This is everything Ceftriaxone.

Third-Generation Cephalosporins

Examples: Cefdinir, Cefditoren, Cefixime, Cefotaxime, Cefpodoxime, Ceftazidime, Ceftriaxone (Rocephin) MOA: Bactericidal—Inhibits bacterial cell wall synthesis. Spectrum: Stronger gram-negative coverage (E. coli, H. influenzae, K. pneumoniae, N. gonorrhoeae).

Indications

Respiratory, skin, GU, bone/joint, abdominal infections; meningitis; septicemia; otitis media.

Major Contraindications

• Allergy: Cephalosporin or serious penicillin hypersensitivity.
• Neonates: Ceftriaxone contraindicated (<28 days, jaundiced, or on Ca²⁺ IV).
• Caution: Renal impairment, GI disease, urolithiasis (Ceftriaxone).

Red-Flag Adverse Effects

🚨 Anaphylaxis: Stop drug, treat immediately. 🚨 C. diff Diarrhea: Report fever, bloody stool; avoid antidiarrheals. ⚡ Seizures: High doses or renal failure → monitor neuro status, adjust dose. 🩸 Bleeding: Ceftriaxone + Warfarin = ↑ INR; monitor. 💧 Nephrotoxicity: Watch BUN/Cr, ensure hydration. 🧬 Hematologic: Agranulocytosis, thrombocytopenia → monitor CBC. Common: N/V, cramps, rash, IM pain, phlebitis.

Interactions

• Probenecid: ↑ levels/toxicity.
• Loop diuretics/Aminoglycosides/NSAIDs: ↑ renal risk.
• Antacids/H2 blockers: ↓ absorption (Cefdinir, Cefpodoxime).
• Warfarin: ↑ bleeding.
• OCPs: ↓ efficacy (Cefixime).
• Alcohol: Disulfiram-like reaction → avoid.

PK Highlights

Mostly renally excreted; dose-adjust in renal impairment. Half-life: Cefotaxime 1–1.5 hr ⟶ Ceftriaxone 5–9 hr (once daily).

Top 5 NCLEX Pearls

1️⃣ Anaphylaxis & CDAD = life-threatening. 2️⃣ Ceftriaxone = no neonates or Ca²⁺ IV. 3️⃣ Adjust dose if Cr ↓. 4️⃣ Monitor INR w/ Warfarin. 5️⃣ Bactericidal cell-wall inhibitor → great Gram-negative coverage.

💊 Quick Recap: “Ceph-3 = Caution: CNS, C. diff, CrCl ↓.” 🩺 Watch for allergy, renal toxicity, and bleeding.