L 5 Cephalosporins Flashcards by Trent mueller

How are most Cephalosporins excreted?

Through the kidney

Exception is Ceftriaxone which is partially metabolized by the liver

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What bugs are killed by 1st gen Cephalosporins?

First PECK
Proteus
E. Coli
Klebsiella

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Which drug is DOC for surgical prophylaxis?

Cefazolin

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Which Cephalosporins are the best for CNS penetration?

Cefotaxime Sodium

Ceftriaxone

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Which Cephalosporins are good killers of P. aeruginosa?

3rd gen Cephalosporins

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Which Cephalosporins is good against MRSA?

Ceftaroline fosamil (Teflaro)

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How do Cephalosporins compare to penicillins?

Similar beta lactam ring

Better resistance to penicillinases

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How does spectrum change over the generations of Cephalosporins?

1st gen to 4th gen the coverage and spectrum gets wider

Start with good g(+) coverage and slowly lose g(+) for g(-) coverage

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What are 1st gen Cephalosporins not effective against?

Enterococci
MRSA
S. epidermis

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What drugs are 1st gen Cephalosporins?

Cafazolin (Kefzol, Ancef): IV
Cefadroxil Monohydrate (Duricef): Oral
Cephalexin (Keflex): Oral

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Cefazolin (Kefzol, Ancef)

1st gen Cephalosporin

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Cefadroxil Monohydrate (Duricef)

1st gen Cephalosporin

Oral

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Cephalexin (Keflex)

1st gen Cephalosporin

Oral

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What drugs are 2nd gen Cephalosporins?

Cefoxitin (Mefoxin)
Cefaclor (Ceclor)
Cefuroxime (Zinacef)
Cefmetazole (Zefazone)
Cefotetan (Cefotan)
Cefprozil (Cefzil)
Loracarbef (Lorabid)

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Cefoxitin (Mefoxin)

2nd gen Cephalosporin

IM/IV

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Cefaclor (Ceclor)

2nd gen Cephalosporin

Oral

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Cefuroxime (Zinacef)

2nd gen Cephalosporin

IM/IV

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Cefmetazole (Zefazone)

2nd gen Cephalosporin

IM/IV

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Cefotetan (Cefotan)

2nd gen Cephalosporin

IM/IV

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Cefprozil (Cefzil)

2nd gen Cephalosporin

Oral

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Loracarbef (Lorabid)

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2nd gen Cephalosporin

Oral

3rd gen Cephalosporins

General characteristics

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Better against enterobacteriaciaea than other Cephalosporins
Good P. aeruginosa
Good CNS

What are the notable 3rd gen Cephalosporins?

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Cefotaxime Sodium (Claforan): CNS. IV/IM
Ceftriaxone (Rocephin): CNS, IV/IM, Partial liver excretion
Cefixime (Suprax): similar to Ceftriaxone but oral

Cefotaxime Sodium (Claforan)

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3rd gen Cephalosporin

CNS, IM/IV

Ceftizoxime (Cefizox)

3rd gen Cephalosporin | IM/IV

Ceftazidime (Fortaz)

3rd gen Cephalosporin | IV/IM

Ceftriaxone (Rocephin)

3rd gen Cephalosporin CNS IV/IM Partial liver metabolism

Cefixime (Suprax)

3rd gen Cephalosporin Like Ceftriaxone but Oral CNS, IV/IM, Liver metabolism?

Cefditoren (Spectracef)

3rd gen Cephalosporin | Oral

Cefpodoxime Proxetil (Vantin)

3rd gen Cephalosporin | Oral

Ceftibuten (Cedax)

3rd gen Cephalosporin | Oral

Cefdinir (omnicef)

3rd gen Cephalosporin | Oral

4th gen Cephalosporins

Comparable to 3rd gen but more penicillinase resistant Coverage: P. aeruginosa, Enterobacter, S. pneumonia, S. aureus, Citrobacter, E. coli, Klebsiella, Proteus, N. gonorrhoeae, Shigella, Serratia, Salmonella, Mycobacterium Not: Enterococcus, Bacteroides Cefepime (Maxipime): IV

Ceftaroline fosamil (Teflaro)

Unnamed gen of Cephalosporins MRSA IM/IV

In general, what are Cephalosporins not effective against?

MRSA Listeria Enterococci Atypicals (mcobacterium, chlamydia)

Most Cephalosporins are excreted by the kidney. How can this be slowed?

Admin of Probenacid (Benemid)

DOC for Moraxella Catarrhalis

2nd/3rd gen Cephalosporins

DOC for N. gonorrhoeae

Ceftriaxone, Cefixime

DOC for E.coli, Klebsiella, Proteus

1st/2nd gen Cephalosporins

DOC for Salmonella

3rd gen Cephalosporins

DOC for S. pneumoniae resistant to penicillin

Ceftriaxone

Side effects of Cephalosporins

Pseudomembranous colitis Superinfections by candida and staph aureus Disulfiram-like reaction with alcohol Dose-dependent renal tubular necrosis made worse when combined with aminoglycosides

Can patients allergic to Penicillin take Cephalosporins?

Yes. There is little cross-reaction (6-18%)

Distribution and elimination of Cefepime (Maxipime)

Most tissues including the CNS | Kidney excretion

What was the first effective agent against MRSA?

Ceftaroline fosamil (Teflaro)

What is Ceftaroline fosamil (Teflaro) good against and not good against

Kills MRSA | Not effective against P. aeruginosa

Vancomycin | Coverage, Synergism, Use, Admin, Excretion, Toxicity

ICWS by preventing cross-linking and transglycosylation Coverage of g(+) only, g(-) are resistant Synergistic with aminoglycosides for effect and nephrotoxicity Use: g(+) organisms in penicillin resistant or allergic patients, MRSA, meningitis IV admin unless for pseudomembranous colitis–oral Kidney excretion Adverse: ototoxic, nephrotoxic, red-man syndrome

Telavancin (Vibativ)

Similar to Vancomycin Lipoglycopeptide Used for MRSA

Fosfomycin (Monurol)

ICWS by preventing the early peptidoglycan synth g(+) & g(-) Oral, kidney

Bacitracin

Prevents transport of peptidoglycan out of the cell Mainly g(+) Serious nephrotoxicity Topical use most common including for plastic surgery

Cycloserine

Not on USA market Competes w/D-alanine for enzymes CNS toxicity

Daptomycin (Cubicin)

Lipopeptide–binds membranes causing rapid depolarization and stop to all membrane transport Bactericidal, g(+) No resistance known IV admin, kidney excretion

L 5 Cephalosporins Flashcards

(52 cards)