Cephalosporins interaction

Whether other aminoglycosides or cephalosporins interact similarly is uncertain, but the possibility should be borne in mind. Risk factors for this interaction ate said to include raised aminoglycoside trough levels, decreased albumin, male gender, advanced age, increased length of treatment, liver disease or aseites, and some other diseases, including... 

Bohm N, Crosby B. Hemarthrosis in a patient on warfarin receiving ceftaroUne a case report and brief review of cephalosporin interactions with warfarin. Ann Pharmacother 2012 46 el9. 

The interaction of acid chlorides (167 X = Cl) with imines in the presence of bases such as triethylamine may involve prior formation of a ketene followed by cycloaddition to the imine, but in many cases it is considered to involve interaction of the imine with the acid chloride to give an immonium ion (168). This is then cyclized by deprotonation under the influence of the base. Clearly, the distinction between these routes is a rather fine one and the mechanism involved in a particular case may well depend on the reactants and the timing of mixing. Particularly important acid chlorides are azidoacetyl chloride and phthalimidoacetyl chloride, which provide access to /3-lactams with a nitrogen substituent in the 3-position as found in the penicillins and cephalosporins. 

Discuss uses, general drug action, adverse reactions, contraindications, precautions, and interactions associated with the cephalosporins. 

Snyder NJ, Tabas LB, Berry DM, Duckworth DC, Spry DO and Dantzig AH. Structure-activity relationship of carbacephalosporins and cephalosporins antibacterial activity and interaction with the intestinal proton-dependent dipeptide transport carrier of Caco-2 cells. Antimicrob Agents Chemother 1997 41 1649-57. 

The antibiotic activity of certain (3-lactams depends largely on their interaction with two different groups of bacterial enzymes. (3-Lactams, like the penicillins and cephalosporins, inhibit the DD-peptidases/transpeptidases that are responsible for the final step of bacterial cell wall biosynthesis.63 Unfortunately, they are themselves destroyed by the [3-lactamases,64 which thereby provide much of the resistance to these antibiotics. Class A, C, and D [3-lactamases and DD-peptidases all have a conserved serine residue in the active site whose hydroxyl group is the primary nucleophile that attacks the substrate carbonyl. Catalysis in both cases involves a double-displacement reaction with the transient formation of an acyl-enzyme intermediate. The major distinction between [3-lactamases and their evolutionary parents the DD-peptidase residues is the lifetime of the acyl-enzyme it is short in (3-lactamases and long in the DD-peptidases.65-67... 

Now we turn to a discussion of the influence of a-substitution at C(6) or C(7) on the chemical reactivity of the lactam ring (Table 5.4,B). This substitution has been introduced mainly to improve lactamase stability (see Sect. 5.2.2.2). The insertion of an additional a-substituent at C(6) or C(7) of penicillins or cephalosporins, respectively, has a relatively small effect on the rate of base hydrolysis [82] [83], 6a-Methoxypenicillin is hydrolyzed at a rate that is approximately half that observed for the unsubstituted parent penicillin. This decrease is due mainly to unfavorable steric interaction between the... 

Drugs that may interact include cephalosporins, nitroglycerin, penicillins, and salicylates. 

Agents that may interact with cephalosporins include ethanol, aminoglycosides, anticoagulants, polypeptide antibiotics, probenecid, antacids, H2antagonists, iron... 

Uses Infxns of the resp tract, skin, bone, urinary tract Action 3rd-gen cephalosporin -1- cell wall synth Dose Adults. 400 mg PO daily-bid Peds. 8-20 mg/kg/d PO daily—bid -1- in renal impair Caution [B, +] Contra Cephalosporin allergy Disp Susp SE N/V/D, flatulence, abd pain Interactions t Nqjhrotox W/ aminoglycosides, loop diuretics t effects W/ nifedipine, probenecid EMS t Risk of nephrotox w/ loop diuretics monitor for signs of electrolyte disturbances and hypovolemia d/t D monitor pt for super Infxn OD May cause N/V/D, Szs, muscles spasms symptomatic and supportive... 

Takeda M, Babu E, Narikawa S, et al. Interaction of human organic anion transporters with various cephalosporin antibiotics. Eur J Pharmacol 2002 438 137-142. 

---