Penicillins Flashcards
Overview of Penicillins
Include a Beta lactam ring
Disrupts cell wall so bacteria uptakes excessive water and ruptures
3 Factors of Resistance to Penicillins
Inability to reach targets (PBPs)
Inactivation by bacterial enzymes (beta lactamases, penicillinases)
Production of PBPs with low affinity for beta lactams
Penicillin as a drug, not a class
Narrow spectrum
Penicillinase-sensitive, penicillin
Group A strep pharyngitis, Group B Strep for prophylaxis in OB, syphilis.
Most G+, anaerobic bacteria, spirochetes, and some G- Cocci
ADRs: Most common allergic reaction causing drug of ALL drugs
BOX: IM only, IV can lead to death
Anti-staphylococcal Penicillins
Nafcillin, Oxacillin, Dicloxacillin
MSSA (methicillin-susceptible Staphylococcus aureus) infections, NO activity against MRSA
ADR: Most common of ALL drug allergies
Aminopenicillins
Amoxicillin and Ampicillin
Group A strep pharyngitis, Group B Strep for prophylaxis in OB, syphilis.
Most G+, anaerobic bacteria, spirochetes, and some G- Cocci AND G- Bacilli (shingella, salmonella, e coli)
Have to watch for lack of clinical response from beta lactamases
ADR: Penicillin
Ampicillin/Sulbactam
Brand name: Unasyn
Excellent for cellulitis with anaerobes and aspiration pneumonia
(An Aminopenicillin)
Beta Lactamase Inhibitors
Clavulanic Acid, tazobactam, sulbactam, avibactam
Provide extended microbial spectrum when combined with other drugs
Unasyn (ampicillin and sulbactam)
Augmentin (amoxicillin and clavulanic acid)
Zosyn (Piperacillin and tazobactam)
Zosyn
Piperacillin with tazobactam
Broad spectrum: pneumonia, complicated cellulitis, osteomyelitis, unknown sepsis, catheter infections.
MSSA, big against pseudomonas
Primary use: pseudomonas or other resistant G- bacteria is suspected or confirmed
ADR: Acute kidney injury (different from other penicillins), especially when combined with vancomycin
