Penicillins Flashcards
Narrow Spectrum Penicillins
Penicillin G and V
Penicillinase- resistant penicillins
Dicloxacillin, nafcillin, oxacilin
Extended- spectrum antibiotics
amoxicillin, ampicillin, piperacillin
beta-lactamase inhibitors
clavulanate (w amoxicillin) …. tazobactam w piperacillin and sulbactam with ampicillin
bacitracin and fosfomycin
inhibit cell wall peptidoglycan synthesis - block steps in formation of MurNAc-GlcNAc (disaccharide precursors)
fosfomycin
inhibits enolpyruvyl transferase - enzyme that catalyzes condensation of UDP- GlcNAc with phosphoenolpyruvate to UDP-MurNAc
vancomycin
binds to D-alanyl-D-alanine
name the beta-lactams
penicillins, carbapenems, cephalosporins and a monobactam antibiotic named AZTREONAM
narrow spectrum penicillins - active against?
many gram POSITIVE cocci
penicillinase-resistant penicillins - active against?
some strains of penicillinase producing STAPHYLOCOCCI
extended spectrum penicillins - active agains?
some gram NEGATIVE bacilli & ANAEROBIC & gram POSITIVE organisms
penicillin antibiotics structure
beta-lactam ring fused to thiazolidine ring w unique R group for each antibiotic
penicillin stable in gastric acid &given orally
amoxicillin and penicillin V
acid labile penicillin
piperacillin
penicillins widely distributed to CNS?
NO.
penetrate CSF?
yes, with intravenous administration - meningitis
penicillins excreted in bile
ampicillin and nafcillin
renal tubular secretion inhibited by?
probenecid
penicillin G administered IM - forms?
procaine penicillin G and benzathine penicillin G
penicillin G and V (narrow spectrum) treat
streptococci (+pneumococci), meningococci and spirochetes(treponema pallidum)
PENICILLIN G CAN ALSO TREAT
Clostridium perfringens - gas gangrene
penicillin G ROA
Oral / parenteral
penicillin G elimination half life
0.5 hrs
penicillin G ROE
renal (TS)
penicillin G spectrum
syphilis (treponema pallidum) endocarditis (viridans streptococci, enterococci) meningitis (meningococci) pneumococci(pneumonia) various (streptococci)
penicillin V ROA
oral
penicillin V elimination half life
1 hr
penicillin v ROE
renal (TS)
penicillin v spectrum
pharyngitis (streptococcus pyogenes)
methicillin causes?
interstitial nephritis
staphylococci resistant to penicillinase resistant penicillins?
MRSA
dicloxacilin ROA
oral
dicloxacillin elimination half life
0.6 hr
dicloxacillin ROE
renal (TS)
penicillinase penicillin spectrum
nafcillin
oxacillin
serious staphylococcal infections (acute endocarditis) & osteomyelitis
skin and soft tissue infections
STAPHYLOCOCCUS AUREUS
nafcillin ROA
oral / parenteral
nafcillin elimination half life
0.5 hr
nafcillin ROE
biliary
extended spectrum penicillins
amoxicillin, ampicillin, piperacillin
amoxicillin treat which pathogens?
can be used alone to treat resp tract infections (otitis media, sinusitis, bronchitis and community-acquired pneumonia
also used for prophylaxis, to treat bacterial endocarditis in persons w heart valve disease
amoxicillin ROA
oral
amoxicillin elimination half life
1 hr
amoxicillin ROE
renal (TS)
amoxicillin +- clavulanate infections
otitis upper resp tract infections pneumonia skin and soft tissue infections UTIs
amoxicillin +- clavulanate pathogens
pneumococci streptococci staphylococci haemophilus influenza moraxella catarrhalis e. coli pasteurella multocida
ampicillin ROA
oral or parenteral
ampicillin elimination half life
1 hr
ampicillin ROE
renal (TS) and biliary
ampicillin +- sulbactam infections
meningitis (listeria monocytogenes)
decubitus and diabetic foot ulcers (gram + and anaerobic)
endocarditis (streptococci, enterococci)
Lyme disease (borrelia burgdorferi)
piperacillin ROA
parenteral
piperacillin elimination half life
1.2-1.3 hr
piperacillin ROE
renal (TS)
piperacillin +- tazobactam infections
intraabdominal infections
skin and soft tissue infections
pneumonia
other infections (lower resp, complicated urine, gynec and febrile neutropenia)
sometimes given in combo w aminoglycoside antibiotic
piperacillin +- tazobactam pathogens
aerobic & anaerobic organisms
pseudomonas aeruginosa
ampicillin + gentamicin (aminoglycoside)
enterococcal infections;
enterococcal endocarditis