Sketchy - Cell Wall and Membrane Active Antibiotics - Penicillins

Question 1

How do penicillins work their magic?

Answer 1

They interfere with the transpeptidation reaction of bacterial cell wall synthesis

Penicillin binding proteins do this by removing a terminal alanine in the D-ala-D-ala motif preventing cross-linking.

Question 2

Penicillins work best against what kind of bacteria in general?

Answer 2

Gram positives ie staph and strep

Question 3

The cell wall of gram positive organisms is made of:

Answer 3

peptidoglycan with repeating D-alanyl-D-alanine oligopeptides

Question 4

T/F: Penicillin is bacteriocidal.

Answer 4

True

Question 5

How is Penicillin V administered?

Answer 5

Orally - Penicillin V is acid stable

Question 6

What is the dosing for Penicillin V?

Answer 6

4x/day

Question 7

Why is penicillin V not a great choice?

Answer 7

Frequent dosing;

Poor bioavailability

Question 8

How is Penicillin G administered?

Answer 8

IV and IM

Question 9

What is an appropriate treatment for Group A streptococcal pharyngitis?

Answer 9

Penicillin V

Question 10

What is an appropriate tx for rheumatic fever?

Answer 10

Pen V or G

Question 11

What is an appropriate treatment for left-sided endocarditis caused by Strep viridans or Strep bovis?

Answer 11

Penicillin G

Question 12

What is the intrapartum treatment for Strep agalactiae (Group B strep)?

Answer 12

Pencillin G prophylaxis

Question 13

What gram positive bacillus that grows in chains is treatable with penicillins?

Answer 13

Actinomyces israelii

Question 14

T/F: Clostridium perfringens can be treated with penicillins.

Answer 14

True

Question 15

What is an appropriate treatment for Pasturella multocida caused by dog bits?

Answer 15

Penicillins
Ampicillin
Piperacillin

Question 16

What is the treatment of choice for Syphilis?

Answer 16

single dose of benzathine Penicillin G

Works for primary, secondary and early latent forms of syphilis

Question 17

What gram negative organism can be treated with Penicillin G and causes meningitis?

Answer 17

Neisseria meningitidis

Question 18

What is the most common mode of resistance against penicillins?

Answer 18

The production of beta lactamases, such as those made by staph aureus

Question 19

Penicillins can cause what a Type I hypersensitivity reaction resulting in:

Answer 19

anaphylaxis

Question 20

Penicillin administration can result in what form of anemia as an adverse effect?

Answer 20

Autoimmune hemolytic anemia

Positive direct Coombs test

Question 21

What adverse effect can penicillins have on the kidney?

Answer 21

Drug-induced interstitial nephritis

Question 22

Penicillins have cross-reactivity with what drug class?

Answer 22

Cephalosporins