Cephalosporins 2
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- What type of antibiotics are cephalosporins ?
- beta lactam antibiotics
- Are cephalosporins bactericidal or static ?
- BACTERICIDAL !
- How do they work ?
- disrupt cell synthesis and activate autolysins
- Describe cephalosporin characteristics as you move from first generation to fourth generation ?
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1.)increasing effect against gram negative
2.)increasing ability to penetrate the CSF
3.)icreased resistance to beta lactamase - First generation cephs are useful for ....
- are highly active against gram positive bacteria and are the most active of ALL cephs against staphylococci and nonenterococcal strep
- List some of the first generation cephs, especially the prototype ?
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cephalothin
Cephalexin (Keflex)
Cefadroxil (Duricef)
Cefazolin (Ancef) - List the second generation cephalosporins.
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Cefaclor
Ceclor
Ceftin
Zinacef - What are indications for use for the second generations ?
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They have an increased activity against some gram negative such as H. flu
-useful in respiratory infections, otitis media, sinusitis and bronchitis - What makes the third generation Cephs unique ?
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Even more activity against gram negative like salmonalla, enterobacter, n. gonorrhea and anaerobes
PLUS....will penetrate the CNS - What generation ceph is Rocephin ?
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THIRD generation
Other 3rds are Ceftriaxone
Suprax
Vantin (Cefpodozime)
Claforan (Cefotaxime) - Fourth generations cephs can be given po or IV...TRUE OR FALSE?
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FALSE..ONLY IV.
Cefepime
Maxipime - Two main points for the 4the generation Cephs are:
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1.can penetrate the CNS
2. effective against psuedemonas - If you had a patient with a psuedemonas infection, what are some of the options ?
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The anti-psuedemonas drugs (aka extended spectrums) like piperacillin, ticarcillin, mezlocillin or carbenicilin) OR a 4th generation ceph like Cefepime or Maxipime.
-also a good alternative if they are pen allergic -
Practically all cephalosporins are excreted by this route ?
What are the clinical implications of this ? -
Almost all are renal excretion
LOWER the dose for renally impaired patients OR prescribe cefoperazone and ceftriaxone...both of which are not excreted renally and are therefore safe in renal impairment - What is the most common side effect cephalosporin Rx ?
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maculopapular rash that develops several days after the onset of treatment
-anaphylaxis is rare