What are the First generation of Cephalosporins?
- Cephalexin (Keflex)
- Cefadroxil (Duricef)
What are the Second generation of Cephalosporins?
- Cefuroxime (Zinacef)
- Cefoxitin (Mefoxin)
- Cefotetan (Cefotan)
- Cefuroxime axetil (Ceftin)
- Cefaclor (Ceclor)
- Cefprozil (Cefzil)
What are the Third Generation Cephalosporins?
- Cefotaxime (Claforan)
- Ceftriaxone (Rocephin)
- Ceftazidime (Fortaz)
- Cefdinir (Omnicef)
- Cefpodoxime (Vantin)
What are the Forth Generation Cephalosporins?
How are most Cephalosporins eliminated?
How are Cefoperazone and Ceftriaxone eliminated?
Any reach good CNS levels?
- - renal elimination
- -biliary tract
- - Only the 3rd generations reach good CNS levels
Which Cephalosprins are good for:
-gram positive activity?
-good anaerobic coverage?
-Borellia bergdorfi infection?
- Which are good for Enterococci, Listeria or MRSA?
- -First generation Cephalosporins ( as you move from 1st to 4th generations you increase in Gram neg activity)
- -Cefoxitin and Cefotetan
- - NONE!!
What are some clinical uses for :
- First generation
- -Surgical prophylaxis
- -Soft tissue infections
- Second generation
- -Intra-abdominal infections
What are the Clinical uses for:
3rd/ 4th generations?
- -pediatric infections (meningitis)
- - Pseudomonas infections
- Cefepime-Very broad spectrum
What are some Cephalosporin Toxcitys?
- - Allergic reactions (minimal cross allergy sensitivity between penicillins and cephalosporins)
- -Disfiram-like reaction--cefamandole or cefoperazone
- -Bleeding Diathesis
- -Phlebitis at the infusion site
- -Biliary Obstruction---Ceftriaxone
What are some Combinations OF BETA LACTAM ANTIBIOTICS WITH BETA LACTAMASE INHIBITORS ???
Clavulanic Acid, Sulbactam,Tazobactam
- -Amoxicillin-Clavulanic Acid
- -Ticarcillin/Clavulanic Acid
What is in the spectrum of COMBINATION OF BETA LACTAM ANTIBIOTICS WITH BETA LACTAMASE INHIBITORS????
- -Broadens spectrum against:
- S. aureus,
- H. influenzae,
- Moraxella catarrhalis,
- Gram negative enteric bacteria
name some OTHER BETA-LACTAM ANTIBIOTICS.
- -Imipenem--administered with cilastatin which inhibits renal inactivation.
These have minimal
susceptability to Beta-Lactamases
What are the spectrums of..
- gram negative organisms including pseudomonas but NOT anaerobes
- very broad spectrum often drugs of last resort for resistant organisms. Not effective against Anaerobes.
What are the Toxicity for OTHER BETA-LACTAM ANTIBIOTICS????
GI, Allergic, Renal, Hepatic, Hematologic, Drug fever, Bacterial or fungal Overgrowth
*Imipenem – rare neurologic reactions
What is VANCOMYCIN's structure like?
What is its mechanism of action?
A complex Gluco-polypeptide, unrelated to other antibiotics
- -Irreversibly inhibits biosynthesis of peptidoglycan polymers in cell wall of dividing gram positive organisms
- -Blocks cell wall synthesis
What are some Mechanisms of Microbial resistance to Vancomycin?
-Mutation of antibiotic binding site (target)
What is Vancomycins Spectrum of action???
-Narrow: Resistant Gram Positive Organisms including: MRSA, enterococci, and pneumococci
What is the Clinical used of Vancomycin?
-Drug of choice for serious infections with resistant gram positive organisms MRSA, PCN resistant pneumococci
-Not as effective for lung infections
-Drug of second choice for Pseudomembranous colitis caused by clostridium difficile
What are the Toxicities of Vancomycin?
- -Auditory – dose related, especially in adults
- -“Red man” syndrome (not allergic) – ameliorated by slow infusion
What is Daptomycin's mechanism?
what is its Antimocorbial action?
-Mechanism of action: Unique, Cidal. Disrupts multiple aspects of bacterial plasma membrane function,
including peptidoglycan synthesis, lipoteichoic acid synthesis, and bacterial membrane potential.
- -Narrow: Gram positive organisms,
- including: Linazolide resistant MRSA
What are some Clinical uses of Daptomycin?
what are some of its adverse effects?
- -Skin and soft tissue infections
- -Endocarditis - (With resistant gram positive infections)
*Transient muscle weakness, myalgias