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Pharmacology Antimicrobials > Penicillins > Flashcards

Penicillins Flashcards

1
Q

Penicillin G administration

A

P, O

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2
Q

Pen V (Phenoxymethyl penicillin) administration

A

O

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3
Q

Phenoxyethyl Penicillin administration

A

O

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4
Q

Half life of Natural Penicillins

A

</= 1 hr (except in renal failure… could be up to 5 hours)

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5
Q

What does the repository forms of penicillins IM (e.g. procain pen G, benzathine pen G) change?

A

Makes the half-life of Pen much longer.

T1/2 of procaine pen G= 6-8hrs, benzathine pen G= 6 days

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6
Q

Antistaphylococcal penicillin half-life

A

All 0.5 hours in serum

>not changed significantly in renal failure (except Methicillin) b/c largely met/excreted by liver

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7
Q

Antistaphylococcal pen dosage must be changed in what circumstance?

A

Hepatic failure, esp for Nafcillin

Exception is methicillin (mostly renal)

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8
Q

Oral antistaphylococcal penicillins

A

CLOXacillin

diCLOXacillin

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9
Q

Antistaph penicillins taken P, O

A

Nafcillin

Oxacillin

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10
Q

Parenteral only Antistaph penicillins

A

Methicillin

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11
Q

Extended range penicillins

A

Ampicillin
Amoxicillin
Piperacillin
Ticarcillin

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12
Q

T1/2 for extended range penicillins

A

~1hr

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13
Q

What factor changes clearance of extended range penicillins?

A

Renal failure. Can be up to 10-15 hrs.

Except Piperacillin, which has some liver clearance

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14
Q

Parenteral only extended range penicillins

A

Piperacillin

Ticarcillin

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15
Q

Oral only extended range penicillin

A

Amoxicillin

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16
Q

P, O extended range penicillin

A

Ampicillin

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17
Q

Antistaphylococcal penicillins (Penicillinase-resistant)

A 
Methicillin
Oxacillin
Nafcillin
Cloxacillin
Dicloxacillin
18
Q

Penicillins that have best % absorption

A

Amoxicillin & Pen V

19
Q

All penicillins are metabolized to varying degree by _______ and all get into _______ in good concentrations

A

All penicillins are metabolized by LIVER and all get into BILE in good concentrations

20
Q

All penicillins (except Nafcillin) are chiefly eliminated by what structure?

A

Kidney–primarily by tubular secretion

21
Q

This drug can inhibit tubular secretion to inhibit penicillin elimination

A

Probenecid

22
Q

Penicillin distribution

A
  • Wide but not in Prostate, CNS, or Eye,

- Inactivated in Abscesses

23
Q

Penicillin is the DOC for…

A
  • Strptococcal infections: GAS (pharyngitis, cellulitis); Strep pneumo (pneumonia, meningitis); E. faecoalis (w/ aminoglycosides)
  • Some Non-Penicillinase-producing Staph aureus infxns
  • Many non-Bacteroides anaerobes
  • N. meningitidis
  • Syphilis (treponemes)
24
Q

Ticarcillin & Piperacillin notable coverage

A

Pseudomonas, Bacteroides

25
Q

Community-acquired infections involving respiratory tract (OM, sinusitis, pneumonia, bronchitis) often treated with…

A

Ampicillin, Amoxicillin

26
Q

Serious infections due to Gram - organisms usually treated with …

A

IV Ticarcillin, Piperacillin

w/ aminoglycosides

27
Q

Extended range penicillins have synergistic activity with aminoglycosides against which two organisms in particular?

A

Enterococcus faecalis

Pseudomonas

28
Q

IgE to MDM causes what reaction?

A

Anaphylaxis

29
Q

IgE to BPO causes what reaction?

A

urticaria, rashes, angioedema

30
Q

IgG and IgM cause what reaction?

A

Serum sickness, common rashes

31
Q

Penicillin General Adverse Reactions

A
  • Allergic reaction
  • GI: Diarrhea, pseudomemb colitis
  • Neuromuscular irritability: seizures (in high dose or renal failure)
  • Hematologic: neutropenia, anemia
  • Drug fever
  • Interstitial nephritis
32
Q

Ampicillin/Amoxicillin Reactions

A

Skin rash
Diarrhea
Pseudomemb colitis (C. diff)

33
Q

Methicilin adverse reaction

A

Interstitial nephritis

34
Q

Nafcillin adverse reaction

A

Phlebitis

Neutropenia

35
Q

Oxacillin adverse reaction

A

Elevated hepatic transaminases

Neutropenia

36
Q

Penicillin-Procaine adverse reactions

A

Neurologic reactions/abnormal behavior w/ high doses

37
Q

Beta-lactamase inhibitors add activity against what organisms in particular?

A
  • B-lactamase producing S. aureus
  • B-lactamase producing H. flu
  • Bacteroides
  • Moraxella catarrhalis
38
Q

Tx for mixed aerobic/anaerobic organism coverage where high-resistance strains (e.g. pseudomonas, enterobacter) are not suspected

A

Parenteral Ampicillin/Sulbactam

E.g. for GI/GU tract surgical infectiona dn pneumonias

39
Q

Tx for upper and lower respiratory infections (OM, sinusitis, bronchitis) where b-lactamase producing H. flu or Moraxella are expected

A

Amoxicillin/Clavulanic Acid

40
Q

“shotgun therapy” in seriously ill patients pending definitive identification of infecting organism(s).

A

Ticarcillin/Clavulanic Acid or
Piperacillin/Tazobactam
»may be used w/ aminoglycoside for enhanced spectrum and synergy

Pharmacology Antimicrobials (4 decks)

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