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Pharmacology > Lecture 12 3/7/24 > Flashcards

Lecture 12 3/7/24 Flashcards

1
Q

How do cephalosporins differ from penicillins?

A

the beta-lactam ring is attached to a 6-membered ring in the cephalosporin, making it more resistant to beta-lactamases

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2
Q

What are the characteristics of cephalosporin pharmacokinetics?

A

-poor oral absorption
-short half-lives
-renal elimination
-considerable renal accumulation
-time-dependent activity

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3
Q

What are the cephalosporin classifications and admin. routes?

A

-1st gen: parental, oral
-2nd gen: parenteral
-3rd gen: parenteral, oral
-3rd gen, anti-pseudomonal: parenteral
-4th gen: parenteral

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4
Q

What is the spectrum of first gen. cephalosporins?

A

-high susceptibility of gram pos. aerobes and FAs
-decent susceptibility of gram pos. anaerobes and gram neg. aerobes
-some susceptibility of gram neg. anaerobes and FAs

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5
Q

Which bacteria exhibit resistance against first gen. cephalosporins?

A

-MRSA
-MRSP
-Enterococcus spp.
-Pseudomonas spp.
-Enterobacter spp.
-Bacteroides fragilis

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6
Q

What is the parenteral first gen. cephalosporin?

A

cefazolin

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7
Q

What are the oral first gen. cephalosporins?

A

-cefadroxil
-cephalexin

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8
Q

What is the intramammary first gen. cephalosporin?

A

cephapirin

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9
Q

What is the spectrum of second gen. cephalosporins?

A

-decent susceptibility of gram pos. bacteria
-high susceptibility of gram neg. bacteria

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10
Q

Which second gen. cephalosporin is able to treat Bacteroides fragilis and other anaerobes?

A

cefoxitin

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11
Q

Which bacteria exhibit resistance to second gen. cephalosporins?

A

-Pseudomonas
-Enterococcus spp.
-MRSA

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12
Q

What are the general characteristics of second gen. cephalosporins?

A

-limited applications in animals
-more expensive than first gens.
-used based on susceptibility test results

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13
Q

What is the spectrum of third gen. cephalosporins?

A

-high susceptibility of gram pos. and neg. aerobes, gram neg. FAs
-decent susceptibility of gram pos. anaerobes
-decent susceptibility of gram pos. FAs and gram neg. anaerobes EXCEPT Bacteroides

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14
Q

Which bacteria exhibit resistance to third gen. cephalosporins?

A

-some Serratia spp.
-some Enterobacter spp.
-Pseudomonas aeruginosa
-Enterococci
-MRSA
-MRSP

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15
Q

What are the main uses of third gen. Ceftiofur?

A

-resp. infections in food animals
-UTIs in small animals

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16
Q

What are the characteristics of third gen. Cefovecin?

A

-broader activity against Staph.
-single-dose SQ injectable

17
Q

What are the characteristics of third gen. Cefpodoxime?

A

-prodrug
-broader activity against Staph.
-given once daily as an oral tablet
-extra-label use may require higher dose frequency for higher MICs

18
Q

What is the spectrum of third gen. antipseudomonal cephalosporins?

A

-high susceptibility of gram pos. and neg. aerobes; especially gram neg. FAs
-decent susceptibility of gram pos. anaerobes
-some susceptibility of gram pos. FAs and gram neg. anaerobes EXCEPT Bacteroides

19
Q

What are the general characteristics of third gen. antipseudomonal cephalosporins?

A

-higher activity against difficult to treat gram neg. organisms
-ceftazidime is most active against Pseudomonas
-not used without susceptibility test

20
Q

What are the characteristics of cephalosporin use in food species?

A

-banned for use in cattle, swine, poultry if not approved specifically for that species
-banned for use at unapproved levels/frequencies/durations/routes
-banned for disease prevention

21
Q

What are the exceptions to bans on cephalosporins in food animals?

A

-use of approved cephapirin products
-extralabel condition at a label dose in approved species
-use in minor species

22
Q

What are the clinical uses of ceftiofur?

A

-colibacillosis in poultry
-resp. tract infections in horses/food animals
-metritis in cattle
-UTIs in small animals

23
Q

What is the clinical use for cephapirin?

A

mastitis prophylaxis/treatment

24
Q

What are the clinical uses for cefadroxil/cephalexin/cefpodoxime/cefovecin?

A

-skin and soft tissue infections in small animals
-UTIs in dogs

25
Q

What is the clinical use for cefazolin?

A

surgical prophylaxis

26
Q

What are the clinical uses for cefoxitin?

A

-septic peritonitis
-mixed infections

27
Q

What is the clinical use for ceftazidime?

A

serious infections involving Pseudomonas or resistant gram. neg. bacteria

28
Q

What are the adverse effects associated with cephalosporins?

A

-diarrhea
-thrombocytopenia
-neutropenia

29
Q

What is the spectrum of carbapenems?

A

high susceptibility of all gram neg. and gram pos. categories

30
Q

Which bacteria exhibit resistance to carbapenems?

A

-MRSA
-some Enterobacter spp.
-Pseudomonas aeruginosa
-Enterococcus faecium

31
Q

What are the general characteristics of carbapenems?

A

-all are human products
-typically IV admin.
-more bactericidal
-reserved for severe infections that would otherwise require multiple antibiotics

32
Q

What are the characteristics of Meropenem?

A

-broad spectrum
-beta-lactamase stable
-IV or SQ admin.
-used mostly in small animals for resistant infections

33
Q

What are the characteristics of Imipenem-cilastatin?

A

-broad spectrum
-beta-lactamase stable
-potent and expensive
-IV, IM, or SQ admin.
-used for resistant infections
-culture and susceptibility testing done first

34
Q

What are the characteristics of Ertapenem?

A

-more human applications
-Pseudomonas is usually intrinsically resistant

35
Q

What are the limitations of carbapenem use in vet med?

A

-no CLSI breakpoints
-culture and susceptibility results for one carbapenem do not transfer to another

36
Q

What are the adverse effects associated with carbapenems in people?

A

-nephrotoxicity
-injection site reactions
-seizures

Pharmacology (27 decks)

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