerobes other than peptostreptococcus

Question 36

Ceftriaxone elimination is mainly?

Answer 36

Extrarenal, via biliary, making its half-life stable to changes in renal function.

Question 37

Ceftriaxone binds highly to what, and leads to what?

Answer 37

Highly bound to albumin Avoid in neonates at risk for hyperbilirubinemia (especially preterm infants)

Question 38

Ceftriaxone (IM) is recommended treatment for?

Answer 38

Gonorrhea

Question 39

Cefdinir and Cefpodoxime activity

Answer 39

Best against gram-positive

Question 40

Cefdinir and cefpodoxime drug interations

Answer 40

Antacids (take 2 hours before or after) Cefdinir (iron supplements)

Question 41

All cephalosporin drug interactions

Answer 41

Probenecid Loop diuretics Warfarin

Question 42

Do 3rd generation cephalosporins cross the BBB?

Answer 42

Yes, parenteral form is used to treat meningitis.