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Pharmacology II > Penicillin > Flashcards

Penicillin Flashcards

1
Q

What are the Penicillin Gs?

A

Na Pen G, K Pen G, Procaine Pen G, Benzathine penicillin G

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2
Q

What are the penicillinase-resistant penicillins?

A

Oxacillin, Cloxacillin

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3
Q

What are the aminobenzylpenicillins?

A

Ampicillin, Potassium betacillin, Amoxicillin

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4
Q

What are the extended spectrum (antipseudomonal) penicillins?

A

Ticarcillin, Piperacillin

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5
Q

What are the potentiated penicillins?

A

Amoxicillin-Potassium Clavulanate, Ampicillin-sulbactam

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6
Q

Are penicillin hydrophilic or hydrophobic?

A

Hydrophilic, poor lipid solubility

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7
Q

What structure is responsible for the antibacterial activity of penicillin?

A

B-lactam ring

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8
Q

Can Na & K Pen G be injected IV? Why or why not?

A

Salts of Pen G are water soluble

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9
Q

Can you inject Benzathine Pen G or Porcaine salt of Pen G IV? Why or why not?

A

No, not water soluble

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10
Q

What occurs after IV administation of Procaine salt?

A

Procaine toxicity from rapid dissociation of procaine from Pen G molecule

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11
Q

Why can you administer Procaine pen G IM and SQ?

A

Slower dissociation of procaine fro PenG molecule

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12
Q

How to penicillins work?

A

Inhibiting bacterial cell wall synthesis

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13
Q

Why are penicillins/B-lactams not effective against mycoplasma?

A

Only effective against bacteria that are rapidly growing & dividing

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14
Q

What is the spectrum of Penicillin G?

A

Anaerobes +++++
Gram (+) Aerboes +++++
Gram (-) Aerobes ++

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15
Q

What is staph susceptible to penicillin at first but not later?

A

Staph has inducible penicillinase enzymes

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16
Q

Which bacteria is penicillin best for treating?

A

Anaerobes!

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17
Q

What are the aminopenicillins?

A

Amoxicillin, ampicillin

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18
Q

What is the spectrum for aminopenicillins?

A

Anaerobes: ++
Gram (+) Aerobes: ++
Gram (-) Aerobes: +++++

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19
Q

What bacteria do aminopenicillins work best against?

A

Gram - Aerobes!

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20
Q

Are aminopenicillins as active against Gram - aerobes as aminoglycosides or fluoroquinolones?

A

No (+++++ rating is relative to other quadrants)

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21
Q

Do aminopenicillins work against enterobacteriaceae? Is there a specific infection that aminopenicillins can reach enterobacteriaceae? Why?

A

No but can address pathogens in UTI due to huge concentrations in urine?

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22
Q

Which drug is amoxicillin often paired with for 4-quadrant therapy? Which quadrants/bacteria does amoxicillin target in this therapy?

A

Combined with fluoroquinolone to pick up Streptococci and Anaerobic bacteria

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23
Q

Why is amoxicillin combined with fluoroquinolone instead of Pen G?

A

Amoxicillin has better bioavailability

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24
Q

What are the antipseudomonal penicillins (extended spectrum?)

A

Ticarcillin, piperacillin

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25
Q

What is the spectrum of antipseudomonal penicillins?

A

Gram + aerobe: ++
Gram - aerobe: +++++
Anaerobes: none

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26
Q

Are antipseudomonal penicillins or PenG/aminopenicillins better for Gram + aerobes?

A

PenG/aminopenicillins

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27
Q

Are antipseudomonal penicillins or PenG/aminopenicillins better for Gram - aerobes?

A

Antipseudomonal penicillins are the best for Gram - aerobes!

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28
Q

Which bacteria specifically are antipseudomonal penicillins used for?

A

Enterobacteriaceae

Pseudomonas

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29
Q

What are the penicillinase resistant penicillins?

A

Oxacillin, cloxacillin

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30
Q

Which bacteria are penicillinase resistant penicillins used for?

A

Staph!

31
Q

What does “methicillin resistant” strains of Staph refer to in reference to susceptibility of B-lactams?

A

Methicillin resistant are resistant to all B-lactams

32
Q

List the 3 ways bacteria are resistant to B-lactams

A

Degradation by enzymes
Reduced penetration
Penicillin bind site alteration

33
Q

Can resistant be plasmid induced?

A

Yes, mecA gene in Staph aureus

34
Q

What is the route of administration for Na/K PenG?

