Penicillin Flashcards

1
Q

Who discovered penicillin?

A

Alexander Fleming

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2
Q

How does penicillin work?

A

Penicillin inhibits the final stage of cell wall synthesis by irreversibly inhibiting transpeptidase enzyme

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3
Q

What is transpeptidase enzyme responsible for?

A

Formation of peptidoglycan cross-links

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4
Q

Why are gram-negative cells not susceptible to penicillin?

A

Walls have a strong barrier which prevents hydrophilic penicillin molecules passing through so penicillin can only diffuse through pores

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5
Q

Why does penicillin resistance occur?

A

Bacteria are prone to genetic mutations and can form resistant strains
Bacterial transpeptidase enzyme may have a low affinity for penicillin
Bacteria may have efflux mechanisms which pump penicillin out of cells

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6
Q

What does the penicillinase enzyme do?

A

Destroys penicillin

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7
Q

How are penicillin G and penicillin V different?

A

Acyl side chains

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8
Q

Why is the acyl side chain different on penicillins?

A

Due to the carboxylic acid present in the fermentation medium

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9
Q

What are the key groups on penicillin?

A

Bicyclic ring system
Carboxylic function
Amine bond to attach acyl chain

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10
Q

What shape is penicillin G?

A

Envelope shape

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11
Q

Why is the amide bond on penicillin G unstable?

A

N’s lone pair cannot delocalise
High degree of angular strain due to 4 membered ring

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12
Q

Why is penicillin G injected?

A

It is not orally available

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13
Q

How can penicillin G be developed?

A

Increase acyl group size to make lactam ring less accessible - increasing resistance to B-lactamase
Increase the chemical stability for oral administration

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14
Q

What can be varied on penicillin?

A

Variation is limited to the acyl side chain

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15
Q

What structures on penicillin G are involved in bonding?

A

Amide and carboxylic acid (as carboxylate ion)

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16
Q

What happens after transpeptidase enzyme is inhibited?

A

Cell wall leaks and limits the activity of bacteria and viability
Cross-linking of cell wall is prevented

17
Q

What are markers of infection?

A

Patient reported - pain
Haematological - white cell count, platelets and lactate
Physiological - low BP, tachycardia and temperature

18
Q

What antibiotic should be used on skin?

A

Gram positive aerobes

19
Q

What antibiotic should be used in lungs?

A

Gram positive aerobes

20
Q

What antibiotic should be used in GI tract?

A

Gram negative anaerobes

21
Q

What antibiotic should be used for UTI?

A

Gram negative anaerobes

22
Q

What does the spleen do?

A

Filters blood
Removes old RBCs
Releases immune cells in response to infection
Stores platelets and RBCs

23
Q

Significance of asplenia

A

Lifelong antibiotics
Rescue antibiotics
Patient alert cards