penicillins Flashcards
Question: What are the characteristics of benzylpenicillin sodium (Penicillin G)?
Answer: Benzylpenicillin sodium is an important antibiotic effective against streptococcal, gonococcal, and meningococcal infections, as well as anthrax, diphtheria, tetanus, gas gangrene, and leptospirosis. However, it’s inactivated by bacterial beta-lactamases and is no longer the first-choice drug for pneumococcal meningitis. It has low gastrointestinal tract absorption and must be given by injection.
Question: When is benzathine benzylpenicillin used, and how is it administered?
Answer: Benzathine benzylpenicillin is used for the treatment of early syphilis and late latent syphilis, administered via intramuscular injection.
Question: What are the characteristics of phenoxymethylpenicillin (Penicillin V)?
Answer: Phenoxymethylpenicillin has a similar antibacterial spectrum to benzylpenicillin sodium but is less active. It’s stable in gastric acid and suitable for oral administration. It’s indicated primarily for respiratory tract infections in children, streptococcal tonsillitis, and continuing treatment when clinical response to benzylpenicillin sodium has started. However, it should not be used for serious infections, meningococcal, or gonococcal infections.
Question: For what prophylactic purposes is phenoxymethylpenicillin used?
Answer: Phenoxymethylpenicillin is used for prophylaxis against streptococcal infections following rheumatic fever and against pneumococcal infections following splenectomy or in sickle-cell disease.
Question: What are the characteristics of benzylpenicillin sodium (Penicillin G)?
Answer: Benzylpenicillin sodium is an important antibiotic effective against streptococcal, gonococcal, and meningococcal infections, as well as anthrax, diphtheria, tetanus, gas gangrene, and leptospirosis. However, it’s inactivated by bacterial beta-lactamases and is no longer the first-choice drug for pneumococcal meningitis. It has low gastrointestinal tract absorption and must be given by injection.
Question: When is benzathine benzylpenicillin used, and how is it administered?
Answer: Benzathine benzylpenicillin is used for the treatment of early syphilis and late latent syphilis, administered via intramuscular injection.
Question: What are the characteristics of phenoxymethylpenicillin (Penicillin V)?
Answer: Phenoxymethylpenicillin has a similar antibacterial spectrum to benzylpenicillin sodium but is less active. It’s stable in gastric acid and suitable for oral administration. It’s indicated primarily for respiratory tract infections in children, streptococcal tonsillitis, and continuing treatment when clinical response to benzylpenicillin sodium has started. However, it should not be used for serious infections, meningococcal, or gonococcal infections.
Question: For what prophylactic purposes is phenoxymethylpenicillin used?
Answer: Phenoxymethylpenicillin is used for prophylaxis against streptococcal infections following rheumatic fever and against pneumococcal infections following splenectomy or in sickle-cell disease.
Question: What makes flucloxacillin effective in treating certain infections, and how is it administered?
Answer: Flucloxacillin is effective against infections caused by penicillin-resistant staphylococci because it is not inactivated by penicillinases. It can be administered by mouth and injection, and it’s well absorbed from the gut.
Question: What is the primary indication for using flucloxacillin?
Answer: Flucloxacillin is primarily used in infections caused by penicillin-resistant staphylococci.
Question: What is temocillin’s spectrum of activity, and when should it be used?
Answer: Temocillin is active against Gram-negative bacteria and stable against a wide range of beta-lactamases. It should be reserved for treating infections caused by beta-lactamase-producing strains of Gram-negative bacteria, including those resistant to third-generation cephalosporins. Temocillin is not active against Pseudomonas aeruginosa or Acinetobacter spp.
Question: What makes flucloxacillin effective in treating certain infections, and how is it administered?
Answer: Flucloxacillin is effective against infections caused by penicillin-resistant staphylococci because it is not inactivated by penicillinases. It can be administered by mouth and injection, and it’s well absorbed from the gut.
Question: What is the primary indication for using flucloxacillin?
Answer: Flucloxacillin is primarily used in infections caused by penicillin-resistant staphylococci.
Question: What is temocillin’s spectrum of activity, and when should it be used?
Answer: Temocillin is active against Gram-negative bacteria and stable against a wide range of beta-lactamases. It should be reserved for treating infections caused by beta-lactamase-producing strains of Gram-negative bacteria, including those resistant to third-generation cephalosporins. Temocillin is not active against Pseudomonas aeruginosa or Acinetobacter spp.
