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List of Cephalosporins
- First generation
- second generation
- third generation
- fourth generation
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What is the drug interactions for Cephalosporins?
- PCN & Tetracycline = less effectiveness of PCNs
- PCN & Aminoglycoside = inactivates the Aminoglycosides
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What are you looking for with Cephalosporins?
- ASSESS, ASSESS, ASSESS
- Drug effectiveness
- Adverse reactions
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What are the adverse reactins for Cephalosporins?
- skin and mucus membranes dry
- respiratory status
- abdomen/GI effects
- abnormal BUN & creatinine
- Phlebitis
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Nursing Interventions of Cephalosporins
- GET THE CULTURE
- observe for reactions
- have epinephrine on hand
- give with water
- monitor urine output
- monitor for bleeding if dosage large
- MONITOR WBC !!!
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What will you teach cleint taking Cephalosporins?
- take full course, side effects, storage, s/s,
- infection, take on empty stomach, 8 oz water,
- no fruit juices, milk or soda
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What will you assess for with Cephalosporins?
- Infection
- superinfection
- teaching effectiveness (teach back)
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Someone that is allergic to Cephalosporins is most likely to be allergic to ______?
PCN
- Do cephalosporins inhibit _______ _________ _________
- Inhibit cell wall synthesis
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Cephalosporins are structurally and pharmacologically related to ______
PCN
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With Cephalosporins the spectrum of coverage broadens with ________
each generation
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How are the Cephalosporins divided?
into groups according to their antimicrobial activity
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History of Cephalosporins
- introduced clinically in 1960s
- similar to PCN in structure and activity
- 4 generations each with its own spectrum of activity
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First generation Cephalosporins - names and how given
- cefazolin (Ancef & Kefzol) - IV & PO
- cephalexin (Keftab & Keflex)- PO
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what are Cephalosporins used for?
- surgical prophylaxis
- URIs
- otis media
- strep & staph
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What is mechanism of action for Cephalosporins?
- Both bacteriostatic and bactericidal
- Depends on dose and drug
- Interferes with cell wall synthesis
- Cell swells and ruptures from osmotic pressure inside cell
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Pharmacokenetics of Cephalosporins
Well absorbed from GI tract
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Metabolized in liver
- excreted by kidneys
- use caution in pregnancy and laction
- cross into breast milk
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What happens to clients with impaired renal and liver function?
alters drug matabolism
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Adverse effects of Cephalosporins
- Similar to PCN
- Allergic reactions most common
- Headache, anal/genital itching
- Skin rash common
- GI Distress..pseudomembranous colitis
- C-diff often reported with ceph’s
- Nephrotoxicity in early ceph generations
- Not so much in the newer drugs
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Major distinctions of the 1st generation Cephalosporin
- most effective against gram positive organisms
- distroyed by beta-lactamase
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Major distinctions of the 2nd generation Cephalosporin
- more potent, more resistant to beta-lactamase
- broader spectrum against gram negative organisms than 1st generation ceph's
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Major distinctions of the 3rd generation Cephalosporin
- longer duration of action than 2nd
- even broader spectrum against gram negative
- resistance to beta-lactamase
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3rd generation Ceph drug of choice
- Pseudomonas
- Salmonella
- Less effective against gram positive
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Major distinctions of 4th generation Cephalosporin
- effective in treating septicemia
- effective against many strains of gram negative
- e-coli
- klebsiella
- streptococci
- staphyloccus....certain strains
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