Ch. 8 Cephalosphorins
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| describe the difference between cephalosporins and penicillins in terms of how they work | cephs have similar cell wall inhibition activity as penicillins, but are inherently more resistant to baeta lactamases than penicillins because of a slight difference in structure.
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| what bugs are particularly sensitive to first generation cephalosporins? | "Peck": proteus, E.Coli, Klebsiella, PLUS gram positives
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| what bugs are particularly sensitive to the second generation cephalosporins? | "HenPeck": Haemophilus influenzae, Enterobacter Aerogenes, Neisseria, Proteus, E.Coli, Klebsiella
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| what bugs are particularly sensitive to third generation cephalosporins? | "HenPeckPlus": haemophilus influenzae, Enterobacter Aerogenes, Neisseria, Proteus, E.Coli, Klebsiella, PLUS Enterics (intestinal bacteria)
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| what bugs are particularly sensitive to fourth generation cephalosporins? | pseudomonas
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| what bugs are particulary sensitive to fifth generation cephalosporins? | MRSA Plus complicated mixed gram positive and gram negative infections
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| as you go from the first to the fifth generation of cephalosporins, what happens to the ability to fight gram negative organisms? | it increases
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| name a first generation cephalosporin and what it is used for | Cefozalin- one of the two drugs of choice for skin infections, including cellulitis. It has excellent penetration into bone.
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| list the second generation cephalosporins | CefaMANdole, CeFOXitin, CeFURoximine, CefoTETan (many are all about gender related issues)
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| what is the significance of Fefamandole? | it is a second generation cephalosporin no longer used in the US today, but it is used in many places around the world. it causes a disulfuram-like reaction when ingested with alcohol
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| briefly describe the metabolism of alcohol | ethanol goes to acetaldehyde via alcohol dehydrogenase, acetaldehyde goes to acetate via acetaldehyde dehydrogenase
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| why are asians particularly susceptible to non-drug induced disulfuram-like reactions? | because they lack one of the isoenzymes of acetaldehyde dehydrogenase
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| list some drugs which cuase disulfiram like reactions when ingested with alcohol | metronidazole, chloramphenicol, isoniazid, nitrofurantoin, sulfamethaxazole, sulfisoxazole,cefoperazone, cefotetan, cefamandole, griseofulvin, disulfuram, nitroglycerin, isosorbide dinitrate, tolbutamide, chlorpropamide, glyburide, glipizide, tolazamide,
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| what is unique about cefuroxime? | it crosses the blood brain barrier
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| what is unique about cefoxitin | it's especially active against anerobes, so it is often used in treatment of pelvic inflammatory disease, and intra-abdominal infections
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| list the third generation cephalosporins and why they are important | cefTAzidime, cefoTAxime, cefTRIAxone, often used for tough organisms or infections, so they have TOUHG ASSASSINS
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| what is special about ceftriaxone? | commonly used in infected patients who also have renal problems; this is because ceftriaxone, unlike other cephalosporins, is not renally excreted. instead, it is excreted with the bile.
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| what third generation cephalosporin is active against pseudomonas aeruginosa? | ceftazidime
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| what is special about the fourth generation cephalosporins and what are they/ | they are specifically effective agianst pseudomonas aeruginosa. they include cefepime and cefpirome
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| what is the fifth generation cephalosporin? | ceftaroline
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