Penicillins (class)

Question 1

Natural Penicillins

Answer 1

Drug: Aqueous Pen G (IV), Bentzanthine, penicillin (IM), procaine, penicillin G (IM), penicillin VK (PO)
Gram+: GROUP ABCFG STREPTOCOCCI, VIRIDANS STREPTOCOCCI, PCN-susceptible S. aureus (very limited) and S. pneumoniae, some enterococcus, bacillus, corynebacterium
Gram-: NEISSERIA MENINGITIDIS, B-lactamase negative N.gonorrhoeae, pasterella multocida
Anaerobes: peptostreptococcus, actinomyces, CLOSTRIDIUM (not c. diff)
Other: TREPONEMA PALLIDUM (syphilis)

Question 2

Penicillinase-resistant penicillins

Answer 2

Drug: NAFCILLIN (IV), oxacillin (IV), DICLOXACILLIN (PO)
Gram+: METHICILLIN-SUSCEPTIBLE STAPHYLOCOCCUS AUREUS (MSSA)
Gram-: None
Anaerobes: Limited
Other:

Question 3

Aminopenicillins

Answer 3

Drug: AMPICILLIN (IV, PO), amoxicillin (PO)
Gram+: Similar to the natural penicillins but better against ENTEROCOCCUS, LISTERIA MONOCYTOGENES
Gram-: B-lactamase negative H. influenzae, E. coli, proteus mirabilis, salmonella, shigella
Anaerobes: Similar to natural penicillins
Other:

Question 4

Carboxypenicillins

Answer 4

Drug: Ticarcilin (IV)
Gram+: Minimal activity
Gram-: Aminopenicillins plus enterobacter, providencia, morganella, PSEUDOMONAS, STENOTROPHOMONAS, STENOTROPHOMONAS MALTOPHILIA
Anaerobes: Similar to the natural penicillins wtihout actinomyces
Other:

Question 5

Ureidopenicillins

Answer 5

Drug: PIPERACILLIN (IV)
Gram+: Group ABCFG strep, viridans strep, enterococcus
Gram-: Carboxypenicillins plus klebsiella, serratia marscescens, NOT ACTIVE against S. maltophilia, used for BROAD GRAM- COVERAGE INCLUDING P.AERUGINOSA
Anaerobes: Similar to natural penicillins
Other:

Question 6

B-lactamase inhibitor combinations

Answer 6

Drug: AMPICILLIN/SULBACTAM (Unasyn, IV), AMOXICILLIN/CLAVULANATE (Augmentin, PO) Ticarcillin/clavulanate (Timent, IV), PIPERACILLIN/TAZOBACTAM (Zosyn, IV)
Gram+: Same activity as parent penicillin plus METHICILLIN-SUSCEPTIBLE STAPHYLOCOCCUS AUREUS (MSSA)
Gram-: Enhanced against B-LACTAMASE PRODUCING STRAINS of e.coli, h.influenzae, m.catarrhalis, n.gonorrhoae, Timentin and Zosyn have the broadest gram- activity
Anaerobes: ENHANCED from natural penicillins to include BACTEROIDES FRAGILIS and fusobacterium
Other: