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List of Cephalosporins
- First generation
- second generation
- third generation
- fourth generation
What is the drug interactions for Cephalosporins?
- PCN & Tetracycline = less effectiveness of PCNs
- PCN & Aminoglycoside = inactivates the Aminoglycosides
What are you looking for with Cephalosporins?
- ASSESS, ASSESS, ASSESS
- Drug effectiveness
- Adverse reactions
What are the adverse reactins for Cephalosporins?
- skin and mucus membranes dry
- respiratory status
- abdomen/GI effects
- abnormal BUN & creatinine
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 !!!
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
What will you assess for with Cephalosporins?
- teaching effectiveness (teach back)
Someone that is allergic to Cephalosporins is most likely to be allergic to ______?
- Do cephalosporins inhibit _______ _________ _________
- Inhibit cell wall synthesis
Cephalosporins are structurally and pharmacologically related to ______
With Cephalosporins the spectrum of coverage broadens with ________
How are the Cephalosporins divided?
into groups according to their antimicrobial activity
History of Cephalosporins
- introduced clinically in 1960s
- similar to PCN in structure and activity
- 4 generations each with its own spectrum of activity
First generation Cephalosporins - names and how given
- cefazolin (Ancef & Kefzol) - IV & PO
- cephalexin (Keftab & Keflex)- PO
what are Cephalosporins used for?
- surgical prophylaxis
- otis media
- strep & staph
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
Pharmacokenetics of Cephalosporins
Well absorbed from GI tract
Metabolized in liver
- excreted by kidneys
- use caution in pregnancy and laction
- cross into breast milk
What happens to clients with impaired renal and liver function?
alters drug matabolism
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
Major distinctions of the 1st generation Cephalosporin
- most effective against gram positive organisms
- distroyed by beta-lactamase
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
Major distinctions of the 3rd generation Cephalosporin
- longer duration of action than 2nd
- even broader spectrum against gram negative
- resistance to beta-lactamase
3rd generation Ceph drug of choice
- Less effective against gram positive
Major distinctions of 4th generation Cephalosporin
- effective in treating septicemia
- effective against many strains of gram negative
- staphyloccus....certain strains