C/8. Penicillins Flashcards

1
Q

Penicillins

MOA

A

Inhibit cell wall synthesis
Beta-lactam antibiotics bind specific PBP’s in the bacterial wall and inhibit assembly of the peptidoglycan chains, resulting bacterial cell death (bactericidal effect)

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2
Q

Penicillin

Pharmacokinetic/dynamic properties

A

Orally active(resistant to gastric acid inactivation)
Parenteral formulation (penicillin G, ampicillin, piperacillin, tigarcillin)
Excreted unchanged in the urine
Biliary clearance (nafcillin, oxacillin), enterohepatic cycling (ampicillin)
Short half life, requires multiple dosing 3-4 times daily, or continuous IV infusion
Cross BBB only when meninges are inflamed
Synergistic effect with aminoglycosides
Enhanced if used in combination with beta-lactamase inhibitors (Clavularic acid, sulbactam, tazobactam)

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3
Q

Penicillin

A
Penicillin G(IV)
Penicilling V(Oral)

Narrow-spectrum
Beta-lactamase sensitive

Streptococcal infections(pharyngitis, rheumatic fever, endocarditis)
Gram positive rods (Actinomyces israelii)
Clostridium perfringens
Entercocci
Prophylaxis against group B strp. (S. Agalactiae)
Neisseria meningitis

Hypersensitivity/allergic reaction; fever, urticaria, pruritus, joint swelling, anaphylaxis
Drug induced hemolytic anemia
Intestitial nephritis
Jarisch-Herxheimer reaction

Benzathine penicillin G
Syphilis - IM depot injection (slow release)

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4
Q

Oxacillin

A

Very narrow spectrum
Beta-lactamase resistant

Staphylococcal infections (skin and soft tissue infections, endocarditis, osteomyelitis)

Interstitial nephritis
Neutropenia

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5
Q

Ampicillin

Ammoxicillin

A

Broad-spectrum
Beta-lactamase sensitive
Amino-peniciilin

Ampicillin (IV)

against gram - rods
E.coli, enterococci
L. Monocytogen
Anaerobic infection
Otitis media and sinusitis caused by H. Influenza, S. Pneumoniae, M. Catarrhalis
Pneumonia caused by S. Pneumoniae and H. Influenza
Streptococcal pharyngitis
H. Pylori eradication
Borellia burgdoferi
Prophylaxis

Maculopapular skin rash
GI disturbances
Steven-Johnson syndrome

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6
Q

Piperacillin

A

Extended-spectrum
Beta-lactamase sensitive
Ureido-penicillin

Pseuomonas infection
Sepsis

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7
Q

Commonly used combination preparations

A

Amoxicillin/Clavularic acid (Augmentin)
Ampicillin/Sulbactam
Piperacillin/Tazobactam

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