Beta-Lactam Flashcards
What is the MOA for Penicillin V?
Bacterocidal (interferes with transpeptidation of bacterial cell wall – by binding to PBP).
When would you use Penicillin V?
G for IV & V or VK for oral. Strepto-,entero, & pneumococci, T pallidum. V = streptococci only.
What are the SE/ADR’s when using Penicillin V?
Diarrhea. High dose = renal impairment, convulsions. Prolonged/high dose = superinfection.
What are the contraindications to using Penicillin V?
Anaphylaxis with prior treatment
What are the drug to drug interactions with Penicillin V?
Warfarin effect ↑. Tetracyclines ↓ pen effect
What would you need to monitor when prescribing Penicillin V?
CrCl if prolonged or very high dose. Renal clearance (~90%)
Tender erythema of the skin of her right thigh x 3 days.
Afebrile, 5 cm diameter area of tender erythema without fluctulence in skin of right thigh. What medication?
Penicillin V
What Abx have the following MOA of: In actively growing bacterial cells, interferes with transpeptidation of bacterial cell wall by binding to PBP
Dicloxacillin, Amoxicillin, Amoxicillin-Clavulanic, Cephalexin, Cefazolin, Cefuroxime (ceftin), Cetriaxone (Rocephin), Cefixime (Suprax), Cefepime, Ceftaroline, Vancomycin.
When would you use Dicloxacillin?
Soft Tissue Infections caused by penicillinase- producing Staph. Susceptible to Beta Lactamases; multiple Gram neg organisms produce Beta Lactamase and restricts empiric use for UTIs (i.e. klebsiella)
What are the common SE/ADR for Dicloxacillin?
Nausea Diarrhea Prolong PT
Prolonged use C.diff associated with diarrhea
When would you not use Dicloxacillin?
hypersensitivity to penicillin
What drugs might the patient be taking that would interact with Dicloxacillin?
warfarin (incr PT), methotrexate (incr effect)
What would you need to monitor when prescribing Dicloxacillin?
if used with warfarin, monitor PT/INR. no dosage adjustment for CrCl required; compare Methicillin.
When would you use Amoxicillin?
Sinusitis, otitis media, UTIs, LRTIs (infrequently)
What are the common SE/ADR for Amoxicillin?
Diarrhea, erythematous rash with viral illnesses; bacterial or fungal superinfection, seizures, Stephens Johnson Syndrome
What is a contra-indication to using Amoxicillin?
Hypersensitivity
What are the drug-drug interactions to Amoxicillin?
warfarin (incr PT/INR); allopurinal (incr prob amox rash
What would you need to monitor when when prescribing Amoxicillin?
CrCl if prolonged use.
Your patient is a 1 year old with acute otitis media (AOM) not responding to treatment with HD amoxicillin after two days.
Why?
Beta lactamase breaking down the amoxicillin. Which makes it not work.