Question: Why should resistance likelihood be considered before using ampicillin for treating infections?
Answer: Ampicillin is inactivated by penicillinases, and almost all staphylococci, around 60% of E. coli strains, and approximately 20% of H. influenzae strains are now resistant. It’s essential to consider resistance before using ampicillin for the ‘blind’ treatment of infections.
Question: What is the primary indication for using ampicillin?
Answer: Ampicillin is mainly indicated for the treatment of exacerbations of chronic bronchitis, middle ear infections, and urinary-tract infections.
Question: What common side effect is associated with ampicillin and amoxicillin, and in which patient groups does it frequently occur?
Answer: Maculopapular rashes are common side effects of ampicillin and amoxicillin, especially in patients with glandular fever. The risk of rash is also increased in patients with acute or chronic lymphocytic leukemia or cytomegalovirus infection.
Question: What makes amoxicillin different from ampicillin in terms of oral administration and absorption?
Answer: Amoxicillin is better absorbed than ampicillin when given orally, producing higher plasma and tissue concentrations. Unlike ampicillin, amoxicillin’s absorption is not affected by the presence of food in the stomach.
Question: What is the role of clavulanic acid in co-amoxiclav, and when should co-amoxiclav be used?
Answer: Clavulanic acid in co-amoxiclav inactivates beta-lactamases, making the combination active against beta-lactamase-producing bacteria resistant to amoxicillin. Co-amoxiclav should be used for infections likely to be caused by amoxicillin-resistant beta-lactamase-producing strains.
Regenerate
Question: Why should resistance likelihood be considered before using ampicillin for treating infections?
Answer: Ampicillin is inactivated by penicillinases, and almost all staphylococci, around 60% of E. coli strains, and approximately 20% of H. influenzae strains are now resistant. It’s essential to consider resistance before using ampicillin for the ‘blind’ treatment of infections.
Question: What is the primary indication for using ampicillin?
Answer: Ampicillin is mainly indicated for the treatment of exacerbations of chronic bronchitis, middle ear infections, and urinary-tract infections.
Question: What common side effect is associated with ampicillin and amoxicillin, and in which patient groups does it frequently occur?
Answer: Maculopapular rashes are common side effects of ampicillin and amoxicillin, especially in patients with glandular fever. The risk of rash is also increased in patients with acute or chronic lymphocytic leukemia or cytomegalovirus infection.
Question: What makes amoxicillin different from ampicillin in terms of oral administration and absorption?
Answer: Amoxicillin is better absorbed than ampicillin when given orally, producing higher plasma and tissue concentrations. Unlike ampicillin, amoxicillin’s absorption is not affected by the presence of food in the stomach.
Question: What is the role of clavulanic acid in co-amoxiclav, and when should co-amoxiclav be used?
Answer: Clavulanic acid in co-amoxiclav inactivates beta-lactamases, making the combination active against beta-lactamase-producing bacteria resistant to amoxicillin. Co-amoxiclav should be used for infections likely to be caused by amoxicillin-resistant beta-lactamase-producing strains.
Regenerate
Question: What is the broad-spectrum of activity for both piperacillin with tazobactam and ticarcillin with clavulanic acid?
Answer: Both piperacillin with tazobactam and ticarcillin with clavulanic acid have a broad spectrum of activity against a range of Gram-positive and Gram-negative bacteria, as well as anaerobes.
Question: Which of these antipseudomonal penicillins has more activity against Pseudomonas aeruginosa?
Answer: Piperacillin with tazobactam is more active against Pseudomonas aeruginosa than ticarcillin with clavulanic acid.
Question: Are these antipseudomonal penicillins effective against methicillin-resistant Staphylococcus aureus (MRSA)?
Answer: No, these antipseudomonal penicillins are not active against MRSA.
Question: In which types of infections are piperacillin with tazobactam and ticarcillin with clavulanic acid commonly used?
Answer: They are used in the treatment of septicaemia, hospital-acquired pneumonia, and complicated infections involving the urinary tract, skin and soft tissues, or intra-abdomen. For severe Pseudomonas infections, they can be given with an aminoglycoside for a synergistic effect.
Question: What is the broad-spectrum of activity for both piperacillin with tazobactam and ticarcillin with clavulanic acid?
