Penicillins Flashcards
Spectrum of Penicillin G
Gram +- cocci, non-B-lactamase producing anaerobes (Clostridum perfringens), spirochetes, gram + bacilli (bacillus anthracis, diphtheria)
Which has better oral availability?
Ampicillin vrs. Amoxicillin
Amoxicillin
Antipseudomonal penicllins spectrum C T P A M
Carbenicillin, Ticarcillin, Piperacillin, Azlocillin, Mezlocillin
Penicillin G is highly water ____
Stable in _____(dry/wet) state
Acid _____ (Labile/resistant)
Water soluble, dry state, acid labile
1 IU of crystalline benzyl penicillin =
0.6 micrograms of standard preparation
Concentration of standard natural penicillins can be increased by
Probenecid
2.4 million units IM of Benzathine penicillin once a week for 3-4 wks to treat
Syphilis
Action of probenecid
Inhibits tubular secretion of penicillin
Action of Benzathine and procaine penicillins
Delay absorption resulting in prolonged blood/tissue conc.
How to administer benzathine penicillin? Time in blood? Prevents?
IM injection of 1.2 million units
3 weeks
Prevents B-hemolytic streptococcal infection
How many hours will Procaine penicillin be Sufficient in 600,000 units
12-24 hours
Name 1 drug to treat UTIs caused by Enterobacteriaceae and E. coli
Amoxicillin
Therapeutic uses of Penicillin V
Taken orally for minor infections especially group A streptococcus
Nafcillin is ____(water/lipid) soluble
Crosses BB? (Yes/no)
Extracted primarily in____
Administered via___ of ____grams every ____hours
Lipid soluble,
Can cross BBB
Excretes in bile
Intravenous infusion 1-2g every 4-6 hours
What treatment is preferred for Shigellosis?
Ampicillin
MRSA staphylococcal species action:
Altered penicillin binding proteins
Aminopenicillins spectrum
Grab + cocci, E. coli, H. Influenza, Listeria monocytogenes, borrelia burgdorferi, H pylori
Will food interfere with absorption of Isoxazolyl penicillins?
Yes
Narrow spectrum Anti-staphylococcal Penicillins M N O C D I
Methicillin Nafcillin Oxacillin Cloxacillin Dicloxacillin Isoxazolyl Penicillin
If methicillin resistant staph aureus, treat with____, if still resistant treat with (L,Q,D)
Vancomycin
Linezolid, Quinupristin, Daflopristin
All oral penicillins should be given 1-2 hours before/after a meal except
Amoxicillins
3 B-lactamase inhibitors
Clavulanic acid, Sulbactam, Tazobactam
Extended spectrum of Ampicillin E L E S
Anaerobes, enterococci, listeria monocytogenes, Non B-lacatmase strains of E. coli and salmonella
Treatment of Salmonella infections
Ampicillin
Severe adverse effect of Ampicillin
Psuedomembranous colitis
Therapeutic uses of aminopenicillins
URTIs
Treatment of Meningitis caused by Listeria monocytogenes
Ampicillin + Vancomycin + third generation cephalosporins
Name 2 carboxypenicillins
Carbenicillin, Ticarcillin
Ampicillin is good for what complication of salmonella?
Salmonella gastroenteritis
GI distress, pseudomembranous colitis, and vaginal candidiasis caused by which penicillin?
Ampicillin
Treatment of pseudomonas aeruginosa
Carboxypenicillins
High dose of carboxypenicillins can cause
Bleeding by interfering with platelet function
3 Ureidopenicillins
Piperacillin
Mezlocillin
Azlocillin
Treatment of Klebsiella pneumoniae
The ureidopenicillins
A dentist undergoes oral surgery and treats the patient (has abnormal heart valves) for prophylactic use of
Amoxicillin
Outside of the urinary tract, antipseudomonal Penicillin is frequently used in combo with ___or___
Aminoglycoside or fluoroquinolone
Nephrotoxicity results from which penicillin?
Methicillin
Which 2 penicillins causes platelet dysfunction?
Carbenicillin, Ticarcillin
Which penicillin causes neutropenia?
Nafcillin
Penicillin injected into syphilitic patient produces fever, malaise, joint pain, hypotension is called a ____reaction…
Jarisch-herxheimer reaction
Clavulanic acid is prepared with 2 penicillins
Amoxicillin(oral) and Ticarcillin(parenteral)
Sulbactam is taken with ___ administered via ___
Ampicillin via parenteral
Tazobactam taken with _____ administered via ____
Piperacillin via parenteral
Difference between B-lactams and penicillins
B-lactams are more stable to B-lactamases
Burn patients and Cystic fibrosis patients need what type of drug?
Carboxypenicillins
