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17 Cards in this Set

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Resistance to cephalosporins:
1. Inability to reach its site of action.
2. Alt. of PBP
3. Beta-lactamase production
What are the 2nd generation drugs?
- Cefaclor, Ceprozil, Cefuroxime Axetil, and Loracarbef (oral)
- Cefuroxime, Cefoxitin, Cefamandole
What bugs do 2nd generation cover?
- E. Coli
- Proteus
- Klebsiella
(gram +)
Cefoxitin covers::::::
B. fragilis (abdominal surgery & anaerobic infection)
Cefuroxime, Cefaclor, Cefprozil
- VERY GOOD staph aureus coverage.
What are the 2nd generation possible side effects?
Cefamandole - mtt
1. Disulfiram-like reaction w/ alcohol tx for alcohol abuse and dependence.
2. Hypoprothrombinemia
3. Inhibition of Vitamin K activation.
Ceftriaxone and Ceftazidime
- greatest against gram (-) bacteria, have some gram (+) bacteria.
- resistance against enterobacter.
- cross bbb.
Cefoperazone
- MTT moiety
- high conc. in bile.
- p. aeruginosa.
Ceftriaxone and Cefotaxime:
- GOOD CNS PENETRATION.
- Active against strept and MRSA.
- Triaxone 1/2 bile and 1/2 urine
Cefipime (MAXIPIME)
- Broad spectrum
- 100% renal
- EXCELLENT CSF PENETRATION.
MTT GROUPS cause what kind of a.e.:
Cefamandole
Cefoperazone
- intolerance to alcohol w/ ceph.
- bleeding related to hypothrombinemia (
Binds to PBP3
AZTREONAM
- Reduce dosage in renal insufficiency.
- allergic to pencillin/cephal not usually allergic to these.
- NARROW, PSEUDOMONAS
IMIPENEM ORGANISMS (broad spectrum)
- GRAM (+) and gram (-)
- anaerobic, aerobic
- B. fragilis
- Psuedomonas
Renal insufficiency
- Imipenem (dosage)
A.E. OF IMIPENEM
N/V (20%)
Seizures (CNS lesions or renal insufficiency)
Allergic to other beta-lactam
Ertapenem:
no pseudomonas or enterococcus
Meropenem:
stable to hydrolysis to dehydropeptidase.