Classify the following drugs (cefazolin, cephalexin, ceftazidime, cefixime, cefaclor, ceftriaxone, cefepime, cefuroxime, cefpirome, cefotaxime, ceftobiprol, cefoperazone)

7. Classify the following drugs (cefazolin, cephalexin, ceftazidime, cefixime, cefaclor, ceftriaxone, cefepime, cefuroxime, cefpirome, cefotaxime, ceftobiprol, cefoperazone)

Generation	Oral	Parenteral
1generation
2 generation
3 generation
4 generation
5 generation

8. Define cephalosporins (Cefazolin, cephalexin, ceftazidime, cefixime):

Drug	Route of administration		Resistance to cephalosporinase	Activity against Pseudomonas aeruginosa	Penetration into CSF
Drug	Parenteral	Oral	Resistance to cephalosporinase	Activity against Pseudomonas aeruginosa	Penetration into CSF
А	+	-	+	+	+
B	-	+	-	-	-
C	+	-	-	-	-
D	-	+	+	+	+/-

9. Describe cephalosporins by selecting the correct answer:

A. Cefazolin: has spectrum of activity (broad, narrow), is (destroyed, not destroyed) by cephalosporinase, is more active against (G+/G - flora), is administered (parenterally, orally).

B. Ceftriaxone: is (active, inactive) against the Pseudomonas aeruginosa, acts more strongly (on Gr+/Gr - flora), is injected (3 times a day/ 1 time a day), (passes, does not passes) through the BBB).

C. Cefepime: has (wide, very wide, narrow) spectrum, is (active, inactive) against Pseudomonas aeruginosa, is (susceptible, not susceptible) to β-lactamases, is used (parenterally, enterally).

10. Fill in the table, specify the possible indications for the use of cephalosporins:

Indications	Cephalexin	Cefazolin	Cefixime	Ceftriaxone	Ceftazidime
Respiratory infections
Meningitis infections
Intestinal biliary infections
Urinary infections
Skin and soft tissue infections
Nosocomial infections caused by Pseudomonas aeruginosa

11. Case problem 1.10 minutes after the injection of penicillin, the patient fainted. The doctor saw that mucous membranes and skin were pale with cyanotic shade, breathing was weak, superficial, pupils dilated and poorly reacted to light. Pulse was thready, 102 beats/min, heart tones were deaf. BP 70/40 mm Hg. Specify the diagnosis and assistance measures

12. Case problem 2.What drug (amoxicillin, cefixim, azithromycin, erythromycin) should be prescribed to a patient with streptococcal tonsillitis and allergy to benzylpenicillin?

13. Explain the mechanism of action of macrolides by choosing the correct answer:

They combine with ( 50S/ 30 S) ribosome subunits, translocase activity (↓ / ↑), bacterial protein synthesis(↓ /.↑),type of action (bacteriostatic / bactericidal).

14. Fill in the table., specify indications for use:

Spectrum of action	Erythromycin	Clarithromycin	Azithromycin
Cocci
Clostridia, C. diphtheriae and Listeria Listeria,
Treponema and Borrelia
Mycoplasma
Chlamydiae
Helicobacter pylori
The frequency of administration

Infections of respiratory organs (pharyngitis, tonsillitis, bronchitis, pneumonia) caused by cocci; chancroid; leptospirosis; gastric ulcer; atypical pneumonia caused by intracellular pathogens; infections of the urinary system and genital infections caused by chlamydia.

15. Complete the statements:

A. Erythromycin is not used for the treatment of intestinal infections, because...

B. The concentration of azithromycin in the focus of inflammation is higher than the concentrations in the blood, because

B. Macrolides are not used for the treatment of neuroinfection, because …

G. Macrolides are reserve antibiotics penicillins, because....

16. Determine the antibiotics:

А. β-lactam antibiotic has ultrawide spectrum. It is effective against flora resistant to penicillins and cephalosporins. resistance of microorganisms to him develops slowly . It passes through BBB and is excreted by the kidneys unchanged. It is used parenterally in severe infections, including urinary tract diseases. It is a reserve antibiotic.

B.It isβ-lactam antibiotic. It acts bactericidal, inhibiting cell wall synthesis. It is resistant to β-lactamases produced by gram-negative bacteria. It is active against gram-negative flora, but does not work against gram-positive bacteria and anaerobes . It is used parenterally in severe infections of the urinary tract, respiratory system, skin.

C. Antibiotic inhibits protein synthesis by binding to 50S ribosomal subunit. It is absorbed from the gastrointestinal tract and enters the white blood cells. He penetrates well into the area of inflammation, and lingers there for 5-7 days. It is applied once a day.

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