Walters-Penicilins Flashcards

1
Q

what do penicillins (PCNs) inhibit?

A

they inhibit transpeptidase. important because gram (+) bacteria undergo cross-linkage reactions. without transpeptidase the D-alanine will not be removed, which inhibits cell wall synthesis-> LYSIS

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2
Q

are PCNs static or cidal?

A

cidal because they disrupt the sythesis of cell wall synthesis, which causes lysis

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3
Q

what defense have microbes evolved to destroy PCNs?

A

beta lactamase enzymes that destroy the beta lactam ring in PCN

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4
Q

how is PCN G administered and why?

A

cannot be taken orally (acidity would inactivate it) and only distributes into the CNS if the meninges are inflammed

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5
Q

what are the 3 forms of PCN G drugs?

A

aqueous, procaine and benzathine

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6
Q

why are people usually allergic to procaine?

A

it is an ester and some patients are allergic to esters

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7
Q

which PCN G drug is the longest lasting?

A

benzathine

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8
Q

What two drugs are combined to form Bicillin C-R?

A

procain and benzathine

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9
Q

what is the difference between PCN G and PCN V?

A

PCN V can be taken orally (acid stable), food will decrease absorption and it is dosed in mgs (not units like PCN G)

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10
Q

when would you use Penicillinase (beta-lactamase) resistant PCNs?

A

only if PCN G and PCN V are ineffective

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11
Q

what are the three type of Penicillinase resistant PCNs?

A

dicloxacillin (taken orally), oxacillin (parenteral) and nafcillin (parenteral)

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12
Q

how are Penicillinases eliminated?

A

eliminated by biliary and renal excretion an advantage in hepatic or renal disease

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13
Q

what are Aminopenicillins useful for?

A

increased coverage for gram negative bacteria but they are still susceptible to PCNases

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14
Q

how is ampicillin delivered?

A

oral or IV

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15
Q

what is sulbactam?

A

is a beta-lactamase (PCNase) inhibitor that protects ampicillin from metabolism, which enhances activity

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16
Q

what is amoxicillin? and what is good to treat?

A

also an aminopenicillin. treats otitis media, prophylaxis before dental work and can be used for peritonitis as an oral prep only after IV therapy

17
Q

what are antipseudomonas PCNs effective against?

A

active against some pseudomonas and some resistant proteus but still susceptible to PCNases

18
Q

what are the types of antipseudomonas PCNs?

A
  1. ) ticarcillin+clavulanate

2. ) piperacillin+tazobactam

19
Q

what are the general side effects of penicillins?

A

hypersensitivity, diarrhea, superinfection, increase risk of seizures (if blood brain barrier is penetrated) and Jarisch-Herxheimer Reaction (in 70-90% of patients with secondary syphilis)

20
Q

what are the symptoms and treatments for Jarisch-Herxheimer Reaction?

A

flu-like symptoms and treat with aspirin (resolves in 12-24 hours)