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Infectious Disease Therapeutics > Penicillins > Flashcards

Penicillins Flashcards

1
Q

Penicillins MOA

A

Bind to PBP resulting in inhibition of peptidoglycan synthesis and activation of autolytic enzymes in cell wall

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2
Q

Penicillin (Bacteriostatic or Bactericidal)

A

Bactericidal

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3
Q

How does penicillin resistance mainly develop?

A
  • Production of beta-lactmases
  • Lack of PBP’s or altered PBP’s
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4
Q

What organisms produce beta-lactamase enzymes?

A
  • Staph
  • Haemophilus
  • Gram Negatives
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5
Q

What structure do all penicillins share?

A
  • All penicillins share the same basic structure – 6-aminopenicillanic acid (thiazolidine ring attached to a beta-lactam ring)
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6
Q

Penicillin G Spectrum of Activity

A

Highly active against Gram positive (gp) bacteria and spirochetes (e.g. syphilis)

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7
Q

Penicillin G is destroyed by….

A
  • Beta-lactamases
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8
Q

Penicillin G Route of Admin

A
  • Acid labile –> Not used orally
  • If a salt, must be IM
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9
Q

Penicillin V Route of Admin

A
  • Oral formulation
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10
Q

What is the difference between Penicillin V and Penicillin G?

Pen V Counselling Tip?

A

Penicillin V –> Oral
Penicillin G –> Injection

Penicllin V ore acid stable but still needs to be taken on an empty stomach –> still very unstable

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11
Q

Natural Penicillins spectrum of activity Specific

A
  • Streptococci
  • Penumococci
  • Meningococci
  • Spirochetes
  • Clostridia
  • Anaerobic gram positive (strep)
  • Actinomyces
  • Enterococci

some people mention that slts can act amazingly everyday

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12
Q

Penicillins. What is there group name?

A
  • Cloxacillin
  • Flucloxacillin
  • DIcloxacillin

Isoxazolyl penicillins

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13
Q

Define MSSA and MRSA. is methicllin used for pharmacotherapy?

A

MRSA –> Methicillin Resistant Staph Aureus –> Never give methicillin as a drug –> resistant to this whole class as well as all penicillin’s
Not a drug we give but a marker in the lab
- Also means cloxacillin resistance –> M is representative of the whole family

MSSA –> Methicillin Susceptible Staph Aureus –> Use cloxacillin (Canadian Name) –> Drug of choice

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14
Q

Isoaxyzol Penicllins are designed for… (which organism)

A
  • Staphlococcus aureus
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15
Q

Isoxazolyl Penicillin Formulations

A
  • IV and oral
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16
Q

Isoxazolyl Penicillin used in ….. infections

A
  • Staphlococcal infections; not MRSA
17
Q

Aminopenicillin Examples

A
  • Ampicillin
  • Amoxicillin
18
Q

Aminopenicillins have activity against….

A
  • Gram positive and negative organisms (limited negative coverage)

Cover more gram + than penicllins

19
Q

Isoxazolyl penicillins and beta-lactmases

A
  • Organisms that produce beta-lactmases are reisstant
20
Q

Aminopenicillins are destroyed by….

A
  • Beta-lactamases
21
Q

Ampicillin Route of Admin

A

used IV; more acid stable than natural penicillins but poor bioavailability

22
Q

Amoxicillin Route of Admin

What is amoxicillin combined with and what is its purpose?

A

used orally; better absorption than ampicillin; also available combined with clavulanic acid (beta-lactamase inhibitor)

23
Q

Aminopenicillins spectrum Specific

A

Streptococci*
enterococci*
Neiserria sp.*
non-beta-lactamase producing H. influenzae E. coli
P. mirabilis
Salmonella

(slTS eat no homies pns sorry)

24
Q

Clauvonic Acid MOA

A

Amoxicillin also available in combination with clavulanic acid

Clavulanic acid is a beta-lactamase inhibitor
Beta-lactamases open the beta- lactam ring of penicillins and cephalosporins ; no longer active

Classification of beta-lactamases depends on genetics, biochemical properties and substrate affinity for a beta-lactamase inhibitor

25
Q

Ureidopenicllins Example

A

piperacillin

26
Q

Piperacillin Spectrum

ACtive against which important organism

A

Increased activity against gn rods

Active against
Pseudomonas aeruginosa

27
Q

Piperacillin Route of Admin

A

Parenteral Use

28
Q

Piperacillin is avilable in combination with

A

Available combined with beta-lactamase inhibitor tazobactam

29
Q

Penicllins are distributed…..

A

-Widely; including the CNS

30
Q

Penicillins are excreted primarily by….

A
  • Kidney
31
Q

Penicllins are mainly taken on….. except for penicllin can be take with….

A

are taken on an empty stomach except amoxicillin

32
Q

Drug Interaction of Penicllins

A
  • Oral Contraceptives

Generally, the efficacy of estrogen is enterohepatic recirculation. With penicillins, you get destruction of estrogen and prevent enterohepatic recirculation. May get pregnant.

An unattended pregnancy can have huge consequences. Inform pt about using another form of contraception

33
Q

Adverse effects of Penicllins

A

Allergic reactions – many people report allergies to antibiotics
Anaphylactic shock
Serum sickness*
Skin rashes
Fever
Nephritis
Eosinophilia
Seizures, Encephalopathy delirium
Electrolyte imbalances
Neutropenia, thrombocytopenia
Diarrhea, gi upset

Infectious Disease Therapeutics (17 decks)

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