8. Penicillins Flashcards

1
Q

natural Penicillins

A

Penicillin G

penicillin V (oral)
(blue)
——————————————————————————–MOA (green)
-
Beta Lactam Ring interferes with transpeptidation reaction of bacterial cell wall synthesis

-pBP forms peptidoglycan cross links, penicillin’s will halt peptidoglycan synthesis in the cell walls: bactericidal

Delivery

  • penicillin V is acid stable and only used in minor infections due to poor bioavailability (oral)
  • administered IV (pen G)

Used to Treat

-against gram (+) organisms (Staph and Strep)

-Oral Penicillin V treats streptococcal pharyngitis
(“Red bandanna”)

  • Penicillin G or V treats rheumatic fever
  • Strep Viridians endocarditis

-GBS prophylaxis

  • Actinomyces Israeli
  • Clostridium Perfringens causing gangrene
  • pastuerella pen g
  • benzathine pen g treats syphilis (spirochete)
  • penicillin G - treats Neisseria meningitides

Resistance

Beta Lactamases are immune to penicillin
(“Beta Trooper shooting down a ship”)

-beta lactamases expressed by plasmid genes (“Circular shape”)

Adverse Reactions

Type 1 IgE mediated hypersensitivity reaction
(“Astronaut shutting eyes w/ IgE missiles on ship”)

-drug-induced autoimmune hemolytic anemia
(+ direct coombs test) (“Exploding asteroids w/ IgG”)

-drug induced interstitial nephritis
(“Kidney shaped nebula”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

anti staph penicillin

A

Nafcillin
Oxacillin
Dicloxacillin

  • bulky R-groups prevent beta-lactamase binding
  • Narrow spectrum, only activity against staphylococci
  • empiric treatment for skin and soft tissue infections (folliculitis, abscesses)

Tricuspid pyramids: treatment for staph endocarditis

Fish bones: treatment for Staph osteomyelitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

broad spectrum penicillins

+beta lactamase inhibitors

A
  • *Amoxicillin**
  • amoxicillin – oral bioavailability

amoxicillin and ampicillin to treat strep throat

  • amoxicillin treats otitis media and sinusitis caused by strep pneumoniae, Haemophilus influenza, moraxella catarrhalis
  • amoxicillin and ampicillin treat pneumonia caused by strep pneumoniae, H. influenza

H Wing ship: activity against Haemiphilus influenza

-amoxicillin is part of the triple therapy (with clarithromycin and a PPI) for helicobacter pylori infection

  • amoxicillin treats Lyme Disease caused by Borrelia burgdorferi
  • amoxicillin prophylaxis against encapsulated bacteria (s. pneumo, H. Flu) in asplenic patients
  • Amoxicillin prophylaxis before dental procedures in patients at high risk for endocarditis

Ampicillin
–IV administration

  • ampicillin treats anaerobic infections (enterococcus)
  • Gram Positive enterococcus
  • ampicillin resistant strains of Enterococcus due to beta-lactamase production
  • ampicillin treats meningitis caused by Listeria monocytogenes
  • activity against gastrointestinal and urinary tract gram (-) rods

-sensitive to beta-lactamases
(typically used with clavulanate)

Piperacillin/Ticarcillin

  • Paired with beta lactamase inhibitors to prevent cleavage of beta lactamases
  • piperacillin and ticarcillin treat anaerobic infections,
  • active against pseudomonas

**Beta lactamase inhibitors

Sulbactam
Tazobactam
Calvulanate**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly