study about Cephalosporin

 

Cephalosporin

Pronunciation: seh-fuh-low-spaw-ruhn

Learn the five generations of

cephalosporin in one carousel

Try this before start

   ·    Do you think the following about

      cephalosporin are true?

   · The later the generation, the

      broader the spectrum of activities.

  ·    The later the generation, the less

   adverse effects will it cause.

What to learn?

  ·    Five generations

Ø  Drug example

Ø  Spectrum of activities

  ·    Pharmacokinetics

  ·    Key nursing notes

  ·    TL;DR

1^St Generation:-

·    Drug: Cephalothin, Cefazolin

·    Spectrum: Most gram-positive cocci (including penicillinase- producing staphylococci).

·    Structure:

Cephalothin	Cefazolin

2^nd Generation:-

·    Drug: Cefuroxime, Cefoxitin, Cefotentan

·    Spectrum: Less active against staphylococci, but greater activities against gram-negative bacilli.

·    Structure:

Cefuroxime	Cefoxitin	Cefotentan

3^rd Generation:-

·    Drug: Cefotaxime, Ceftriaxone

·    Spectrum: Broad spectrum with Gram+, Gram- and anaerobe activities; but less active against most Gram+ when competed to 1^st generation.

·    Structure:

Cefotaxime	Ceftriaxone

3^rd Generation&  pseudomonas :-

·    Drug: Ceftazidime

·    Spectrum: Extra spectrum of activities covering Pseudomonas aeruginosa.

·    Structure:

Ceftazidime

4^th Generation:-

·    Drug: Cefepime

·    Spectrum: similar activities as 3^rd generation with Pseudomonas coverage; also active against some ceftazidime-resistant isolates.

Structure:

Cefepime

5^th Generation:-

·    Drug: Ceftaroline

·    Spectrum: Extra activities against MRSA, and vancomycin-intermediate Staphylococcus aureus (VISA).

·Structure:

Ceftaroline

Pharmacokinetics

·  ·   Most parenteral cephalosporins (except cefazolin and ceftriaxone) have short serum half-live and should be administered at Q4H.

·    · All of the cephalosporins except ceftriaxone require dose modification in the presence of severe renal failure.

·    · 1^st and 2^nd generation has poor CSF penetration ability, and should NOT be used to treat CNS infection.

·    · 20-30% bound to plasma proteins.

·    · 80-90% excreted unchanged in urine.

·   · Well distributed in body fluids.

·    · Cross placenta and secreted in breast milk.

Key nursing notes 

·    Avoid alcohol to prevent a disulfiram reaction.

·    Monitor for signs of rash and super- infection (overgrowth on tongue; vaginal itching or discharge; loose or foul-smelling stool)

·    Take with food. Refrigerate suspension; discard any drug after 14 days.

·    Complete the full course of the medication, even if you feel better. 

TL; DR

·    Cephalosporin is a commonly used beta-lactam drug for treating infection.

·    There are 5 generations available, and they have very different spectrum of activities and clinical uses.

·    Most cephalosporin require renal adjustment.

·    Avoid alcohol while on cephalosporin.

·    Monitor for signs of rash and superinfection.