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Antibiotics > Penicillin II > Flashcards

Penicillin II Flashcards

1
Q

Why has amoxicillin largely replaced ampicillin for treatment?

A

ampicillin had a high incidence of causing bad diarrhea as a side effect; amoxicillin lessened that side effect

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2
Q

Why does amoxicillin not cause diarrhea as badly as ampicillin does?

A

it is more completely absorbed from the GI tract

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3
Q

What was the first penicillin that had activity against pseudomonas, and what were its problems?

A

carbenicillin; even though it worked, needed very high doses for it to be effective (about 30 g per day), resistance to it developed rapidly, not effective against beta lactamases

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4
Q

Which of the anti-pseudomonal penicillins only has a spectrum of activity towards pseudomonas?

A

azlocillin

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5
Q

What are five anti-pseudomonal penicillins?

A

carbenicillin, ticarcillin, azlocillin, mezlocillin, piperacillin

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6
Q

Of the anti-pseudomonal penicillins, which two are mostly of historical interest now (not really used)?

A

carbenicillin, ticarcillin

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7
Q

What was the idea behind creating combination products with a penicillin and a beta-lactamase inhibitor?

A

the beta lactamase inhibitors (which were also beta lactams with little antibiotic activity on their own) would protect penicillins that would normally be broken down by beta lactamases so they could be effective

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8
Q

Ticarcillin and Clavulanic Acid is what combination product?

A

timentin

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9
Q

Ampicillin and Sulbactam is what combination product?

A

unasyn

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10
Q

Piperacillin and Tazobactam is what combination product?

A

zosyn

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11
Q

Amoxicillin and Clavulanic Acid is what combination product?

A

Augmentin

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12
Q

What are the three categories of Broad-Spectrum Penicillins?

A

aminopenicillins, anti-pseudomonal penicillins, penicillin/beta lactamase inhibitors

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13
Q

What leads to the broad spectrum penicillins’ increased activity against gram-negative bacteria? Why are they still not very useful against many gram-negative organisms?

A

increasing ability to penetrate the gram-negative cell wall; still not very useful against gram-negative organisms because often hydrolyzed by gram-negative beta lactamases

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14
Q

Which two categories of Broad-Spectrum penicillins are broken down by beta lactamases?

A

aminopenicillins, anti-pseudomonal penicillins

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15
Q

Why is ampicillin/amoxicillin not good against MSSA?

A

they would be broken down by the beta lactamases

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16
Q

Which organisms do aminopenicillins have good activity against?

A

streptococci, enterococci

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17
Q

Which organisms do aminopenicillins have moderate activity against?

A

enteric gram-negative rods (GNRs), Haemophilus (non-penicillinase producing organisms)

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18
Q

Which organisms do aminopenicillins have poor activity against?

A

MSSA/MRSA, anaerobes, pseudomonas, nosocomial Enterobacteriaceae (many produce beta lactamases)

19
Q

What is the oral bioavailability of ampicillin?

A

40%

20
Q

What conditions are aminopenicillins commonly used to treat?

A

otitis media, bacterial sinusitis, bacterial exacerbations of chronic bronchitis, some Salmonella infections

21
Q

Amoxicillin has a higher incidence of what reaction compared to other penicillins?

A

skin rashes

22
Q

Which oral form of carbenicillin is still used today only in the treatment of UTIs, and why is it good for that?

A

carbenicillin indanyl, cleared through the kidneys so can achieve very high concentrations in the urine (to treat UTIs)

23
Q

Which type of people are usually found to have stenotrophomonas infections?

A

hospitalized patients who have recently gone through multiple rounds of antibiotics

24
Q

What are two organisms ticarcillin is NOT active against?

A

Enterococci, Klebsiella

25
Q

What organisms is ticarcillin good against?

A

anaerobes (including Bacteroides fragilis)

26
Q

Ticarcillin is a ________ salt, meaning there are _____ mEq/gm of sodium per gram of drug.

A

di-sodium, 5.2

27
Q

What is one serious disease that ticarcillin can cause?

A

acquired platelet dysfunction

28
Q

What is the most popular anti-pseudomonal penicillin used today?

A

piperacillin

29
Q

What organisms does piperacillin have activity against (provided they don’t produce beta lactamases)?

A

klebsiella, pseudomonas (most active anti-pseudomonal), serratia, enterobacter, enterococci, anaerobes (including bacteroides fragilis)

30
Q

Which organisms does Zosyn (piperacillin + tazobactam) have good activity against?

A

gram positive aerobes: MSSA, streptococcus, gram negative aerobes: enterococci, enteric GNRs, pseudomonas, gram positive and gram negative anaerobes (especially B. fragilis)

31
Q

Which organisms does Zosyn (piperacillin + tazobactam) have moderate activity against?

A

GNRs producing “advanced” beta lactamases

32
Q

Which organisms does Zosyn (piperacillin + tazobactam) have poor activity against?

A

MRSA, extended-spectrum beta lactamases produces by GNRs (gram-negative rods)

33
Q

Zosyn is commonly used for ______ treatment in hospitals.

A

empiric

34
Q

Patients with __________ are at an increased risk for skin rashes when taking ampicillin/amoxicillin.

A

mononucleosis

35
Q

Taking allopurinol with penicillins increases the incidence of _____

A

rash

36
Q

Take probenicid with amoxicillin ________ amoxicillin levels

A

increases

37
Q

Take warfarin with penicillins ________ the anticoagulant effect of warfarin.

A

increases

38
Q

Taking methotrexate with penicillins _____ the exposure (effect) to methotrexate

A

increases

39
Q

Should you warn your patient about beta lactams possibly decreasing the effectiveness of oral contraceptives?

A

yes, to be safe

40
Q

What is neutropenia, and when does it usually occur?

A

abnormally low white blood cell count; usually occurs when taking high doses of penicillins over long time period

41
Q

What are three penicillins which commonly cause thrombocytopenia (low platelet count)?

A

ticarcillin, piperacillin, mezlocillin

42
Q

Hypokalemia (low potassium) can occur if the drug makes the _______ more efficient at excreting potassium.

A

kidney

43
Q

Which penicillin commonly causes hepatitis/cholestasis (backup of bile)?

A

oxacillin

44
Q

Which adverse penicillin reaction is rare but occurs 100% of the time in people with syphillis?

A

Jarixch-Herxheimer reaction

Antibiotics (13 decks)

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