Penicillins Flashcards
Beta lactamase inhibitor binds to what part of the penicillin
beta-lactamase ( garage)
what part of the cell does penicillin work
- inhibit bacterial cell wall synthesis
- blocks crosslinking of adjacent peptidoglycan strands
Beta-lactam antibiotics target what
penicillin-binding proteins (PBP)
Penicillin-binding proteins include what
transpeptidase
transglycolases
D-alanine carboxykinase
name 3 broad mechanisms for resistance for penicillin
- beta-lactamase production by existing disease
- failure of antibody to penetrate to PBP targets
- low affinity binding of antibiotic to PBP
what does beta-lactamase do to penicillin
eats garage structure of penicllin
name 2 diseases that produce beta lactamase
staphylococcus
strep. pneumo
for penicillin resistance why is it hard for antibiotics to penetrate to PBP targets
gram negative organisms - porin channel does not allow longer chain penicillin go through pore
absorption of penicillin is dependent on what
acid stability
how does food impact absorbtion
delays and decreases absorption
what drug gets inactivated by surfactant
Daptomycin
how well is penicillin distributed throughout the body
well distributed
is penicillin soluble in lipid
no
where does penicillin have poor distribution? at these locations what makes distribution better
brain, CSF, and prostate,
-inflammation
for most antibiotics, most drug concentration is found where in the body
urinary concentration
where is drug distribution generally really hard to get to
lung then bones
what is the most important route of elimination for penicillin
renal
at what rate do infants excrete penicillin
slower rate due to immature transpor system
what penicillin drugs excrete through biliary
- ampicillin
- nafcillin
- antipsedominal pencillinse
what does Cockroft-Gault equation used for
renal function
Cockroft-Gault equation
((140-age) (weight)) / ( ( serumcreatine)(72))
weight = kg
female= times.85
when can hypersensitivity occur with pencillin
first exposure or re-exposure
who mediates an immediate (anaphylaxis) reaction of penicillin in body
IgE
who mediates an delayed (rash) reaction of penicillin in body
IgM or IgG
what is the most common hypersensitivity reaction to pencillin? where does it usually start
maculopapular rash
abdomen
by getting a blood test, how does one know if they have a maculopapular rash
eosinophil count goes up
eosinophilia
increased eosinophils
what are some adverse effects of taking penicillin
- eosinophilia
- interstitial nephritis
- pseudomembranous colitis
what is the difference between administration penicillin G and VK
G: IM
VK: oral
name two types of penicillin G
procaine pencillin G
Benzatine penicillin
Penicillin G has what acid stability, how do you work around it
acid labile
- use Pen VK orally
Penicillin G/VK work for what bacteria
gram positive except staph, step. pneumoniae, gonorrhea gaining resistance
antistaphylococcal penicillins (penicillinase resistant penicillins) are used to treat what
strap/strep
name two aminopenicillins
ampicillin
amoxicillin
in aminopenicillins what does the amino group allow
penetration into gram negative cell wall
what is the difference between ampicillin and amoxicillin
ampicillin - 4 times a day
amoxicillin - 3 times a day ( better absorption)
what do aminopenicillins treat
strep enterococcus PEK salmonella shigella haemophilus
what are adverse effects of using aminopenicillins
hypersensitivity
diarrhea
how do you decrease the side effect of diarrhea for aminopenicillins? how does this impact the types of aminopenicillins
take with food
ampicillin absorption > amoxicillin
what are two types of carboxypenicillins
carbenicillin
ticarcillin
what does carboxypenicillins do to cell wall
increase permeability
what bacteria does carboxypenicillin cover
- Strep
- fence/pek
- space bugs
- pseudomonas aeruginosa
- enterobacrer spp.
when does doc perscribe ticarcillin
can’t get pipercillin
what type of salt is carbenicillin
indanyl salt
where are high concentrations of carbenicillin found
urine
how does the body react to carbenicillin
cannot tolerate high dosages necessary to treat infection
compare ticarcillin with carbenicillin
more active against pseudomonas
What do heart failure patients need to watch out for when taking ticarcillin
need to watch sodium levels, ticarcillin gives daily amount of Na
what are 2 major adverse effects for carboxypenicillins
- carboxy group cause platelet dysfunction
- sodium overload
name a ureidopenicillin
piperacillin
what bacteria does pipercillin cover
strep enterococcus Fence Space bugs pseudomonas aeruginosa
beta-lactamase inhibitor /penicillin combinations add what coverage
staphylococcus
anaerobes
what are the Beta-lactamase inhibitors
Clavulanic acid
sulbactam
tazobactam
