Penicillin Flashcards by Muhammad ASR

Mechanism of action in penicillin

• Inhabit transpeptidation reaction which is the last step in the formation of cell wall synthesis through binding to penicillin-binding proteins (PBP)

↑ activity of autolysins in some bacteria → cell wall lysis

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Why it’s a good idea to take penicillin with Aminoglycosides

Aminoglycosides can’t penetrate gram+ bacteria thick Call wall so if it’s taken with penicillin it causes a new generation of bacteria with a wick call wall that could penetrate the call wall

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Penicillin should not be taken with static drug , why

We need new generation

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Members of Penicillins drifters in 1-3 according to group attached to

Beta lactam ring

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Spectrum of natural penicillin

Narrow spectrum mainly pos.

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Members of nautral penicillin

Penicillin G (benzyl p.)
Penicillin V

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HCL (Stability or gastric acidity)
Of natural penicillin

Penicillin G:unstable يتكسر بالحمض
Penicillin V: stable (oral)

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Nautral penicillin Sensitive to beta lactamase

Sensitive

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Antistaph penicillin spectrum

Narrow spectrum mainly pos.

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Members of anti-staph penicillin

Oxacillinمهم, Cloxacillin
Flucloxacillin
Methicillin (not used)

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HCL (Stability or gastric acidity) Of antistaph penicillin

Stable (oral)

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Sensitivity to beta lactamase

Not sensitive (stable)

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Antistaph are given

postprandialما بعد الأكل معدى فارغة

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Broad(extended) spectrum penicillin spectrum is

Broad spectrum

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Broad(extended) spectrum members are

Ampicillin
Amoxicillin

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Broad(extended) spectrum penicillin in hcl

Stable(oral)

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Broad(extended) spectrum and beta lactamase

Not stable

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Antipseudomonal penicillin spectrum

Broad spectrum

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Members of Antipseudomonal
Penicillin

Ticarcillin
Carbenicillin
Piperacillin

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HCL stability of antipseudomonal penicillin

Piperacillin مهم& Ticarcillin (unstable)
Carbenicillin: stable

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Beta-lactamase relationship with antipseudomonal penicillin

Inactive, sensitive

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Long acting penicillin spectrum is

Narrow mainly pos.

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Members of long acting penicillin

Procaine: taken /12 h
Benzathine: taken/per month

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Long acting penicillin in stomach

Unstable, insoluble (IM only)

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Beta lactamase and long acting penicillin

Sensitive

All penicillin preparations are susceptible for B lactamase except

Antistaph penicillin

(Beta lactamase resistant ___group).

antibiotic

.ORSA treated by

Vancomycin or rifampicin

All members Can be taken orally except:

Penicillin G(lV), Piperacillin(lV) & long-acting penicillin(lM)

Penicillin Route of administration is according to

stability in HCL

Long acting Penicillins SHOULD be taken IM to act as ___

Depot

Most members of penicillin are ________absorbed e.g_____

Incompletely Ampicillin

Penicillin Useful in Shigella is

Ampicillin

Ampicillin prodrugs is

(Bacampicillin)

shigella in Intestine causes dysentery, so it's better to use____

Ampicillin

Taking Ampicillin can cause diarrhea because

It kill bacteria flora

advantage of amoxicillin over ampicillin

Completely absorbed → -Less diarrhea - High serum level - Not preferred in Shigella Dysentery(blood+mucosa)

penicillin Can Cross the ______ during pregnancy

placenta

Safe drugs in pregnancy

(all B lactams and erythromycin are safe, Not teratogenic)

Penicillin can cross BBB or CSF insufficient amount except during

Inflammation

If penicillin could cross bbb so it can be used to treat

So penicillin is used in meningitis

When meningitis dec. Penicillin level ____ because it can't cross _____ anymore , and to slove this issue, penicillin dose should be ___

Dec Bbb Ink.

due to Prostatic barrier , penicillin con. In prostate is

insufficient(غير كافي) to be effective in prostatic infection

Excretion in Renal by

active secretion & by filtration

How to Prolong t 0.5 of penicillin

Add Probenecid: dec. renal tubular secretion of penicillin

Metabolism of Oxacillin & Nafcillin can be _____ or _____

Hepatic metabolism Excreted in bile

excreted in bile penicillin can be used in

Biliary Tract Infection (BTI) renal dysfunction

Adverse effects of penicillin

1. Hypersensitivity 2. Diarrhea 3. Neurotoxicity 4. Cation disturbance 5. Decreased coagulation

Hypersensitivity of penicillin e.g

Rash, Angioedema up to anaphylactic shock(type 1 hypersensitivity)

Most hypersensitivity of penicillin occur with which type

Penicillin G

Cross Allergy occur with other B lactam antibiotics except...

Aztreonam

What cause diarrhea

disturbance of normal flora especially with ampicillin (BS/Incomplete absorption)

Neurotoxicity of penicillin

Seizuresتشنجات : High doses or Intrathecally

Hyperkalemia with penicillin G--->

Cation disturbance

Decreased coagulation causes

High doses of piperacillin → bleeding

Taking Piperacillin with___ and___ ---->↑ bleeding

warfarin and heparin

Therapeutic uses of Penicillins: Depends on the

Members

Therapeutic uses of Penicillins: +ve bacilli

Diphtheria Anthrax

Therapeutic uses of Penicillins, +ve cocci

Staphylococcal infections Streptococcal infections Pneumococcal

E.g for streptococcal infections

Acute sore throat Wound sepsisتعفن الجرح Bacterial endocarditis

Therapeutic uses of Penicillins: Neg cocci

Neisseria--> Meningitis Penicillin G or Ampicillin + chloramphenicol(الدواء هذه يستخدم عندما يقل تركيز البينيسيلين بسبب انخفاض إلتهاب سحايه المخ Gonorrheaالسيلان

Penicillin G + aminoglycoside is Used in treatment of ______ but not mixed in the same _____

bacteria endocarditis syringe

Benzathine penicillin is used for prophylactic in

.Recurrent rheumatic fever