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  1. Structure of Cephalosporins
    Contains a cephim nucleus including beta lactam ring and 2 variable side chains
  2. Cephalomycins have a ____ at position ____
    methoxy group, 7
  3. Cephalosporin MOA (1)
    Binds to and inhibits Transpeptidase.
  4. ____________ crosslink peptides found in the peptidoglycan cell wall, thereby connecting parallel chains to each other.
  5. cephalosporin MOA (2)
    bind to penicillin binding proteins (PBPs)
  6. cephalosporin MOA (3)
    Induces cell death by lytic and nonlytic mechansims
  7. Cephalospoirn Resistance (3 types)
    1) enzymatic degradation 2) Decreased affinity of PBPs for b-lactams 3) Inability of b-lactams to access site of action
  8. Cephalosporin SE
    diarrhea, alcohol intolerance
  9. Cephalosporin AE
    hyprsensitivity, nephrotoxicity
  10. First-generation effective against
    Gram positive activity and modest Gram-negative activity
  11. Second-generation effective against
    Less Gram positive activity than first-generation, but improved Gram negative activity (but not as good as third-generation)
  12. Third-generation effective against
    Some Gram positive activity and enhanced Gram negative activity, including the Enterobacteriaceae and Pseudomonas aeruginosa (Ceftazidime
  13. Fourth-generation effective against
    Similar to third-generation, but more resistant to b-lactamases
  14. All cephalosporins lack activity against ___________
    enterococci, Listeria monocytogenes, Legionella spp., MRSA
  15. cefazolin is a ____ generation delivered _________
    first, IM or IV
  16. Cephalexin is a ____ generation delivered _________
    first, oral
  17. First-generation cephalosporins are useful against _______
    Streptococci (except for penicillin-resistant strains)
  18. First-generation cephalosporins are only moderately useful against _______
    Some enteric Gram-negative rods
  19. _________ are the most commonly used antibiotics in hospitals, why?
    First-Generation Cephalosporins. Inexpensive and low SE
  20. Cefoxitin is a ____ generation delivered _________
    2nd, by injection or orally
  21. Cefprozil is a ____ generation delivered _________
    2nd, orally
  22. Cefuroxime is a ____ generation delivered _________
    2nd, by injection or orally
  23. Cefotetan is a ____ generation delivered _________
    2nd, by injection
  24. second-generation cephalosporins are useful against _______and______
    Escherichia coli, Haemophilus influenzae
  25. second-generation cephalosporins are only moderately useful against _______
    Streptococci, Staphylococci
  26. _________and_________also have activity against anaerobes, especially Bacteroides fragilis and other Bacteroides species
    Cefoxitin and Cefotetan
  27. cephalosporins with an N-methylthiotetrazole side chain, such as ______, have additional side effects. What are they? (2)
    1)inhibited vitamin K production, leading to bleeding 2) Alcohol intolerance
  28. acetylaldehyde poisonin symptoms include (4)
    1)flushed and scarlet face, 2)vasodilation over whole body, 3)intense throbbing in head and neck with pulsating headache, 4)nausea & vomiting
  29. Cefotaxime is a ____ generation delivered _________
    3rd, injection
  30. Cefdinir is a ____ generation delivered _________
    3rd, oral
  31. Ceftrixone is a ____ generation delivered _________
    3rd, injection
  32. Ceftazidime is a ____ generation delivered _________
    3rd, injection
  33. third-generation cephalosporins are useful against? (4)
    Steptococci, enteric Gram-negative rods, Neisseria gonorrhoeae, Staphylococcus aureus
  34. although it lacks significant gram + activity, ceftazidime is useful against _____
    Pseudomonas aeruginosa
  35. the major adverse effect with 3rd generation cephalosporins is __________
    strong association with C diff associated diarrhea
  36. Cefepime is a ____ generation delivered _________
    fourth, injetion
  37. A benefit 4th generation has over 3rd is _________
    more resistant to some beta lactamases
  38. T/F fourth-generation cephalosporins are useful against the same as third generation.
  39. carbapenams are similar to cephalosporins in that they?
    Have a beta lactam ring
  40. Imipenem is a ____ delivered _________
    carbapenem, injection
  41. imipenem is hydrolyzed by _______
  42. imipenem is often combined with ___________
  43. imipenem inhibits cell wall synthesis by
    binding to PBPs
  44. meropenem is similar to imipenem except? (4)
    1) Does not require co-administration with Cilastatin. 2) Lower risk of seizures 3) May be effective against Imipenem-resistant Pseudomonas aeruginosa.
  45. 4) Less activity against Gram-negative cocci
  46. aztreonam is a ____ delivered _________
    monobactam, injection
  47. aztreonam binds to PBP inducing?
    formation of long filamentous bacteria
  48. aztreonam has excelent activity against ________ , _______and __________
    Enterobacteriaceae, P. aeruginosa, and H. influenzae
  49. _________appears to be suitable for patients with penicillin hypersensitivity
  50. the beta lactamase inhibitors are:
    clavulanic acid, sulbactam, tazobactam
  51. clavulanic acid is administered ______ and combined with _____
    orally or injection, amoxicillin or ticarcillin
  52. sulbactam is administered ______ and combined with _____
    by injection, ampicillin
  53. tazobactam is administered ______ and combined with _____
    by injection, piperacillin
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