Cephalosporins (PART 2)
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- Which THREE cephs can cause bleeding tendencies and alcohol intolerance ?
- Cefmetazole (Zefazone..2nd), cefoperazone (Cefobid, 3rd gen) and cefotetan (Cefotan..2nd)
- Concomittant administration of cephalosporins with probenacid causes what ?
- the probenacid delays excretion of the cephs and INCREASES circulating amount of roceph
- When a cephalosporin is indicated for a gram positive infection, which generation should be prescribed ?
- A first generation because they are the MOST active of all cephs against gram + and they are cheaper.
- What is another use for the first generation cephs ?
- surgical prophylaxis (less expensive and less broad antimicrobial spectrum)
- Second generation cephs are often useful for...
-
pnuemonia caused by H.flu; klebsiella, pnuemococci and staphylococci
-oral cefuroxime (Zinacef) also useful in otitis, sinusitis and respiratory tract infections - Why are third generations the DOC against meningitis ?
- Because they are highly effective against gram negative organisms AND because they penetrate the CNS.
- Ceftazidime is especially useful for treating memingitis caused by this organism ?
-
psuedemonas aeruginosa
-it is THE most effective of all cephs against p. aeruginosa and is clearly the preferred ceph for treating infections caused by this microbe - What is another common use of the 2nd generation cephs ?
- nosocomial infections
- What are the DOC for infections caused by Neisseria gonorrhoeae, hflu, proteus, salmonella, klebsiella and serratia ?
- Ceftriaxone (Rocephin..a 3rd generation) and cefotaxime (Claforan)= they are both third generations.
- The third and fourth generation cephs should be AVOIDED in what situations ?
-
in situations where a first or second generation would do
-the treatment should be no broader than required, - Why should the prescriber consider duration of action when choosing a ceph ?
-
Half life of the cephs varies from 30 minutes to 9 hours
-drugs with a longer half life require fewer administrations per day = better compliance - Which two cephs have the longest half lives ?
-
Cefazolin (Keflex)
Cefonicid
Ceftriaxone (Rocephin)
Rocephin CANNOT be given PO - Most all cephs are eliminated via this route ?
- Renal
- Which two are not eliminated renally ?
- Cefoperazone and ceftriaxone (Rocephin) and also deftriaxone
- Most cephs cannot be absorbed orally, TRUE OR FALSE
- TRUE..only 12 can be given orally