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12 Cards in this Set
- Front
- Back
what are the fourth generation cephalosporins
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cefepime (P)
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what allows cephalosporins greater structural diversity and stability?
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2-3 R groups make it more stable to beta lactamase and less allergenic
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what are the 1st generation cephalosporins?
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cephalexin(O)
cefazolin (P) |
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what are the second generation cephalosporins
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cefprozil (O)
cefuroxime (O & P) cefotetan (P) |
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what are the third generation cephalosporins
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ceftriaxone
ceftazidime (P) cefdiner (O) cefpodoxime (O) |
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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 |
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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 |
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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 |
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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 |
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Vancomycin
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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 |
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Bacitracin
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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 |
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Fosfomycin
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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 |