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Pharmacology - Blood Module > Penicillins (CWIs) > Flashcards

Penicillins (CWIs) Flashcards

1
Q

How can we classify penicillins?

A

We classify penicillins on the basis of antibacterial spectrum,

  1. Natural penicillins
  2. Antistaphylococcal penicillins
  3. Extended-spectrum penicillins
  4. Antipseudomonal penicillins
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2
Q

Give examples of natural penicillins.

A 
Penicillin G (benzylpenicillin)
Penicillin V
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3
Q

Natural penicillins are obtained from the fermentation of fungus __________ ___________

A

Penicillium chrysogenum

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4
Q

What is the antibacterial spectrum of natural penicillins?

A

Gram-positive and negative cocci
Gram-positive bacilli
Spirochetes

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5
Q

__________ (Penicillin G/Penicillin V) is not used to treat bacteremia because of poor oral absorption.

A

Penicillin V

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6
Q

Penicillin ____ (G/V) is more acid-stable and is often employed orally in the treatment of infections.

A

Penicillin V

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7
Q

__________ is the drug of choice in treating gas gangrene and syphilis.

A

Penicillin

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8
Q

What are the examples of Antistaphylococcal penicillins?

A

Methicillin
Nafcillin
Oxacillin
Dicloxacillin

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9
Q

Antistaphylococcal penicillins are __________ resistant penicillins

A

Beta-lactamase

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10
Q

__________ is not used because it causes interstitial nephritis.

A

Methicillin

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11
Q

Penicillinase resistant penicillins have no activity against __________ bacteria

A

gram-negative

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12
Q

________ use is restricted to the tx of infections caused by penicillinase-producing staphylococci, including MSSA

A

Antistaphylococcal penicillins

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13
Q

Potency of penicillin ___ is five times more greater than penicillin ___

A

Potency of penicillin G is five times more greater than penicillin V

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14
Q

Piperacillin has activity against _______________ (bacteria)

A

Pseudomonas aeruginosa

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15
Q

Formulation of piperacillin with _________ extends the antimicrobial spectrum to include penicillinase producing organism

A

tazobactam

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16
Q

What is the mechanism of resistance to penicillins?

A

B-lactamase production
Decreased permeability
Altered PBPs

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17
Q

Gram +ve organisms secrete B-lactamases ___________ (intracellularly/extracellularly)

A

extracellularly

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18
Q

Gram -ve drugs inactivate B-lactam drugs in the _________(cytoplasm/periplasm)

A

periplasm

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19
Q

How do b-lactam antibiotic enter gram -ve bacteria

A

they have porins

20
Q

Pseudomonas aeruginosa shows resistance by lacking ________ (PBP/porins)

A

porins

21
Q

How does Klebsiella pneumonia show resistance to B-lactam antibiotic?

A

K. pneumonia has efflux pumps

22
Q

How does MRSA works?

A

Modified PBP have a lower affinity for B-lactam antibiotics requiring clinically unattainable concentrations of the drug to effect inhibition of bacterial growth

23
Q

Ampicillin w/ sulbactam is given _______ (IV/IM/orally/IV and IM)

A

IV and IM

24
Q

Name the B-lactamase resistant penicillins.

A 
Flucloxacillin
Nafcillin
Dicloxacillin
Oxacillin
Methicillin
Cloxacillin
25
Q

Penicillin V is available as ______ (IV/oral) form

A

oral

26
Q

Piperacillin w/ tazobactam is given ______ (orally/IV/IV and IM)

A

IV and IM

27
Q

What antistaphylococcal penicillins are administed orally?

A

Dicloxacillin

28
Q

What antistaphylococcal penicillins are administed IV or IM?

A

Nafcillin

Oxacillin

29
Q

Procaine penicillin G and benzathine penicillin G are administered _____

A

IM (depot forms)

30
Q

Food __________ absorption of penicillinase resistant penicillins (dicloxacillin)

A

decreases

31
Q

Amoxicillin is _________ (acid-stable/acid-sensitive)

A

acid stable

32
Q

We can take dicloxacillin orally. Is this true?

A

No. Stomach acid destroyes dicloxacillin

33
Q

Can we take amoxicillin orally?

A

Yes

34
Q

______ (all/some) penicillins cross the placental barrier

A

ALL

35
Q

Penicillins penetrate bone and CSF ___________ (easily/hardly/only when tissue is inflammed)

A

only when tissues are inflammed

36
Q

Pencillins are ________ (good/bad) for prostate infections.

Also give reason why they are good/bad.

A

bad

penicillin levels are insufficient in the prostate to be effective against infxn

37
Q

What b-lactam antibiotics are metabolised in the liver?

A

Nafcillin

Oxacillin

38
Q

Which penicillins do not require dose adjustments in renal impairement?

A

Nafcillin

Oxacillin

39
Q

_________ Inhibits the secretion of penicillins by competing for active tubular secretion via the organic acid transporter hence can increase blood levels

A

Probenecid

40
Q

Are penicillin excreted in breast milk?

A

yes

41
Q

What are the adverse reactions of penicillin?

A 
Hypersensitivity reactions
Diarrhea
Nephritis
Neurotoxicity
Cytopenias
42
Q

______ from Clostridium difficile and other organisms may occur with penicillin use

A

Pseudomembranous colitis

43
Q

The penicillins are irritating to neuronal tissue, and they can cause ________ (dizziness/seizures) if injected intrathecally or if very high blood levels are reached

A

seizures

44
Q

Epileptic patients are particularly at risk due to the ability of penicillins to cause
_________ inhibition

A

GABAergic

45
Q

__________ (Increased/decreased) coagulation may be observed with high doses of piperacillin and nafcillin if therapy is continued for greater than 2 weeks

A

Decreased

Pharmacology - Blood Module (11 decks)

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