Cephalosporins
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shevyatiwari's
version from
2015-04-18 06:41
Section
| Question | Answer |
|---|---|
| Are not B lactams | F |
| Resistant to B lactamases | T |
| Safe in children | T |
| Pregnancy category C | F, B |
| Low likelihood of congenital malformations if used in 2nd and 3rd trimester | T |
| Excreted in breast milk | T, can cause diarrhoea, candida and skin eruption in infants |
| 4 generations of cephalosporins | F, now 5. |
| First generation include cefadroxil and cefaclor | F, cefadroxil, cefazolin and cephalexin |
| First generation are most active against staph and non enterococcus strep | T |
| MRS, penicillin resistant S pneumoniae, GN's are all susceptible to first generation cephalosporins | F |
| First generations are active against oral anerobes | T, except B fragilis |
| Second generations have increasing GN effect. | T |
| Cephamycins are third generation | F, second |
| Cephamycins are more active than true second generation cephalosporins for H influenzae, M catarrahalis, N meningitidis, N gonorrhea, enterobacteriaceae | F, true cephalosporins are better |
| Cephamycins are active against B fragilis | T |
| Ceftazidime, cefepime, cefoperazone have anti psuedomonal activity | T |
| Cefditoren has activity against psuedomonas | F |
| Ceftazidime has the greatest activity against pseudomonas | T, but not active against S auerus |
| Cefdinir is active against S aureus and S pyogenes | T |
| Cefepime is fourth generation and is effective against B fragilis | F, not effective against B fragilis |
| Fifth generation includee activity against MRSA, VISA, hVISA, VRSA | T, weak for pseudomonas |
| Cefuroxime is best taken on an empty stomach | F, BA increased with food |
| Cefaclor, cephalexin, cefadroxil, cephradine best absorbed on empty stoamch | T |
| First and second generations are excreted hepatobiliary | F, primarily by the kidneys |
| Dose adjustments are needed for first and second generation cephalosporins in renal failure | T |
| Cefoperazone and ceftriaxone undergo hepatic metabolism and excretion | T |
| Half life of most cephalosporins is 6-8 hours | F, only ceftriaxone. Remainder are 0.5-2 hours |
| Ceftaroline has a short half life and is really excreted | T |
| Antibiotic associated colitis is common | F |
| GI toxicity is common | T |
| Mild elevation of LFT's is common and hepatic injury is common | F, liver transaminase increase is common, injury is rare |
| Ceftriaxone is associated with biliary sludge formation | T |
| 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/E | T |
| cefaclor can cause serum sickness like reaction | T, esp in children with otitis media |
| Jarish-Herxheimer reaction can occur in Lyme disease with ceftriaxone | F, with cefuroxime, in up to 29% |
| Local reactions occur in 5% | T |
| Nail changes seen in cephalexin | T |
| Haemolytic anaemia is common | F, rare |
| Cefotetan, ceftriaxone, piperacillin, are all common causes of haemolytic anaemia | T. Cefotean is the most common |
| Hyperprothrombinaemia can occur | F, hypo. |
| Eosinophilia and neutrophilic are not reported S/E | F |
| Neprhotoxicity is not common | T |
| Can interact with ETOH | T -> disulfiram type reaction |
| Cefotetn -> prolonged prothrombin times | T |
| Probenicid -> increased levels | T |
| Co-administration with ahminoglycosides is safe | F, increased nephrotoxicity |
| H2 antihistamines, PPI, oral antacids -> increased ceftriaxone | F, decreased cefditoren |
| No new interactions with the new cephalosporins | |
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