Cephalosporins Overview
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Questions and Answers

What is the primary mechanism of action of cephalosporins?

  • Inhibition of RNA synthesis
  • Inhibition of mucopeptide synthesis in the bacterial cell wall (correct)
  • Inhibition of DNA synthesis
  • Inhibition of protein synthesis
  • Why are cefoxitin and cefotetan usually included with the cephalosporins?

  • For their antifungal capabilities
  • Because of their chemical similarity to penicillins (correct)
  • Due to their antiviral properties
  • Because they inhibit RNA polymerase
  • Which classification system is used to divide cephalosporins into five generations?

  • Chemical structure
  • Clinical utility
  • Spectrum of activity
  • Order of development (correct)
  • What is the primary reason for grouping cephamycins and carbacephem with cephalosporins?

    <p>Chemical similarity</p> Signup and view all the answers

    When are cephalosporins most effective against bacteria?

    <p>When antibiotic concentrations exceed the pathogen's MIC for at least 50% of the dosing interval</p> Signup and view all the answers

    What is the bactericidal effect of cephalosporins dependent on?

    <p>Organism susceptibility and tissue concentration</p> Signup and view all the answers

    What is the recommended timing for taking Ceftibuten to ensure proper absorption?

    <p>1 hour before or 2 hours after meals</p> Signup and view all the answers

    Why should cefuroxime axetil tablets and suspension formulations not be used interchangeably?

    <p>They have different bioavailabilities</p> Signup and view all the answers

    What precaution should patients with phenylketonuria take regarding cefprozil?

    <p>Avoid it as it contains phenylalanine</p> Signup and view all the answers

    Why must suspensions and antibiotic solutions be shaken before measurement?

    <p>To disperse or dissolve drug particles</p> Signup and view all the answers

    What should a patient do if severe diarrhea occurs while taking antibiotics?

    <p>Contact the prescriber before starting any treatment</p> Signup and view all the answers

    How can diabetics taking cephalosporins avoid false positives on urine testing for glucose?

    <p>Use blood glucose monitoring</p> Signup and view all the answers

    Which cephalosporin should be avoided in neonates at risk for hyperbilirubinemia?

    <p>Ceftriaxone</p> Signup and view all the answers

    What is the main route of excretion for most cephalosporins?

    <p>Kidney</p> Signup and view all the answers

    Which generation of cephalosporins does not readily enter the CSF even with meningeal inflammation?

    <p>First generation</p> Signup and view all the answers

    What is a notable characteristic of ceftriaxone metabolism?

    <p>Mainly renal excretion</p> Signup and view all the answers

    Which cephalosporin is a prodrug metabolized to active metabolites?

    <p>Cefuroxime</p> Signup and view all the answers

    Why is ceftriaxone contraindicated in neonates younger than 28 days with hyperbilirubinemia?

    <p>Risk of CNS toxicity</p> Signup and view all the answers

    Which cephalosporin has high concentrations found in bile?

    <p>Cefazolin</p> Signup and view all the answers

    What characteristic makes cefuroxime and cefpodoxime unique among cephalosporins?

    <p>Metabolized to active metabolites</p> Signup and view all the answers

    What is unique about the bioavailability of suspension and tablet formulations of cefpodoxime proxetil and cefixime?

    <p>Differences in bioavailability exist between them</p> Signup and view all the answers

    Which statement about cephalosporins excretion is correct?

    <p>Renal impairment may decrease half-life.</p> Signup and view all the answers

    Which patient population might experience serum sickness–like reactions when treated with cephalosporins?

    <p>Patients with impaired renal function</p> Signup and view all the answers

    What is a common delayed reaction seen with some cephalosporins, usually occurring following a second course of therapy?

    <p>Serum sickness–like reactions</p> Signup and view all the answers

    Which of the following cephalosporins is not detected in breast milk?

    <p>Cefdinir</p> Signup and view all the answers

    Under what condition might seizure activity be induced by some parenteral cephalosporins?

    <p>In the presence of renal impairment</p> Signup and view all the answers

    Which age group has safety and efficacy not been established for when taking cefuroxime?

    <p>Children younger than 3 months</p> Signup and view all the answers

    Which condition is associated with an increased risk of coagulation abnormalities when administering certain cephalosporins?

