THER.Penicillin.9.1.15

Question 1

Are most penicillins bacteriostatic or bactericidal?

Answer 1

They are bactericidal (except against enterococcus)

Question 2

What are the names of the natural penicillins?

Answer 2

aqueous penicillin G (IV)

benzathine penicllin G (IM, long acting)

procaine penicillin G (IM)

penicillin VK (oral)

Question 3

Targets of Natural penicllins

Answer 3

Gram pos: Group strep, viridans strep

Gram neg [cocci]: Neisseria spp.

Anaerobes: clostridium spp. (not difficile)

Other: Treponema pallidum-syphillis

Misc: Pen G is used for anthrax, clos. tetani and perfingens

Question 4

Name the Penicillinase-resistant penicillins

Why they were discovered?

Answer 4

Nafcillin

Oxacillin

Methicillin (not available)

Dicloxacillin (oral)

**Made to deal with pencillinase enzyme made by natural penicillin resistant staph

Nah, can’t oxidize my-enzymes Dic

Question 5

Targets of Penicillinase Resistant Penicillins

Answer 5

Gram pos: methicillin-susceptible staph aureus (MSSA)

Gram neg: no activity

Misc: no MRSA

Question 6

Names of Aminopenicillins

Why were they created?

Answer 6

Ampicillin (only IV used)

Amoxicillin (oral)

Developed to target gram neg activity

A = amp’d + amo

Question 7

Targets of Aminopenicillins

Answer 7

Gram pos: enterococcus spp. and listeria monocytogenes (not staph)

Gram neg: H. influenzae, E. coli, Shigella, Salmonella

Misc: More limited effects and always given with Beta lactamase inhibitor

Misc II: very effective with entero and listeria even though these were designed for gram neg originally

Question 8

Name the Carboxypenicillins

Why were they created

Answer 8

TiCARcillin (not available)

Developed to target gram neg activity

TiCARcilin = CARboxy

Question 9

Targets of the carboxypenicillin

Answer 9

Gram pos: minimal effect

Gram neg: Similar to aminopen + Enterobacter spp., Pseudomonas aeruginosa (common w/ hospital infections)

Question 10

Name the Ureidopenicillins

Answer 10

Piperacillin (not available)

Question 11

Target of Ureidopenicillin

Answer 11

Gram pos: Good for Streptococcus, ok for enterococcus (no staph)

Gram neg: Pseudonomas aeruginosa

Anaerobes: Clostridium and Peptostreptococcus

Ureidopenicillin = _S_treptococcus, _E_nterococcus, Pseudomonas aeruginosa, Clostridium, Peptostreptococcus

“don’t USE PCP”

Question 12

Name the function of a beta lactamase inhibitor

Answer 12

Prevents the bacterial enzyme beta lactamase from degrading the beta lactam from an abx

Question 13

Name the Beta lactamase inhibitor combinations

Answer 13

Unasyn (IV) = Ampicillin + Sulbactam

Zosyn (IV) = Piperacillin + Tazobactam

Timentum (IV) = Ticarcillin + Clavulanate

Augmentin (oral) = Amoxicillin + Clavulanate

Question 14

Targets of Beta lactamase inhibitor combos

Answer 14

Gram pos: Staph aureus (not MRSA)

Gram neg: H. Influenzae & Moraxella catarrhalis

Anaerobes: Bacteriodes spp. and/or B. fragilis

Misc: these won’t be effective against bacteria with mutated PBP

Beta-lactamase inhibitor combo = Bacteroides, Staph aureus, H. influenzae, Moraxella catarrhalis, B. fragilis

“Better, But Still won’t Hit Mutated Bacteria”