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20 Cards in this Set

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Cephalosporins characteristics?
Broad spectrum. Good against gram + and gram - but not active against enterococci.
well tolerated
wide therapeutic window
DOC for surgical prophylaxis
Cephalosporins not good for?
Variable CSF penetrance
Limited against pseudomonas and resistance quick to gram -'s (ceftazadime)
Risk to give C. difficile
First generation IV/oral cephalosporin?
Cefazolin

ORAL: Cephalexin/Cephradine
Second generation IV/oral cephalosporin?
Cefoxitin
Cefuroxime

ORAL: Cefprozil
Third generation IV/oral cephalosporin?
Cefotaxime
Ceftriaxone
Ceftazidime
Cefepime

ORAL: Cefixime
Cefazolin (1st gen)
-Most active against MSSA
-Favorite of surgeons for prophylaxis and GAS.
-community acquired gram + and gram - like e.coli and klebsiella
-Penicillin susceptible streptococci like viridans strep.
-Add metronidazole to be good against intraabdominal infections
-NOT good for enterococci
Cefamandole, Cefuroxime, Cefoxitin, Cefotetan goal? (2nd gen)
Goal was to increase activity against H.influenzae and B.fragilis
Cefamandole
Increase prothrombin time. N-methylthiotetrazole (NMTT)side chain interference with prothrombin time.
Cefuroxime
Now used over Cefamandole. Increase activity against H. Influenzae including beta lacatamse makers.
Popular for resp infection like H.flu and M.catarrhalis
Cefoxitin
1st cephalosporin to be active against:
B.fragilis and N.gonorrhoeae
AND
community acquired gram -
little less active for MSSA

GOOD for intra-abdominal and pelvic infection.

Expensive so replaced with penicillin beta lacatam combinations.
Cefotetan
Like Cefoxitin but longer half life.
NMMT which leads to increased prothrombin.
One dose surgical prophylaxis only real use now
Ceftriaxone, Cefatazidime goal?(3rd gen)
Claim to fame is increase gram negative activity.
Can now be used for p.aeruginosa and avoid toxic aminoglycosides
Ceftriaxone
Active against all community acquired and hospital acquired gram - but NOT p.aeruginosa.
Good gram + activity including MSSA.
Pneumococci including penicillin resistant strains.
GAS, group B strep. and viridan strep.
CNS penetrates good for meningitis
Renal excretion but only adjust in endstage renal failure
UTI, CAP, sepsis, meningitis
Avoid ceftraixone in what kind of patients?
Neonates, use cefotaxime instead. May bind to serum proteins to displace bilrubin
Cefatazidime
Gives up better gram + to get better nonsocomial gram - infections.
P.aeruginosa (+aminoglycoside for synergy) and hospital acquired gram -.
Fever of uknown origin in leukopenic patients
Cefepime (4th gen)
Combines gram + activity of cetriaxone with gram - activity of ceftazidime.
Very broad so must watch out for selecting for resistance.
Adust dose in renal failure
For nonsocomial infections and leukopenic fever patient.
Cephalexin & Cephradine(1st gen oral)
Modest MSSA
Good GAS
Comminuty acquired gram -
Oral absorption good and well tolerated
Good for susceptible gram - UTI
Cefuroxime & Cefprozil(2nd generation oral)
Increased H.influenzae active against penicillin-susceptible s.pneumoniae.
Cefprozil tastes like gum while Cefuroxime doesn't.
Adult - Cefuroxime
Children - Cefprozil
Acute otis media DOC if allergic to amoxicillin.
Cefixime (3rd generation)
increase gram - but gives up pneumococcal activity
tissue gram - infection or UTI
Cephalosporins side effects
Primary allergic reactions
1. rashes, hives
2. anaphylaxis very rare
In patients allergic to penicillin that is delayed administer it slowly. If immediate anaphylaxis then its contraindicated.