    <p>Patients with vitamin K synthesis impairment</p> Signup and view all the answers

    Which adverse reaction is more likely to occur in patients who receive cefaclor?

    <p>Serum sickness–like reactions</p> Signup and view all the answers

    What should be done if a patient develops anemia within 2 to 3 weeks of starting cephalosporin therapy?

    <p>Evaluate for potential drug involvement and consider stopping the drug</p> Signup and view all the answers

    Which oral cephalosporins are associated with a high incidence of non–C.difficile diarrhea?

    <p>Cefdinir, cefixime, and cefpodoxime</p> Signup and view all the answers

    What potential adverse reaction may occur with ceftriaxone use that clears upon discontinuation of the drug?

    <p>Biliary sludge or pseudolithiasis</p> Signup and view all the answers

    Which group of bacteria is intrinsically resistant to cephalosporins?

    <p>Enterococcus species</p> Signup and view all the answers

    Which of the following Enterobacteriaceae is commonly isolated in hospital settings and resistant to first generation cephalosporins?

    <p>Serratia species</p> Signup and view all the answers

    Which second generation cephalosporin has limited activity against anaerobes like Bacteroides fragilis?

    <p>Cefoxitin</p> Signup and view all the answers

    Which bacteria are third generation cephalosporins generally active against?

    <p>Escherichia coli</p> Signup and view all the answers

    Why is the use of third generation cephalosporins discouraged for certain uncommon gram-negative pathogens?

    <p>Due to poor ability to detect inducible beta-lactamases</p> Signup and view all the answers

    Which of the following bacteria are fourth generation cephalosporins like cefepime resistant against?

    <p>Pseudomonas aeruginosa</p> Signup and view all the answers

    What is the notable feature of ceftaroline, a fifth generation cephalosporin, compared to third generation cephalosporins?

    <p>It has excellent activity against MRSA</p> Signup and view all the answers

    Which mechanism of resistance is common among bacteria against cephalosporins?

    <p>'<em>Comma separated</em> beta-lactamase production and altered target sites</p> Signup and view all the answers

    Which drug can increase the risk for nephrotoxicity when interacting with cephalosporins?

    <p>Loop diuretics</p> Signup and view all the answers

    Which cephalosporin is recommended as the treatment for gonorrhea because it is resistant to most other antibiotics?

    <p>Ceftriaxone</p> Signup and view all the answers

    What is the advantage of first generation cephalosporins for penicillin-allergic individuals?

    <p>Fairly narrow spectrum</p> Signup and view all the answers

    Why are second generation oral cephalosporins preferred for skin and tissue infections over third generation?

    <p>Higher activity against gram-positive cocci</p> Signup and view all the answers

    Which second generation cephalosporin is not recommended for otitis media in current guidelines due to susceptibility to beta-lactamases?

    <p>Cefaclor</p> Signup and view all the answers

    What is a key consideration in selecting third generation cephalosporins for infections?

    <p>Extended gram-negative spectrum</p> Signup and view all the answers

    Which cephalosporin can be dosed once daily for most infections due to its long half-life?

    <p>Cefixime</p> Signup and view all the answers

    What is a common side effect associated with some cephalosporins that must be distinguished from C.difficile infection?

    <p>Diarrhea</p> Signup and view all the answers

    Which oral cephalosporin has one of the lowest palatability ratings of all suspensions tested?

    <p>Cefpodoxime proxetil</p> Signup and view all the answers

    Why should patients who are receiving protracted courses of cefotetan be monitored for prothrombin time (PT)?

    <p>To monitor clotting time</p> Signup and view all the answers

    What symptom may indicate the need for C.difficile testing in a patient on cephalosporins?

    <p>Watery, unformed stools</p> Signup and view all the answers

    For which type of infection are third generation parenteral cephalosporins like ceftriaxone and cefotaxime commonly used empirically?

    <p>Serious infections presumed to be caused by resistant pneumococci</p> Signup and view all the answers

    What must be done if renal impairment is indicated in a patient on certain cephalosporins?

    <p>Decrease the dosage according to the schedule</p> Signup and view all the answers

    Which parenteral cephalosporin may require administration of exogenous vitamin K if the prothrombin time (PT) is prolonged?

    <p>Cefotetan</p> Signup and view all the answers

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