Cephalosporins - 3rd Generation - Ceftriaxone, Ceftazidime; Do not prescribe without knowing this!! скачать в хорошем качестве

Cephalosporins - 3rd Generation - Ceftriaxone, Ceftazidime; Do not prescribe without knowing this!!

Welcome to Medicine Beyond Harrison. Third Generation Cephalosporins are the "workhorses" of modern medicine, but they are not created equal. In this lecture, we perform a deep dive comparison between the community superstar, Ceftriaxone, and the anti-pseudomonal specialist, Ceftazidime. We move beyond the textbook "no renal adjustment" rule for Ceftriaxone to discuss Augmented Renal Clearance (ARC) and Hypoalbuminemia in critical illness. We also dissect the specific neurotoxicity risks of Ceftazidime and why it has largely been replaced by Cefepime in many formularies. 📝 Topics Covered in This Video: The Big Picture: Differentiating the "Community Workhorse" from the "Anti-Pseudomonal" agent. Ceftriaxone Pharmacology: Why protein binding (90%) matters in the ICU and when to escalate to 2g q12h. Drug Interactions: The lethal Calcium-Ceftriaxone precipitate and the overlooked Lansoprazole-induced arrhythmia risk. Spectrum Analysis: Why Ceftriaxone fails against Pseudomonas and Enterococcus, and why Ceftazidime fails against Gram-positives. Ceftazidime Toxicity: Understanding the high risk of neurotoxicity (delirium/seizures) in renal failure. Clinical Dosing: Specific protocols for Meningitis, Endocarditis, and Obesity. Stewardship: Avoiding the induction of AmpC Beta-Lactamases (SPICE organisms). References & Further Reading Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases (9th Ed). Harrison's Principles of Internal Medicine, 21st Ed. Joynt et al. "The implications of augmented renal clearance for antibiotic dosing in critically ill patients." Critical Care. IDSA Guidelines for the Management of Community-Acquired Pneumonia. UpToDate: "Cephalosporins" and "Adverse effects of antibiotic therapy." 🧠 Clinical Pearl / Exam Trap: The "No Renal Adjustment" Myth: Textbooks say Ceftriaxone needs no renal adjustment. This is true for failure, but dangerous for hyper-function. The Scenario: A young trauma patient in the ICU with Sepsis. Albumin is 2.0 g/dL. Creatinine Clearance is 150 ml/min (Augmented Renal Clearance). The Problem: Low albumin means more free drug is filtered, and high clearance washes it out rapidly. A standard 1g or even 2g q24h dose may result in sub-therapeutic levels. The Fix: In these specific patients, we often dose 2g q12h. Primary: Third Generation Cephalosporins, Ceftriaxone Dosing, Ceftazidime, Antibiotic Stewardship, Pseudomonas Treatment. Secondary: Ceftriaxone induced biliary sludge, Ceftazidime neurotoxicity, Augmented Renal Clearance Antibiotics, AmpC Beta Lactamase, Meningitis Treatment. Exam Specific: NEET SS Medicine, MRCP Part 1, USMLE Step 2 CK, ABIM Infectious Disease, DNB General Medicine. Third Generation Cephalosporins, Ceftriaxone dosing in ICU, Ceftriaxone renal failure, Ceftazidime vs Cefepime, Antibiotic Stewardship, Medicine Beyond Harrison, NEET SS General Medicine, MRCP Infectious Disease, Pharmacology for Physicians, Beta Lactam antibiotics mechanism of action, Rocephin side effects, Fortaz dosing, Treatment of Meningitis, Pseudomonas aeruginosa treatment, Augmented Renal Clearance. #Ceftriaxone #Ceftazidime #InfectiousDiseases #CriticalCare #AntibioticStewardship #MedEd #MedicineBeyondHarrison #InternalMedicine #Pharmacology #NEETSS #MRCP #Doctors