Penicillins Flashcards
Penicillin family Mechanism of Action
- Bind to Penicillin-binding proteins (PBP)
- Inhibits cell wall synthesis by blocking peptidoglycan linkage
Penicillins ability to enter CSF
Poor distribution unless inflammation is present (due to lipid insolubility)
T/F: Renal excretion is the least important route of elimination of Penicillins
False: Its the most important, adjustment for renal insufficiency must be made
Immediate hypersensitivity reaction: Penicillin
Anaphylaxis (IgE mediated)
Delayed hypersensitivity reaction: Penicillin
Maculopapular rash (IgM or IgG mediated) that generally starts on the abdomen
T/F: Interstitial nephritis is an adverse reaction for the penicillin family of medications
True
Penicillin G: Spectrum of activity
Gram + (Strep and some Enterococcus)
*Staph - must give beta-lactamase inhibitor
Ampicillin/Amoxicillin: Spectrum of activity
Gram + to FENCE bugs
- Cover enterococcus
- Staph - must give beta-lactamase inhibitor
4 penicillins that have anti-staphylococcal activity
- Dicloxacillin
- Nafcillin
- Oxacillin
- Methicillin
Major problem with using anti-staphyloccal medications (reason methicillin was taken off the market)
Interstitial nephritis
Anti-staphyloccal: Spectrum of activity
Basically Staph and Strep only
Ticarcillin/Pipercillin: Spectrum of activity
Strep to SPACE
*Cover pseudomonas
Should ticarcillin or pipercillin be used?
Pipercillin due to ticarcillin causing Na+ overload
*Pipercillin also covers enterococcus better
Augmentin
Amoxicillin/Clavulonic acid
Unasyn
Ampicillin/Sulbactam
