Erdman Penicillin Learning Objectives

Question 1

List natural pencillins

Answer 1

penicillin G

benzathin penicillin G

procaine penicillin G

penicillin VK

Question 2

Natural penicillins facts

Answer 2

• good for gram positive EXCEPT staph spp
• gram positive cocci
• mouth anaerobes and clostridium
• treponema

Question 3

Penicillin G DOC

Answer 3

viridans

N. meningitides

C. diphtheria

B. anthracis

C. perfringens

C. tetani

treponema pallidum

Question 4

List PRPs

Answer 4

nafcillin

methicillin

dicloxacillin

Question 5

PRPs for gram positive

Answer 5

MSSA

Question 6

List aminopenicillins

Answer 6

ampicillin

amoxicillin

Question 7

aminopenicillins for gram positive

Answer 7

ENTEROCOCCUS

listeria

Question 8

aminopenicillins for gram negative

Answer 8

SSHEP

salmonella, shigella, H. influenza, e. coli, proteus mirabilis

Question 9

aminopenicillins also for

Answer 9

mouth anaerobes

clostridium

Question 10

carboxypenicillin examples

Answer 10

ticarcillin

Question 11

carboxypenicillin only for

Answer 11

GRAM NEGATIVE

Question 12

carboxypenicillin for gram negative

Answer 12

SSHEEPP MP

salmonella, shigella, h. influenza, e. coli, enterobacter, proteus mirabilis, providencia, morganella, PSEUDOMONAS AERUGINOSA

Question 13

ureidopenicillin examples

Answer 13

piperacillin

Question 14

ureidopenicillin gram positive

Answer 14

viridans

Question 15

ureidopenicillin gram negative

Answer 15

enterobacteriaceae, PSEUDOMONAS AERUGINOSA

Question 16

ureidopenicillin also for

Answer 16

mouth anaerobes, clostridium, SOME bacteroides fragilis activity

Question 17

Combination examples

Answer 17

amoxicillin/clavulanic acid (augmentin)

ampicillin/sulbactam (unasyn)

piperacillin/tazobactam (zosyn)

Question 18

Combinations good for

Answer 18

***MSSA

M HENPK (m. catarrhalis, h. influenza, e. coli, n. gonorrhoeae, proteus, klebsiella)

***BACTEROIDES FRAGILIS

Question 19

Penicillin distribution characteristics

Answer 19

widely distributed

adequate concentrations of penicillins in the CSF are attainable in the presence of inflamed meninges when high maximal doses of parenteral penicillins are used

Question 20

Nafcillin and oxacillin eliminated

Answer 20

via liver and not removed by hemodialysis

Question 21

penicillins used with caution in pts with congestive heart failure or renal failure

Answer 21

ticarcillin –> 5.2

nafcillin –> 2.9

aqueous sodium penicillin G –> 2.0

piperacillin –> 1.85

Question 22

Natural penicillin DOC for

Answer 22

streptococci

N. meningitidis

C. perfringens

C. tetani

C. diptheriae

b. anthracis

***TREPONEMA PALLIDUM

Question 23

PRPs DOC for

Answer 23

MSSA

Question 24

aminopenicillins DOC for

Answer 24

pharyngitis, sinusitis, bronchitis, otitis media

enterococcal infections

listeria monocytogenes

Question 25

carboxypenicillins and ureidopenicillins DOC for

Answer 25

hospital acquired infections

Question 26

Pip most active against

Answer 26

PSEUDOMONAS AERUGINOSA

Question 27

augmentin combination DOC for

Answer 27

otitis media, sinusitis, bronchitis, RTI, human/animal bites

Question 28

polymicrobial infections examples

Answer 28

intraabdominal, gynecological diabetic foot

Question 29

zosyn DOC for

Answer 29

polymicrobial

PSEUDOMONAS AERUGINOSA

hospital acquired infections

Question 30

major adverse effects with penicillin antibiotics

Answer 30

hypersensitivity

neurologic: seizures
hematologic: leukopenia, neutropenia, thrombocytopenia

GI

interstitial nephritis: immune mediated damage to renal tubules –> methicillin/nafcillin; may present initially as eosinophiluria and increase in SCr

phlebitis w/ nafcillin

hypokalemia

sodium overload/fluid retention

Question 31

what can occur with nafcillin

Answer 31

phlebitis