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Antibiotics > Penicillin I > Flashcards

Penicillin I Flashcards

1
Q

What was the first penicillin with anti-pseudomonal properties?

A

carbenicillin

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2
Q

What is a popular penicillin combination drug in use in hospitals today (trade name Zosyn)?

A

piperacillin and tazobactam

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3
Q

Augmentin contains a combination of…

A

amoxicillin and clavulanic acid

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4
Q

What are six characteristics of the ideal penicillin?

A

stability at low pH (ie in the stomach), slower renal elimination, stability against beta lactamases, broader antimicrobial coverage, better penetration into CSF, no hypersensitivity reactions

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5
Q

What is the half-life of most penicillins?

A

2 hours

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6
Q

Which renal filtration method contributes more to the elimination of beta lactams, glomerular filtration or tubular secretion?

A

glomerular filtration

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7
Q

Penicillin G is mostly active against gram ______ organisms

A

positive

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8
Q

Penicillin G is also known as….

A

benzylpenicillin

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9
Q

What organisms does Penicillin G have good activity against?

A

group A streptococcus, group B streptococcus (ex.: S. agalactiae), S. viridans, S. pneumoniae (although resistance increasing)

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10
Q

What organisms does Penicillin G have moderate activity against?

A

enterococci gram negative aerobes

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11
Q

Penicillin G is a drug given _______

A

intravenously

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12
Q

Which aqueous salt form of Penicillin G is most commonly dispensed?

A

potassium (Penicillin GK)

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13
Q

How many milliequivalents of potassium are present per million units of Penicillin GK given?

A

1.7 mEq

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14
Q

Too much potassium can cause what major health problem?

A

cardiac arrest

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15
Q

How often must Penicillin GK be given for serious infections and why?

A

every 4 hours, because it is quickly eliminated

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16
Q

How many million units per day of Penicillin GK is considered a high dose?

A

24 MU

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17
Q

Which two formulations of Penicillin G are suspensions and only suitable for intramuscular injection?

A

Procaine Penicillin G, Benzathine Penicillin G

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18
Q

Which Penicillin G suspension is not used much anymore because of hypersensitivity issues?

A

Procaine Penicillin G

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19
Q

Which Penicillin G suspension is very long-acting?

A

Benzathine Penicillin G

20
Q

Why is Benzathine Penicillin G so long acting?

A

it deposites a reservoir of drug in the muscle that must slowly diffuse into the blood, so only a little penicillin leaks into the blood at a time

21
Q

What is Benzathine Penicillin G effective in treating?

A

all stages of syphillis, prophylaxis for rheumatic fever, sometimes Strep pharyngitis

22
Q

What is the formulation of Penicillin G meant to be used as an oral dose?

A

Penicillin V

23
Q

What makes Penicillin V effective as an oral dose?

A

it is designed to resist acid hydrolysis (like in the stomach), so oral bioavailability much higher

24
Q

Is it better to take Pencillin V on an empty stomach (1 hour before or 2 hours after meals) or with food?

A

on an empty stomach

25
Q

Which compound, although not a penicillin, is usually taken with penicillin V because it increases the bioavailability?

A

probenecid (benemid)

26
Q

How does probenecid increase the bioavailability of Penicillin V?

A

it blocks selective tubular secretion of pencillins, increasing their half-lives

27
Q

When should you take probenecid?

A

30 minutes before antibiotic

28
Q

Where does selective tubular secretion take place in the kidneys?

A

peritubular capillaries

29
Q

What percentage of people who take penicillins exhibit hypersensitivity reactions?

A

10%

30
Q

What percentage of people “outgrow” their penicillin allergy (do not have a reaction after taking penicillin at least 10 years after their initial reaction)?

A

80%

31
Q

What is the difference between hives and flat, blotchy rashes?

A

hives are raised bumps, happen almost immediately and progressively get worse; flat, blotchy rashes not raised, may not occur until several days after starting therapy (of less concern)

32
Q

What Pregnancy Risk Factor are penicillins placed in and how does it affect therapy in pregnant patients?

A

Pregnancy category B, probably safe to use in pregancy (low risk)

33
Q

What three pregnancy categories indicate drugs that should NOT be used in pregnant patients without very good reason?

A

pregnancy category C, D, X

34
Q

Anti-staphylococcal penicillins are also called __________

A

penicillinase-resistant penicillins

35
Q

What is the preferred anti-staphylococcal penicillin in use today (not active against MRSA)?

A

nafcillin

36
Q

Why is methicillin no longer used in treatment?

A

issues with interstitial nephritis

37
Q

Methicillin and Nafcillin are only useful as ________ agents because of their poor absorption from the GI tract.

A

parenteral

38
Q

What is unique about the elimination of anti-staphylococcal penicillins?

A

they are eliminated primarily through the renal pathways but also through the biliary pathway, therefore the dose doesn’t need to be adjusted in patients with renal failure; the liver sends the drug into the biliary duct which drains into the intestine

39
Q

What is the class of anti-staphylococcal penicillins designed for oral dosing?

A

isoxazolyl penicillins

40
Q

Which anti-staphylococcal penicillin is available as an IV, IM, and oral dose?

A

oxacillin

41
Q

Why can isoxazolyl penicillins be dosed orally?

A

they are specifically designed to resist acid hydrolysis

42
Q

What differentiates cloxacillin and dicloxacillin from oxacillin?

A

cloxacillin/dicloxacillin only available as oral doses, have chlorine groups (1 in cloxacillin, 2 in dicloxacillin) added to them which dramatically increases bioavailability

43
Q

What three additional organisms (besides those already covered by Penicillin G) does ampicillin cover?

A

escherichia coli, haemophilus influenzae, proteus mirabilis

44
Q

What are two aminopenicillins?

A

ampicillin, amoxicillin

45
Q

Of the aminopenicillins, _______ is available in IV, IM, and oral doses, while _________ is only available as an oral dose.

A

ampicillin, amoxicillin

Antibiotics (13 decks)

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