PCNs Flashcards
What is the MOA of all penicillins?
Prevent transpeptidation (cross linking) of peptidoglycan layers of the cell wall by binding to penicillin binding proteins
What are the natural penicillins?
Penicillin V, and Penicillin G
What is the route for Penicillin V and Penicillin G?
Penicillin V: PO
Penicillin G: IV and PO
What non-beta-lactamase producing gram positive bacteria are natural penicillins effective against?
Streptococci
What anaerobes are natural penicillins effective against?
- Actinomyces
- Prevotella
- Peptostreptococci
- Clostridium (not dificile)
What gram negative bacteria are natural penicillins effective against?
- Neisseria
What treponema pallidium are natural penicillins effective against?
- Syphilis
What are the common clinical uses for natural penicillins?
1. Strep infections A. Pharyngitis B. Cellulitis C. Endocarditis 2. Syphilis
What are the SE of natural penicillins?
- Hypersensitivity
2. Seizures at high doses
What are the antistaphylococcal PCNs?
- Oxacillin
- Nafcillin
- Dicloxicillin
What are the routes for Oxacillin, Nafcillin, and Dicloxicillin?
- Oxacillin: IV
- Nafcillin: IV
- Dicloxicillin: PO
What agents are the antistaphylococcal PCNs effective against?
- MSSA
2. Streptococci
What are the clinical uses for Oxacillin, Nafcillin, and Dicloxicillin?
- MSSA infections: superior to vanco for MSSA infections
What are the SE of Oxacillin, Nafcillin, and Dicloxicillin?
- Oxacillin: hepatotoxicity, neutropenia
2. Nafcillin: hepatotoxicity, neutropenia, thrombophlebitis
What are the aminopenicillins?
- Ampicillin
2. Amoxicillin
What are the routes for ampicillin and Amoxicillin?
- Ampicillin: IV
2. Amoxicillin: PO
What gram positive agents are ampicillin and Amoxicillin effective against?
- Streptococci
- Enterococci
- Listeria
What gram negative agents are ampicillin and Amoxicillin effective against?
- Non-beta lactamase producing Haemophilus
2. E. Coli: resistance is 40-50%
What other agents are ampicillin and Amoxicillin effective against?
Oral anaerobes
What are the clinical uses for ampicillin and Amoxicillin?
- Otitis media
- URIs
- UTIs
- Endocarditis from enterococci: IV ampicillin
- Listeria meningitis: IV ampicillin
What are the SE of ampicillin and Amoxicillin?
- Hypersensitivity
- Rash
- GI
What are the extended spectrum PCN-B-lactamase inhibitor combination meds?
- Amoxicillin/clavulanate: Augmentin
2. Pipercillin/tazobactam: Zosyn
What are the routes for Amoxicillin/clavulanate: Augmentin
and Pipercillin/tazobactam: Zosyn?
- Amoxicillin/clavulanate: Augmentin: PO
2. Pipercillin/tazobactam: Zosyn: IV
What is the spectrum of activity for Amoxicillin/clavulanate: Augmentin
and Pipercillin/tazobactam: Zosyn?
- Retained activity against strep and enterococci
- improved activity against MSSA
- Improved activity against gram negative rods (E. coli)
- Improved activity against B. fragilis
- ONLY zosyn has activity against pseuodmonas
What agents do Amoxicillin/clavulanate: Augmentin
and Pipercillin/tazobactam: Zosyn has poor activity against?
- MRSA
2. Extended spectrum B-lactamase producing gram negative rods
What are the clinical uses for Amoxicillin/clavulanate: Augmentin
and Pipercillin/tazobactam: Zosyn?
1. Mixed infections A. Intr-abdominal infections B. Diabetic foot problems C. Nosocomial pneumonia: zosyn D. Aspiration pneumonia
What are the SE of Amoxicillin/clavulanate: Augmentin
and Pipercillin/tazobactam: Zosyn?
- Amoxicillin/clavulanate: Augmentin
A. Diarrhea - Pipercillin/tazobactam: Zosyn
A. Immune-mediated thrombocytopenia, aplastic anemia
