Cephalosporins on the NCLEX
Cephalosporin generations, alcohol interaction, cross-reactivity, common uses.
Cephalosporins are organized by generation. Higher generations cover more gram-negative. NCLEX tests cefazolin uses, ceftriaxone for many infections, and disulfiram-like reaction.
Generations
1st (cefazolin, cephalexin), gram-positive, surgical prophylaxis. 2nd (cefuroxime, cefoxitin), broader. 3rd (ceftriaxone, ceftazidime), gram-negative, meningitis, gonorrhea, pyelonephritis. 4th (cefepime), pseudomonas. 5th (ceftaroline), MRSA.
Disulfiram-like reaction
Cefotetan, cefoperazone with alcohol, flushing, tachycardia, hypotension. Counsel patients to avoid alcohol 72h after.
Cross-reactivity
Penicillin allergy: low actual cross-reactivity. Avoid in severe penicillin anaphylaxis.
Ceftriaxone caution
Don't give with calcium-containing IV solutions in neonates, precipitation, fatal.
Frequently asked
Cefazolin for what?
Surgical prophylaxis. Skin/soft tissue. MSSA infections.
Ceftriaxone in meningitis?
Yes, empiric coverage with vancomycin for bacterial meningitis.
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