Penicillins Flashcards
PCNs have a long or short half life?
Short half life (< 2 hrs)
What could prolong the half-life of PCNs?
Renal dysfunction
(T/F) - If someone has a true hypersensitivity reaction to PCNs, other PCNs should be avoided
TRUE
(T/F) - If a reaction is not severe of PCNs, cephalosporins and carbapenems can be used
TRUE
Are PCNs poorly absorbed?
Yes
What side effect could most commonly occur in PCNs when taken orally?
Diarrhea
Natural PCNs have a good spectrum over which bacteria?
- Group A and B strep
- Treponema pallidum
- Actinomyces [HACEK]
- Peptostreptococci
Natural PCNs are the drug of choice (DOC) for?
Syphillis
(T/F) - Natural PCNs are a great empiric choice for most infections
FALSE - not a great empiric choice due to resistance to most infections
Other than natural PCNs being used for syphilis, what other condition could it be used for?
- Susceptible strep
endocarditis, pharyngitis
Do natural PCNs have a broad or narrow spectrum coverage for susceptible infections?
Narrow spectrum coverage
Antistaphylococcal PCNs have a good spectrum over which bacteria?
- Group A and B strep
- MSSA
What adverse events can occur with antistaphylococcal PCNs?
- Interstitial nephritis
- Phlebitis
(T/F) - Antistaphylococcal PCNs are eliminated by the liver instead of the kidneys
TRUE
Are antistaphylococcal PCNs interchangeable therapeutically?
Yes
What is the DOC for antistaphylococcal PCNs?
MSSA infections (endocarditis, skin/soft tissue)
(T/F) - Vancomycin kills staph quicker than beta-lactams
FALSE - beta-lactams can kill staph quicker than vancomycin
If a patient lacks a serious beta-lactam allergy and has an MSSA infection, what should be done?
Switch to an anti-staph PCN or 1st generation cephalosporin when possible
Aminopenicillins have a good spectrum over which bacteria?
- Group A and B strep and sensitive S. pneumoniae
- Enterococci
- Listeria monocytogenes
- Peptostreptococci
Which aminopenicillin has a great oral bioavailability?
Amoxicillin
Aminopenicillin’s are utilized mainly for
- Susceptible enterococci
- Strep, susceptible gram (-) bacilli
- URTIs (pharyngitis, otitis media)
Which aminopenicillin is the DOC for susceptible enterococci?
Ampicillin
How does ampicillin achieve a bactericidal activity against enterococci?
Ampicillin has to be combined with an aminoglycoside
The combination of ampicillin with aminoglycoside should be done when?
In serious infections, such as endocarditis
Antipseudomonal PCNs have a good spectrum over which bacteria?
- Pseudomonas
- Strep
- Enterococci
Antipseudomonal PCNs are active against which bacteria?
- Streptococci
- Enterococci
Are antipseudomonal PCNs commonly used alone or in combination?
Only in combination with beta-lactamase inhibitor
Beta-lactam/beta-lactamase inhibitors have a good spectrum over which bacteria?
- MSSA
- Group A and B strep and strep pneumoniae
- Anaerobes
- Gram (-) bacilli enteric and non-enteric
- Pasturalla multicide
Which beta-lactam/beta-lactamase inhibitor(s) have a good spectrum over pseudomonas (gram (-) bacilli non-enteric)?
- Piperacillin/tazobactam
- Ticarcillin/clavulanate
(T/F) - Beta-lactamase inhibitors combined with beta-lactams are active against ALL beta-lactamases.
FALSE - are not active against ALL beta-lactamases
Which beta-lactamase inhibitor has a good activity against acinetobacter (highly drug-resistant GNR that causes nosocomial infections)?
Sulbactam
Amoxicillin/clavulanate is mainly utilized for which infections?
URTIs, LRTIs, UTIs
Piperacillin/tazobactam and ticarcillin/clavulanate is mainly utilized for which infections?
Empiric Rx’s for nosocomial infections
Beta-lactams/beta-lactamase inhibitors are greatly utilized for…?
“Mixed infections” because of their anaerobic activity
