Term
| 1st generation cephalosporins |
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Definition
cephalothin
cephapirin
cephradine
cephalexin
cefazolin
cefadroxil |
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Term
| 2nd generation cephalosporins |
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Definition
cefamandole
cefaclor
cefuroxime
cefoxitin
cefotetan
cefprozil
loracarbef
cefmatazole
cefonicid |
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Term
| 3rd generation cephalosporin |
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Definition
ceftriaxone
ceftazidime
cefotaxime
ceftizoxime
cefixime
ceftibuten
cefditoren pivoxil
cefoperazone
cefpodoxime
cefdinir |
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Term
| 4th generation cephalosporin |
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Definition
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Term
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Definition
| 3rd gen. cephalosporin with LONGEST half-life: 8 hrs (most have T1/2= 1-3 hrs) |
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Term
| 1st & 2nd generation cephalosporins |
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Definition
| these do NOT have good penetration into CNS, even meninges are inflamed = NOT RECOMMENDED for Meningites or Brain Abscesses |
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Term
| 3rd generation cephalosporins except cefuroxime |
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Definition
| drugs that DO enter CNS and ARE used for Meningitis |
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Term
| Pharmacokinetics of most Cepahlosporins except 3rd generation cefoperazone and ceftriaxone |
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Definition
excreted by kidney via glomerular filtration & tubular secretion;
doses should be adjusted for renal failure;
probenicid slows tubular secretion of most of these drugs |
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Term
| 3rd generation ceftriaxone and cefoperazone |
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Definition
drugs excreted in the bile rather than by the kidneys;
Dosage adjustment with renal failure is NOT REQUIRED |
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Term
| 5 - 10% cross-allergenicity |
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Definition
percentage of people that are cross-allergenic between penicillins and cephalosporins;
allergic rxns occur less frequently in cephalosporins; |
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Term
| Pts should NOT take cephalosporins in this situation --> switch to another antibiotic |
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Definition
| If a pt has a SEVERE IMMEDIATE rxn to penicillins, what should they do if given an Rx for a cephalosporin? |
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Term
| Adverse Events associated with cephalosporins |
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Definition
hypersensitivity and allergic rxns - urticaria, pruritus, angioedema, bronchospasm, maculopapular rash, fever;
Intolerance of alcohol - disulfiram-like rxn;
Bleeding disorders - prothrombin deficiency, thrombocytopenia, platelet dysfunction;
Nephrotoxicity;
Superinfection w/ opportunistic microorganisms;
Seizures |
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Term
| cefazolin, cefmetazole, cefamandole, cefotetan, cefoperazone |
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Definition
| cephalosporins that cause both intolerance of alcohol (disulfiram-like rxns) AND bleeding disorders (prothrombin deficiency, thrombocytopenia, platelet dysfunction) |
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Term
| Bleeding disorders caused by cephalosporins |
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Definition
| Administer vitamin K (10 mg twice/wk) to prevent these |
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Term
| destruction of beta-lactam rings |
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Definition
| most important resistance mechanism to cephalosporins |
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Term
| limit or restrict usage of cepahlosporins |
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Definition
| best way to minimize resistance to cephalosporins |
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Term
| MRSA (methicillin-resistant Staph. aureus) and Enterococci |
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Definition
| NONE of the cephalosporins have activity against these bugs |
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Term
| 1st generation cephalosporins (cefazolin & cephalexin) |
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Definition
good activity against Gram (+) bacteria & modest activity against Gram (-) bacteria;
Activity against most gram (+) cocci (EXCEPT MRSA);
Good activity against some Gram (-) enterics: PECK - Proteus, E.coli, Klebsiella; |
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Term
| cefazolin (1st generation) |
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Definition
| drug of choice for surgical prophylaxis |
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Term
| Clinical Uses for 1st generation Cephalosporins (cefazolin, cephalexin) |
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Definition
one is a drug of choice for surgical prophylaxis;
alternative agent for penicillin for Staph and Strep infections with mild penicillin allergic rxns;
Used for UTIs;
SHOULD NOT be used for serious systemic infections; |
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Term
| 2nd generation cephalosporins (cefaclor, loracarbef, cefoxitin, cefuroxime, cefprozil) |
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Definition
less activity against Gram (+) bacteria but INCREASED activity against Gram (-) bacteria;
subset has activity against B. fragilis anaerobe;
subset good against agents that cause sinusitis & otitis media (S. pneumoniae, H. influenzae, M. Catarrhalis, S. Pyogenes);
one has coverage over Strep. Pneumoniae --> useful against CAP;
NOT effective against Pseudomonas aeruginosa |
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Term
| Clinical Uses for 2nd generation Cephalosporins (cefaclor, loracarbef, cefoxitin, cefuroxime, cefprozil) |
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Definition
Tx sinusitis, otitis media, and lower respiratory tract infections (e.g. Community acquired pneumonia);
Tx mixed anaerobe infections (peritonitis and diverticulitis);
NOT used for meningitis |
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Term
| cefoxitin (2nd generation) |
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Definition
| subset of 2nd gen. drugs that has good activity against anaerobe B. fragilis |
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Term
| cefuroxime, cefprozil, cefaclor, loracarbef (2nd gen) |
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Definition
| subset of 2nd gens good for bugs that cause sinusitis and otitis media (S. pneumoniae, H. influenzae, M. catarrhalis, S. pyogenes) |
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Term
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Definition
| 2nd generation ceph that has coverage against Strep. pneumoniae --> useful against Community Acquired Pneumonia (CAP) |
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Term
| 3rd generation cephalosporins (ceftriaxone, cefixime, ceftizoxime, ceftazidime) - BROAD SPECTRUM Cephs |
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Definition
broad-spectrum cephalosporins;
more active than 2nd gen against Gram (-) b/c resistant to beta-lactamases;
Less active than 1st gen against gram (+) cocci;
Useful against Gram (-) bacilli resistant to other cephs, penicillins, and aminoglycosides;
activity against Enterobacter sp. but SHOULD NOT BE USED CLINICALLY since mutants that express chromosomal beta-lactamase emerge rapidly during treatment; |
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Term
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Definition
| 1st line drugs for gonorrhea caused by N. gonnorrhoeae; |
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Term
| ceftriaxone, ceftizoxime, ceftazidime (3rd gen) |
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Definition
able to penetrate CNS and can be used to treat Meningitis cause by pneumococci, meningococci, H. influenzae;
NOT useful if Listeria monocytogenes is causative agent (Use ampicillin instead) |
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Term
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Definition
| used for treating neurologic complicatios of Lyme dx caused by Borrelia burgdorferi |
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Term
| 4th generation cephalosporin - cefepime |
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Definition
extended spectrum of activity and are resistant against deactivation by plasmid and chromosomal beta-lactamases;
useful against Gram (-) bacteria (Peudomonas aeruginosa, some Enterobacteriae);
More useful for enterobacter infections (e.g. UTI);
Used for penicillin-resistant Streptococci;
Penetrates into CNS and useful for treating Meningitis |
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