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Therapeutics > Penicillin > Flashcards

Penicillin Flashcards

1
Q

what drug class is penicillin?

A

beta lactam

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2
Q

how does penicillin kill bacteria?

A

interferes w/ cell wall synthesis

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3
Q

spectrum of activity?

A

narrow

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4
Q

what bacteria does penicillin target?

A

mostly gram positive cocci

also:
gram negative bacilli
some negative cocci
potentially anarobes - fuso spp, clostridium, anarobic strep

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5
Q

what does killing of bacteria depend on?

A

time - takes time for inhibition process and eventual rupture of microorganism

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6
Q

name 3 penicillin preparations

A

Pen G - benzylpenicillin (IV)
Pen V - phenoxymethylpenicillin (oral)
Procaine/benzathine penicillin

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7
Q

how are the 3 preparations delivered?

A

pen G = IV form, destroyed by gastric acid
pen V = oral form, gastric acid stable
procaine/benzathine = IM form, named pt basis only

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8
Q

when is pen G indicated?

A

Pen G is reserved for severe infection or if oral route comprimised i.e. malabsorption, vomiting

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9
Q

what % of population will have a penicillin reaction?

A

8%

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10
Q

symptoms of penicillin reaction

A

maculopapular or urticarial rash

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11
Q

most likely age group for penicillin reaction

A

20-49yrs
fatal reactions more likely in elderly

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12
Q

list symptoms of immediate penicillin reaction

A

nausea/vomiting
prutisis
erythema, urticaria, rash
wheeze
laryngeal oedema
angioedema
bronchospasm
hypotension
CV collapse

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13
Q

list symptoms of delayed penicillin reaction

A

rash:
vesicular
maculopapular
bullous
urticarial
scarlatiniform

blood dyscrasias
haemolytic anaemia
leukopenia
thrombocytopenia
aplastic anaemia

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14
Q

should penicillin use be avoided when previous reaction?

A

not if minor delayed reaction - as are short lived and do not show long lasting penicillin hypersensitivity

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15
Q

list obscure autoimmune conditions that can occur from penicillin adverse reaction

A

Eosinophilia
Steven johnson syndrome
Exfoliative dermatitis
DRESS syndrome

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16
Q

list risk factors for penicillin reaction

A

multiple drug allergies
atopic disease - sensitive to allergens
asthma
allergic rhinitis - inflamm. of the inner nose
nasal polyps

17
Q

how much more likely is hypersensitivity to penicillin when re-exposure compared to negative history?

A

4-6x greater

18
Q

what should be filled out when an ADR occurs?

A

yellow card

provides early warning that the safety of a product may require investigation

19
Q

pen V dose

A

500mg every 6hrs (4x a day)

20
Q

pen v course

A

over 3-5 days

21
Q

pen v administration

A

oral

22
Q

pen v loading dose?

A

yes

23
Q

pen v fasting required?

A

yes

24
Q

pen g dose

A

1.2g every 6hrs

25
Q

pen g course

A

3-5 days

26
Q

pen g administration

A

IV

27
Q

pen g loading dose?

A

no

28
Q

pen g fasting?

A

no

29
Q

list 3 ways penicillin can evade the imune system

A
  1. reduce the drug binding to penicillin binding protein
  2. hyrdolysis of beta lactamase enzymes (main mechanism)
  3. disabling autolysins
30
Q

list drugs penicillin can interact with

A

NSAID
Probenecid - gout prevention
Warfirin
Methotrexate
Oral contraceptives

31
Q

what may broad spectrum penicillin do?

A

alter INR - consider monitoring if pt starts course

32
Q

give 3 unwanted effects of penicillin

A

diarrhoea
nausea
rash - non allergic, associated w/ antibody production

33
Q

give 3 uncommon effects of penicillin - but can happen

A

vomiting
urticaria and pruritis
arthralgia

34
Q

list alternative medications to penicillin

A

metronidazole
clarithromycin
erythromycin
clindamycin

35
Q

what enzyme produced by bacteria causes penicillin resistance?

A

beta lactamase

Therapeutics (7 decks)

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