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12 Cards in this Set

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  • Back
what are the fourth generation cephalosporins
cefepime (P)
what allows cephalosporins greater structural diversity and stability?
2-3 R groups make it more stable to beta lactamase and less allergenic
what are the 1st generation cephalosporins?
cephalexin(O)

cefazolin (P)
what are the second generation cephalosporins
cefprozil (O)

cefuroxime (O & P)

cefotetan (P)
what are the third generation cephalosporins
ceftriaxone

ceftazidime (P)

cefdiner (O)

cefpodoxime (O)
1st Generation Cephalosporins

Cefalexin

Cefazolin
Cefalexin... Cefazolin

Class: 1st generation cephalosporin

MOA: same as beta lactam

Use: PEcK - Proteus, E.coli, Klebsiella.. G+ cocci (except enterococci) and a few G- bacilli - SKIN/SOFT TISSUE, UTI, SURGICAL PROPHYLAXIS

AE: Hypersensitivity rxn, platelet dysfxn and bleeding

Contra: if pt had rxn to penecillin

Interaction:

Admin: parental - IM/IV

CEFAZOLIN - longer duration of axn, penetrates well to bone, prophylaxis prior to surgery
2nd generation cephalosporins

cefprozil

cefuroxime

cefotetan
Cefprozil...Cefuroxime... Cefotetan

Class: 2nd generation cephalosporin

MOA: same as beta lactam

Use: HEN - H. influenzae, Enterbacter aerogenes, Neisseria
more active against G-
OTITIS MEDIA, SINUSITIS (ORAL)
PELVIC/INTRAABDOMINAL INFECTION (CEFOTETAN)

AE: Hypersensitivity rxn,
cefotetan - platelet dysfxn and bleeding + disulfiram effect (intolerance to ingested alcohol b/c INHIBIT ALDEHYDE DEHYDROGENASE)

Contra: if pt had rxn to penecillin

Interaction:

Admin: parental - IM/IV

cefuroxime - longer half life, crosses blood brain barrier, used for community aquired bronchitis or pneumonia in elderly and immunocompromised
3rd generation cephalosporins

ceftriaxone,

ceftazidime,

cefdiner,

cefpodoxime
ceftriaxone, ceftazidime, cefdiner, cefpodoxime

Class: 3rd generation cephalosporin

MOA: same as beta lactam

Use: strepto, pneumococci... enhanced against G-

AE: Hypersensitivity rxn, platelet dysfxn and bleeding

Contra: if pt had rxn to penecillin

Interaction:

Admin: parental - IM/IV

ceftazidime - only one against pseudomonas

ceftriaxone - longest half life, once daily dosing - DOC gonorrhea, lyme dz - can b used in renal insufficiency b/c EXCRETED IN BILE

ceftriaxone/cefotaxime - empiric therapy adult meningitis, add vancomycin if pneumococci resistant - also late lympe dz - arthritis, carditis, neurologic, pediatric
cefpodoxime - URI
4th generation cephalosporins

cefepime
4th generation cephalosporins - cefepime

Class: 4th generation cephalosporin

MOA: same as beta lactam

Use: G- bacilli resistant to other agents

AE: Hypersensitivity rxn, platelet dysfxn and bleeding

Contra: if pt had rxn to penecillin

Interaction:

Admin: parental - IM/IV
Vancomycin
Vancomycin

Class: glycopeptide antibiotic

MOA: bind D-alanyl-D-alanine of cell wall precursor --> prevents peptidoglycan synthesis - weaken cell wall

Use: staph (METHICILLIN SENSITIVE + MRSA), ENTERO, G+ (C.diff) *RX RESISTANT BACTERIA*
SYNERGISTIC WITH AMINOGLYCOSIDES - RX ENTEROCOCCAL ENDOCARDITIS*

AE: flushing, hypotension, skin rash, chills, drug fever, auditory impairment,
shock with fast infusion
Contra:

Interaction:

Admin: IV - systemic
oral - life threatening ab associated colitis (C. diff or staph) when metronidazole ineffective
Bacitracin
Bacitracin

Class: peptide antibiotic

MOA: inhibit incorporation of mucopeptide - inhibit cell wall synthesis

Use: G+ COCCI + BACILLI - RX SUPERFICIAL INFECTIONS

AE: renal failure with systemic use

Contra: if pt had rxn to penecillin

Interaction:

Admin: topical b/c nephrotoxicity
Fosfomycin
Fosfomycin

Class: phosphonic acid derivative

MOA: inhibits early step in cell wall synthesis

Use: antimicrobial activity - enterococci, G- rods
ACUTE UNCOMPLICATED LOWER UTI (CYSTITIS) SINGLE 3G DOSE

AE:

Contra:

Interaction:

Admin: oral - high [ ] in urine