Penicillins

Question 1

Beta lactamase inhibitor binds to what part of the penicillin

Answer 1

beta-lactamase ( garage)

Question 2

what part of the cell does penicillin work

Answer 2

• inhibit bacterial cell wall synthesis

- blocks crosslinking of adjacent peptidoglycan strands

Question 3

Beta-lactam antibiotics target what

Answer 3

penicillin-binding proteins (PBP)

Question 4

Penicillin-binding proteins include what

Answer 4

transpeptidase
transglycolases
D-alanine carboxykinase

Question 5

name 3 broad mechanisms for resistance for penicillin

Answer 5

1. beta-lactamase production by existing disease
2. failure of antibody to penetrate to PBP targets
3. low affinity binding of antibiotic to PBP

Question 6

what does beta-lactamase do to penicillin

Answer 6

eats garage structure of penicllin

Question 7

name 2 diseases that produce beta lactamase

Answer 7

staphylococcus

strep. pneumo

Question 8

for penicillin resistance why is it hard for antibiotics to penetrate to PBP targets

Answer 8

gram negative organisms - porin channel does not allow longer chain penicillin go through pore

Question 9

absorption of penicillin is dependent on what

Answer 9

acid stability

Question 10

how does food impact absorbtion

Answer 10

delays and decreases absorption

Question 11

what drug gets inactivated by surfactant

Answer 11

Daptomycin

Question 12

how well is penicillin distributed throughout the body

Answer 12

well distributed

Question 13

is penicillin soluble in lipid

Answer 13

no

Question 14

where does penicillin have poor distribution? at these locations what makes distribution better

Answer 14

brain, CSF, and prostate,

-inflammation

Question 15

for most antibiotics, most drug concentration is found where in the body

Answer 15

urinary concentration

Question 16

where is drug distribution generally really hard to get to

Answer 16

lung then bones

Question 17

what is the most important route of elimination for penicillin

Answer 17

renal

Question 18

at what rate do infants excrete penicillin

Answer 18

slower rate due to immature transpor system

Question 19

what penicillin drugs excrete through biliary

Answer 19

• ampicillin
• nafcillin
• antipsedominal pencillinse

Question 20

what does Cockroft-Gault equation used for

Answer 20

renal function

Question 21

Cockroft-Gault equation

Answer 21

((140-age) (weight)) / ( ( serumcreatine)(72))
weight = kg
female= times.85

Question 22

when can hypersensitivity occur with pencillin

Answer 22

first exposure or re-exposure

Question 23

who mediates an immediate (anaphylaxis) reaction of penicillin in body

Answer 23

IgE

Question 24

who mediates an delayed (rash) reaction of penicillin in body

Answer 24

IgM or IgG

Question 25

what is the most common hypersensitivity reaction to pencillin? where does it usually start

Answer 25

maculopapular rash | abdomen

Question 26

by getting a blood test, how does one know if they have a maculopapular rash

Answer 26

eosinophil count goes up

Question 27

eosinophilia

Answer 27

increased eosinophils

Question 28

what are some adverse effects of taking penicillin

Answer 28

- eosinophilia - interstitial nephritis - pseudomembranous colitis

Question 29

what is the difference between administration penicillin G and VK

Answer 29

G: IM VK: oral

Question 30

name two types of penicillin G

Answer 30

procaine pencillin G | Benzatine penicillin

Question 31

Penicillin G has what acid stability, how do you work around it

Answer 31

acid labile | - use Pen VK orally

Question 32

Penicillin G/VK work for what bacteria

Answer 32

gram positive except staph, step. pneumoniae, gonorrhea gaining resistance

Question 33

antistaphylococcal penicillins (penicillinase resistant penicillins) are used to treat what

Answer 33

strap/strep

Question 34

name two aminopenicillins

Answer 34

ampicillin | amoxicillin

Question 35

in aminopenicillins what does the amino group allow

Answer 35

penetration into gram negative cell wall

Question 36

what is the difference between ampicillin and amoxicillin

Answer 36

ampicillin - 4 times a day | amoxicillin - 3 times a day ( better absorption)

Question 37

what do aminopenicillins treat

Answer 37

``` strep enterococcus PEK salmonella shigella haemophilus ```

Question 38

what are adverse effects of using aminopenicillins

Answer 38

hypersensitivity | diarrhea

Question 39

how do you decrease the side effect of diarrhea for aminopenicillins? how does this impact the types of aminopenicillins

Answer 39

take with food | ampicillin absorption > amoxicillin

Question 40

what are two types of carboxypenicillins

Answer 40

carbenicillin | ticarcillin

Question 41

what does carboxypenicillins do to cell wall

Answer 41

increase permeability

Question 42

what bacteria does carboxypenicillin cover

Answer 42

- Strep - fence/pek - space bugs - pseudomonas aeruginosa - enterobacrer spp.

Question 43

when does doc perscribe ticarcillin

Answer 43

can't get pipercillin

Question 44

what type of salt is carbenicillin

Answer 44

indanyl salt

Question 45

where are high concentrations of carbenicillin found

Answer 45

urine

Question 46

how does the body react to carbenicillin

Answer 46

cannot tolerate high dosages necessary to treat infection

Question 47

compare ticarcillin with carbenicillin

Answer 47

more active against pseudomonas

Question 48

What do heart failure patients need to watch out for when taking ticarcillin

Answer 48

need to watch sodium levels, ticarcillin gives daily amount of Na

Question 49

what are 2 major adverse effects for carboxypenicillins

Answer 49

- carboxy group cause platelet dysfunction | - sodium overload

Question 50

name a ureidopenicillin

Answer 50

piperacillin

Question 51

what bacteria does pipercillin cover

Answer 51

``` strep enterococcus Fence Space bugs pseudomonas aeruginosa ```

Question 52

beta-lactamase inhibitor /penicillin combinations add what coverage

Answer 52

staphylococcus | anaerobes

Question 53

what are the Beta-lactamase inhibitors

Answer 53

Clavulanic acid sulbactam tazobactam