A

IV, IM, SC

35
Q

Can you give Procaine Pen G IV?

A

NO!

36
Q

What are the routes of administration for Procaine Pen G?

A

IM, SC

37
Q

What are the routes of administration for Benzathine penicillin G?

A

IM, SQ

38
Q

What is important about the concentration curve of Benzathine Penicillins given SQ? IM?

A

Long curve tail with SQ

Extended residue potential in food animals for both IM & SQ

39
Q

What is the only oral penicillin? Why can it be give orally?

A

Penicillin V

Only acid stable version of Penicillin G

40
Q

Can you give Cloxacillin to a dry dairy cow? Lactating?

A

Yes (Benzathine)

Yes (Sodium)

41
Q

What is the route of administration for Cloxacillin in a dairy cow?

A

Intramammary

42
Q

What is the route of aministration for Ampicillin?

A

IV as sodium salt

IM/SQ as trihydrate salt

Oral as trihydrate or anhydrous

43
Q

What is the route of administration for Amoxicillin?

A

IV as sodium salt
IM/SQ
Oral
Intramammary

44
Q

What is the route of administration for amoxicillin/clavulnate?

A

Ora

45
Q

What is the route of administration for Ticarcillin? Does it have veterinary guidelines?

A

IV or IM

No, human labeled

46
Q

Why are the Penicillins ionized in plasma?

A

pKa of 2.7

47
Q

Where is the distribution of penicillins mostly confined to?

A

Extracellular fluid space

48
Q

Do Penicillins penetrate meninges?

A

If they are inflamed enhances pentration

49
Q

How are penicillins excreted?

A

Primarily kidney via filtration & active secretion (active drug secreted)

50
Q

Is amoxicillin or ampicillin more bioavailable after oral administration?

A

Amoxicillin (60% vs 30%)

51
Q

Are B-lactams bacteriastatic or bactericidal?

A

Bacteriacidal

52
Q

What is the efficacy of B-lactams linked to?

A

The time which serum remains above MIC for pathogen

53
Q

What is theclass representative for the aminopenicillins?

A

Ampicillin

Considered equipotent to amoxicillin in-vitro

54
Q

Is the therapeutic window for penicillins large or small? Is there cross-sensitivity?

A

Very large (very safe), cross-sensitivity is expected

55
Q

What is the issues with the use of Procaine PenG in race horses?

A

Violative residue in racehorses

56
Q

What administration route leads to the K pen squirts?

A

IV of Potassium PenG

57
Q

What is the issues with administration of Procaine PenG to sows?

A

Abortion

58
Q

Can PenG be given to guinea pigs?

A

No, it is fatal

59
Q

What is the issue in giving ampicillin to small rodents & rabbits?

A

Clostridial colitis

60
Q

What is the issue with antibiotics that are bactericidal to gram - bacteria?

A

Endotoxemia

61
Q

What is the issue of rapid administration of K PenG?

A

Cardiac arrest due to release of potassium

62
Q

Is Na PenG or K penG safer for IV use?

A

Na PenG

63
Q

Can you give procaine PenG IV? What about IM? What animal specificaly are you worried about with IM injections?

A

NO!

Yes but extremely high doses can lead to excitement and death (horses)

64
Q

What disorder in an animal may be reason to not use Ticarcillin?

A

Bleeding disorder or those on anti-coagulants (heparin)

65
Q

PenG has been linked with what disease in horses?

A

Coombs-positive hemolytic anemia

66
Q

What are the B-Lactamase inhibitors?

A

Clavulanic acid
Sulbactam
Tazobactam

67
Q

Do clavulanic acid or sulbactam have antimicrobial activity?

A

No

68
Q

How do B-lactamase inhibitors work?

A

Bind with all chromosomally mediated penicillinases & mot plasmid mediated penicillinases

69
Q

When combined, which spectrum does amoxicillin-clavulanic acid resemble?

A

2nd generation cephalosporin

70
Q

What bacteria specifically are more affected by amoxicillin-clavulanic acid as compared to jut amoxicillin?

A

Enterobacteriaceae & anaerobic spectrum

Staph

71
Q

What are some adverse reactions linked to amoxicillin-clavulanic acid?

A

GI upset

72
Q

What issue are we concerned with in using amoxicillin-clavulanic acid in cats?

A

Inappetance can lead t hepatic lipidosis

73
Q

Can clavulanic acid or sulbactams be used in non-ruminant herbivores?

A

No

Pharmacology II (15 decks)

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