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26 Cards in this Set
- Front
- Back
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What ring structure is found in cephalosporins?
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Beta-lactam
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What is the mechanism of cephalosporins?
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Inhibition of bacterial transpeptidase; can't join A to K.
Cidal |
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What are the mechanisms of resistance to cephalosporins? What are the most important mechanisms?
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Destruction by cephalosporinases
Alteration in the cephalosporin-binding proteins Decreased penetration/increased efflux |
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In S. pneumoniae, where is the alteration in PBP's?
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Chromosomally
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What is the absorption for cephalosporins?
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Orally for generations 1, 2, 3
IV for 4th generation |
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What is the distribution of cephalosporins?
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Well distributed
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What generations of cephalosporins penetrate the CSF?
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Generations 3 and 4
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What is the metabolism and half life of cephalosporins?
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Minimal
T1/2 = .5 - 8 hr. |
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What is the activity of first generation cephalosporins?
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Good against gram positives
Moderate against gram negatives |
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What are the clinical uses of the first generation cephalosporins?
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Staph infections
Strep infections (not penicillin resistant organisms, though) E. coli |
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What is the activity of the second generation cephalosporins?
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Better activity against gram negative organisms 1st generation cephalosporins
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What is the clinical use of the second generation cephalosporins?
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Think PECKS:
Proteus Mirabilis, Klebsiella, Proteus |
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What is the activity of the third generation cephalosporins?
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Not as good against gram positives as 1st gen; much better against gram negatives
Resistant to the beta lactamases |
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What is the clinical use of the third generation cephalosporins?
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S. pneumoniae
N. Gonorrhoeae N. meningitidis P. aeruginosa Salmonella |
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What is the fourth generation cephalosporin
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Cefepime
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What is the clinical activity of Cefepime, a fourth generation cephalosporin?
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Good penetration into gram negative
Good against gram positive Better resistance to beta lactamases |
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What are the clinical uses of fourth generation cephalosporins?
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Pseudomonas aeruginosa
Neutropenic fever |
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What is the "unique" cephalosporin?
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Ceftaroline
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Cefataroline is in what generation of cephalosporins?
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Trick question!
It's in a class all by itself! |
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What is the absorption of ceftaroline?
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Parenterally
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What is the distribution of ceftaroline?
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Well distributed
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What is the metabolism and half-life of ceftaroline?
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Administered as a phosphate
Converted by phosphatases for activity T1/2 = 2.6 hr. |
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What is the clinical use of ceftaroline?
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MRSA
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What are the adverse effects of the cephalosporins?
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Route of administration pain
Disulfram like effect Interaction with clotting factors Nephrotoxicity Hypersensitivity |
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What is the clinical activity of Aztreonam?
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Only against Gram-negative aerobic organisms
Resistant to beta-lactamases |
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What types of patients would you want to use Aztreonam in?
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People who have sensitive kidneys and ears!
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