Beta-Lactam Antibiotics Ii

Front 1

Bacterial Resistance to the cephalosporins is due to?

Back 1

-Production of beta lactamases
i.e. pseudomonas, enterobacter
-Alteration of PBPs
i.e. MRSA, strep pneumoniae
-Change in porin channels
-Efflux Pumps

Front 2

What are the main differences between Cephalosporins and Penicillins?

Back 2

-Cephalosporins are more stable against beta-lactamases
-Cephalosporins have broader spectrums of activity
-Cephalosporins are not active against enterococci and listeria

Front 3

Do oral cephalosporins penetrate the CSF?

Back 3

No.

Front 4

What is the main difference between the earlier and later generations of cephalosporins?

Back 4

Earlier generations: better gram-POSITIVE coverage

Later generations: better gram-NEGATIVE coverage

Front 5

Which organisms are always resistant to cepahalosporins?

Back 5

enterococci, atypicals (Mycoplasma, Chalamydia), Listeria

Front 6

What is the MOA of the cephalosporins?

Back 6

Interfere with synthesis of peptidoglycan (bacterial cell wall synthesis inhibitor).

Front 7

What are the first generation cephalosporins?

Back 7

Cefazolin and Cephalexin

Front 8

What is the spectrum of activity of the first generation cephalosporins?

Back 8

-Gram positive: pneumococci, streptococci, staphylococci (MSSA)
-Gram negative: E.Coli, Klebsiella, Proteus

Front 9

What are the first generation cephalosporins not active against?

Back 9

MRSA, enterococci, more resistant gram negatives (Pseudomonas), Bacteroides

Front 10

Is Cefazolin oral or IV?

Back 10

Cefazolin: IV

Front 11

Is Cephalexin oral or IV?

Back 11

Cephalexin: oral

Front 12

What are the indications for oral 1st generation cephalosporins (cephalexin)?

Back 12

UTIs, minor cellulitis, soft tissue abscesses.

Front 13

What are the indications for IV cefazolin?

Back 13

drug of choice for surgical prophylaxis; DOES NOT PENETRATE CNS!

Front 14

What are the second generation cephalosporins?

Back 14

Cefuroxime, Cefaclor.
Cephapmycins: Cefoxitin & Cefotetan.

Front 15

Which second generation cephalosporins are available IV?

Back 15

Cefuroxime, Cefoxitin, Cefotetan.

Front 16

Which second generation cephalosporins are available orally?

Back 16

Cefuroxime and Cefeclor.

Front 17

What is the spectrum of activity of second generation cephalosporins?

Back 17

-Gram-positive: less active than first generation agents
-Gram-negative: extended gram-negative activity (klebsiella that is resistant to 1st generation, H.Influenzae)
-Anaerobes: Cephamycins – Bacteroides fragilis

Front 18

What are cephalosporins NOT active against?

Back 18

enterococci, pseudomonas, only cefuroxime active against penicillin resistant pneumococci

Front 19

What are indications for oral cephalosporins (cefuroxime & cefeclor)?

Back 19

sinusitis, otitis, lower respiratory tract infections.

Front 20

What are the indications for the cephamycins (cefoxitin (IV) & cefotetan (IV))?

Back 20

peritonitis & diverticulitis

Front 21

What are the third generation cephalosporins?

Back 21

cefotaxime, ceftazidime, ceftriaxone, cefpodoxime.

Front 22

Which of the third generation cephalosporins is the only one that is available orally?

Back 22

cefpodoxime

Front 23

Third generation cephalosporins are not active against these gram-positive organisms?

Back 23

enterococci, Listeria, staphylococci.

Front 24

Third generation cephalosporins are not active gainst these gram-negative organisms?

Back 24

Enterobacter, Citrobacter, Serratia, Providencia.

Front 25

Ceftriaxone is indicated for?

Back 25

penicllin resistant Gonorrhea, penicillin resistant pneumocci, H. influenzae, gram negative rods, meningitis

Front 26

Cefotaxime is indicated for?

Back 26

penicillin resistant pneumococci.

Front 27

Ceftazidime is indicated for?

Back 27

sepsis, pseudomonas, febrile neutropenia.

Front 28

Key features of the third generation cephalosporins are?

Back 28

-expanded gram-negative activity
-most penetrate cerebrospinal fluid will
***NO RENAL ADJUSTMENT IS NEEDED FOR CEFOPERAZONE AND CEFTRIAXONE!!!

Front 29

What is special about the third generation agents Ceftriaxone and Cefoperazone?

Back 29

NO RENAL ADJUSTMENT IS NEEDED!!!
-mainly biliary excretion

Front 30

What is the fourth generation cephalosporin?

Back 30

Cefepime

Front 31

Is cefepime IV or oral?

Back 31

IV

Front 32

Cefepime is active against these gram-negative organisms?

Back 32

Pseudomonas, enterobacteriaceae, Haemophilus, Neisseria

Front 33

Cefepime is active against these gram-positive organisms?

Back 33

Staphylococcus aureus, Streptococcus pneumoniae

Front 34

Cefepime is not active against?

Back 34

Enterococci, Listeria, MRSA

Front 35

Cefepime is indicated for?

Back 35

Meningitis, sepsis, febrile neutropenis (just like ceftazidime 3rd gen)

Front 36

What are the key features of Cefepime (fourth gen cephalosporin)?

Back 36

-more resistant to hydrolysis by chromosomal beta lactamases that inactive many third generation cephalosporins

-Penetrates CSF well-->Meningitis

Front 37

Which cephalosporins are indicated for outpatient community acquired pneumonia?

Back 37

cefuroxime (2nd gen) or cefpodoxime (3rd gen) (both are oral)

Front 38

Which cephalosporins are indicated for inpatient community acquired pneumonia?

Back 38

cefuroxime (2nd gen)/ceftriaxone (3rd gen)/cefotaxime (3rd gen) + a macrolide

*all are IV

Front 39

Which cephalosporins are indicated for Nosocomial Pneumonia?

Back 39

ceftazidime (3rd gen) or cefepime (4th gen) +/- an Aminogylcoside

Front 40

Which cephalosporins are indicated for community acquired meningitis?

Back 40

cefotaxime (3rd gen)/ ceftriaxone (3rd gen) + Vancomycin

Front 41

Which cephalosporins are indicated for post surgical meningitis?

Back 41

ceftazidime (3rd gen)/cefepime (4th gen) + Vancomycin

Front 42

Which cephalosporins are indicated for Febrile Neutropenia?

Back 42

ceftazidime (3rd gen)/cefepime (4th gen) +/- an Aminoglycoside

Front 43

Which cephalosporin is indicated for surgical prophylaxis?

Back 43

cefazolin (1st gen)