Sketchy Pharm: Penicillin

Question 1

What is the Sketchy symbol for beta-lactams?

Answer 1

The planet ringed with the four-membered beta-lactam ring

Question 2

Penicillins –and all other transpeptidase-interfering drugs –work best against _____________.

Answer 2

Gram-positive organisms (thus the penicillin-pencil is purple)

Question 3

Penicillin-binding proteins attach to what residues?

Answer 3

D-alanyl D-alanine; they remove the terminal alanine residue and crosslink the proteins

(Think of the DALA motif on the Death Star.)

Question 4

Which penicillin is orally available?

Answer 4

Penicillin V, because it is acid-stable

Think of the V-wing spacecraft flying comfortably past the acid-yellow nebula.

Question 5

Penicillin _____ must be given IV.

Answer 5

G (like the Princess’s G-shaped bun and the IVy she’s trying to escape from)

Question 6

Penicillin V is often given to ______________.

Answer 6

treat Strep throat (represented by the red bandanas worn by the V-wing pilots)

Question 7

Penicillin G or V can treat ________________.

Answer 7

rheumatic fever (represented by the heart-shaped planet between the princess and the V-wings)

Question 8

Infections of the ____________ can be treated with penicillin G.

Answer 8

mitral valve (represented by the emperor wearing the green cloak – meant to symbolize Streptococcus viridans)

Question 9

What three infections are symbolized by the dune buggy scene?

Answer 9

Actinomyces israelii (the Israeli flag in the branching, filamentous cargo)
Clostridium perfringens (the PERForated spacesuit of the astronaut who crashed) 
Pasturella multocidal (the dog, because P. multocidal infections commonly arise from dog bites)

Question 10

Penicillin G is a common treatment for secondary ______________.

Answer 10

syphilis (Treponema pallidum)

(Think of the guy running with red gloves and boots, like the palmar-plantar rash in secondary syphilis; also, because Treponema pallidum is a spirochete, Sketchy included a spiral galaxy behind this man.)

Question 11

What Gram-negative infection can penicillin treat?

Answer 11

Meningitis from N. meningitidis (represented by the red Boba Fet-like soldier with the prominent helmet)

Question 12

The most common means of resistance to penicillins is ______________.

Answer 12

expression of beta-lactamases (symbolized by the opposing spacecraft with the crossed out Beta)

Question 13

Penicillin can cause three main adverse reactions: _______________.

Answer 13

IgE-mediated anaphylaxis (shown by the pilot’s swollen eyes); IgG-mediated autoimmune hemolytic anemia (like the exploding asteroids with IgG missiles attached); and interstitial nephritis