Penicillins Flashcards
What are the Beta Lactams
Penicillins
Cephalosporins
Carbapenems
Monobactams
How do Penicillins work
Bactericidal
Bind PBPs inhibiting cell wall synthesis
What does PCN activate
Autolysin
Where do Penicillins not work
Prostate
Eye
Brain (except meningitis)
Where are Penicillins excreted
Kidney
Where is Naficillin excreted
Bile
Use for renal insufficiency
What is excreted in renal and bile
Oxacillin
Dicloxacillin
What can be given synergistically with PCN
Aminoglycoside
What is DOC for empiric infective endocarditis
PCN G + Gentamycin
Is there cross allergy reactivity between beta lactams
Yes
Which PCN can cause interstitial nephritis
Methicilin
What is seen in interstitial nephritis
Oliguria
Fever, rash
EOS in urine
Which PCN can cause pseudomembranous colitis
Ampicillin
How do penicillins cause a maculopapular rash
Ampicillin/Amoxicillin for viral infection
Which PCN can cause elevated BT
Ticarcillin
Inhibits platelet function
Which PCN can cause neutropenia
Nafcillin
Which PCN can cause hepatitis
Oxacillin
What are the 4 mechanisms of PCN resistance
Inactivated by Beta-lactamase
Modified PBPs
Impaired penetration
Increased efflux
What resistance mechanism does MRSA/ORSA have
Altered PBPs
What are the “Natural” Penicillins
Penicillin G
Penicillin G benzathine
Penicillin G procaine
DOC strep throat
Penicillin V
DOC P. Aeruginosa
Ticarcillin
Carbenicillin
Piperacillin
What does Penicillin G act on
Gram+ Except staph Gram- cocci Anaerobes Strep Pneumococci
DOC Syphillis
Penicillin G
Which PCN is susceptible to beta lactamase
G
V
TCP
Amox/Ampi
Amox/Ampi URTs
H. influenza
S. pneumoniae
Amox/Ampi UTIs
E. coli
Amox/Ampi misc enterococci
P. mirabilis
Salmonella
Shigella
Which PCN Gs are IM
Benzathine
Procaine
Which Penicillin has highest f
Amoxicillin
Are Amox/Ampi ok in pregnancy
Yes
When is Amoxicillin given
Endocarditis prophylaxis in dental/resp procedures
What do you give for Listeria and enterococci
Ampicillin with aminoglycoside
Which PCN is never used clinically
Methicillin (causes AIN)
DOC Staph endocarditis w/o prosthetic valve
Methicillin
Nafcillin
Oxacillin
Dicloxacillin
What is the infection most likely with prosthetic valve
S. viridans
Amox/Ampi spectrum
Extended
What are the beta-lactamase inhibitors
Clavulanic acid
Sulbactam
Tazobactam