shevyatiwari's version from 2015-04-18 06:41


Question Answer
Are not B lactamsF
Resistant to B lactamasesT
Safe in childrenT
Pregnancy category CF, B
Low likelihood of congenital malformations if used in 2nd and 3rd trimesterT
Excreted in breast milkT, can cause diarrhoea, candida and skin eruption in infants
4 generations of cephalosporinsF, now 5.
First generation include cefadroxil and cefaclorF, cefadroxil, cefazolin and cephalexin
First generation are most active against staph and non enterococcus strepT
MRS, penicillin resistant S pneumoniae, GN's are all susceptible to first generation cephalosporinsF
First generations are active against oral anerobesT, except B fragilis
Second generations have increasing GN effect. T
Cephamycins are third generationF, second
Cephamycins are more active than true second generation cephalosporins for H influenzae, M catarrahalis, N meningitidis, N gonorrhea, enterobacteriaceaeF, true cephalosporins are better
Cephamycins are active against B fragilisT
Ceftazidime, cefepime, cefoperazone have anti psuedomonal activityT
Cefditoren has activity against psuedomonasF
Ceftazidime has the greatest activity against pseudomonasT, but not active against S auerus
Cefdinir is active against S aureus and S pyogenesT
Cefepime is fourth generation and is effective against B fragilisF, not effective against B fragilis
Fifth generation includee activity against MRSA, VISA, hVISA, VRSAT, weak for pseudomonas
Cefuroxime is best taken on an empty stomachF, BA increased with food
Cefaclor, cephalexin, cefadroxil, cephradine best absorbed on empty stoamch T
First and second generations are excreted hepatobiliaryF, primarily by the kidneys
Dose adjustments are needed for first and second generation cephalosporins in renal failureT
Cefoperazone and ceftriaxone undergo hepatic metabolism and excretionT
Half life of most cephalosporins is 6-8 hoursF, only ceftriaxone. Remainder are 0.5-2 hours
Ceftaroline has a short half life and is really excretedT
Antibiotic associated colitis is commonF
GI toxicity is commonT
Mild elevation of LFT's is common and hepatic injury is commonF, liver transaminase increase is common, injury is rare
Ceftriaxone is associated with biliary sludge formationT
Cross reactivity with penicillins is approx 5-10%T. Should be avoided if type 1 or severe type 4 reactions occur with penicillins
Candida overgrowth, haematopoietic changes, mental and sleep disturbances are S/ET
cefaclor can cause serum sickness like reactionT, esp in children with otitis media
Jarish-Herxheimer reaction can occur in Lyme disease with ceftriaxoneF, with cefuroxime, in up to 29%
Local reactions occur in 5% T
Nail changes seen in cephalexinT
Haemolytic anaemia is commonF, rare
Cefotetan, ceftriaxone, piperacillin, are all common causes of haemolytic anaemiaT. Cefotean is the most common
Hyperprothrombinaemia can occurF, hypo.
Eosinophilia and neutrophilic are not reported S/EF
Neprhotoxicity is not commonT
Can interact with ETOHT -> disulfiram type reaction
Cefotetn -> prolonged prothrombin times T
Probenicid -> increased levelsT
Co-administration with ahminoglycosides is safeF, increased nephrotoxicity
H2 antihistamines, PPI, oral antacids -> increased ceftriaxoneF, decreased cefditoren
No new interactions with the new cephalosporins

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