Answer: Both piperacillin with tazobactam and ticarcillin with clavulanic acid have a broad spectrum of activity against a range of Gram-positive and Gram-negative bacteria, as well as anaerobes.
Question: Which of these antipseudomonal penicillins has more activity against Pseudomonas aeruginosa?
Answer: Piperacillin with tazobactam is more active against Pseudomonas aeruginosa than ticarcillin with clavulanic acid.
Question: Are these antipseudomonal penicillins effective against methicillin-resistant Staphylococcus aureus (MRSA)?
Answer: No, these antipseudomonal penicillins are not active against MRSA.
Question: In which types of infections are piperacillin with tazobactam and ticarcillin with clavulanic acid commonly used?
Answer: They are used in the treatment of septicaemia, hospital-acquired pneumonia, and complicated infections involving the urinary tract, skin and soft tissues, or intra-abdomen. For severe Pseudomonas infections, they can be given with an aminoglycoside for a synergistic effect.
Question: Which antibiotic has significant activity against Gram-negative bacteria including Escherichia coli, klebsiella, enterobacter, and salmonellae?
Answer: Pivmecillinam hydrochloride has significant activity against these Gram-negative bacteria.
Question: Is pivmecillinam hydrochloride active against Pseudomonas aeruginosa and enterococci?
Answer: No, pivmecillinam hydrochloride is not active against Pseudomonas aeruginosa or enterococci.
Question: What is the active drug produced when pivmecillinam hydrochloride is hydrolyzed?
Answer: The active drug produced is mecillinam.
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Question: Which antibiotic has significant activity against Gram-negative bacteria including Escherichia coli, klebsiella, enterobacter, and salmonellae?
Answer: Pivmecillinam hydrochloride has significant activity against these Gram-negative bacteria.
Question: Is pivmecillinam hydrochloride active against Pseudomonas aeruginosa and enterococci?
Answer: No, pivmecillinam hydrochloride is not active against Pseudomonas aeruginosa or enterococci.
Question: What is the active drug produced when pivmecillinam hydrochloride is hydrolyzed?
Answer: The active drug produced is mecillinam.
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Question: Which class of antibiotics has a broad-spectrum but decreasing value due to increasing bacterial resistance?
Answer: The tetracyclines are broad-spectrum antibiotics with decreasing value due to increasing bacterial resistance.
Question: What are the specific infections for which tetracyclines are still considered the treatment of choice?
Answer: Tetracyclines are the treatment of choice for infections caused by chlamydia, rickettsia, brucella, Borrelia burgdorferi (Lyme disease), mycoplasma infections, acne, periodontal disease, chronic bronchitis, leptospirosis (in penicillin hypersensitivity), and management of meticillin-resistant Staphylococcus aureus (MRSA) infection.
Question: Which tetracycline has a broader spectrum compared to others and is active against Neisseria meningitidis but is associated with side effects like dizziness, vertigo, lupus-erythematosus-like syndrome, and irreversible pigmentation?
Answer: Minocycline has a broader spectrum compared to other tetracyclines and is active against Neisseria meningitidis, but it’s associated with side effects including dizziness, vertigo, lupus-erythematosus-like syndrome, and irreversible pigmentation.
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Question: Which class of antibiotics has a broad-spectrum but decreasing value due to increasing bacterial resistance?
Answer: The tetracyclines are broad-spectrum antibiotics with decreasing value due to increasing bacterial resistance.
Question: What are the specific infections for which tetracyclines are still considered the treatment of choice?
Answer: Tetracyclines are the treatment of choice for infections caused by chlamydia, rickettsia, brucella, Borrelia burgdorferi (Lyme disease), mycoplasma infections, acne, periodontal disease, chronic bronchitis, leptospirosis (in penicillin hypersensitivity), and management of meticillin-resistant Staphylococcus aureus (MRSA) infection.
Question: Which tetracycline has a broader spectrum compared to others and is active against Neisseria meningitidis but is associated with side effects like dizziness, vertigo, lupus-erythematosus-like syndrome, and irreversible pigmentation?
Answer: Minocycline has a broader spectrum compared to other tetracyclines and is active against Neisseria meningitidis, but it’s associated with side effects including dizziness, vertigo, lupus-erythematosus-like syndrome, and irreversible pigmentation.
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Flucloxacillin cautionary label
An hour before OR two hours after food on an emoty stomach
Flucloxacillin side-effects
Hepatic function should be checked.
Causes hepato jaundice.
