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pharmacology > Penicillins > Flashcards

Penicillins Flashcards

1
Q

Penicillin G

A

o X million units IVPB
o every 4 hours

In Hospital: 5 million units, followed by 2.5 million units

Group B strep

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2
Q

Penicillin G aqueous

A

o 18 to 24 million units IVPB
o per day total divided evenly every 4 hours or continuous infusion for 10-14 days

Neurosyphilis

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3
Q

Penicillin G Benzathine (Bicillin-LA®)

A

o 2.4 million units
o Intramuscularly once

Syphilis
Group A Strep pharyngitis

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4
Q

Penicillin V potassium

A

o 500 mg
o One tablet every 6 hours around the clock

Strep throat
For kids use mg/kg

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5
Q

What are the first generation antimicrobial agents for cell wall synthesis?

A 
Penicillin G
Penicillin G procaine
Penicillin G benzathine
Penicillin G benzathine and penicillin G procaine
Penicillin V potassium
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6
Q

Are Penicillin G and Penicillin V Penicillinase resistant?

A

No, so bacteria can become resistant to the meds

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7
Q

How is Penicillin G’s oral absorption?

A

Variable (poor)

IV best

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8
Q

How is Penicillin V’a oral absorption?

A

Good, only in oral form

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9
Q

Are Ampicillin and Amoxicillin Penicillinase resistant?

A

No, so bacteria can become resistant to the meds

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10
Q

How is Ampicillin’s oral absorption?

A

Good

Can be IV too

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11
Q

How is Amoxicillin’s oral absorption?

A

Excellent (oral only)

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12
Q

What are the first generation penicillins primarily used for?

A 
Syphilis
Streptococcal pharyngitis
Meningococcal infection
Necrotizing Fasclitis
Streptococcal endocarditis
Pasturella multocida
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13
Q

What are the Broad spectrum antimicrobial agents for cell wall synthesis?

A

Ampicillin
Amoxicillin
Amoxicillin and clavulanate

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14
Q

What are the Broad spectrum antibiotics (ampicillin, amoxicillin) used for?

A

Upper respiratory infections
Active against S. pyogenes, S. pneumoniae, H. influenzae; sinusitis, otitis media, acute exacerbations of chronic bronchitis, epiglottitis

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15
Q

Amoxicillin

A

o 500 mg
o One capsule every 8 hours around the clock

Smaller person = 250 mg
Kid = 125 mg
*Kid can do mg/kg but NEVER exceed adult dose

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16
Q

Ampicillin/sulbactam (Unasyn®)

A

o 3 g IVPB
o every six (6) hours

For every 3 g you get:
2 g Ampicillin and 1 g Sulbactam
* So calculate for ampicillin *
(Sulbactam is B-Lactamase inhibitor)

17
Q

What are the Antistaphylococcal antimicrobial agents for cell wall synthesis?

A

Nafcillin
Oxacillin
Dicloxacillin

18
Q

Are Nafcillin and Dicloxacillin Penicillinase resistant?

A

Yes! so no bacterial resistance

19
Q

How is Dicloxacillin’s oral absorption?

A

Good

20
Q

How is Nafcillin’s oral absorption?

A

Variable (IV only)

21
Q

What is Dicloxacillin good against?

A

Less effective against organisms sensitive to penicillin G
No gram-negative activity

Staph infections, MRSA

22
Q

What is Nafcillin good against?

A

staphylococcal meningitis

MRSA

23
Q

Nafcillin (Nallpen®)

A

o 1 or 2 g IVPB
o every four (4) hours

Can dose 3 g ever 6 hours
Prosthetic joint infection

24
Q

Dicloxacillin

A

o 500 mg orally
o One capsule every six (6) hours

Can be 1 g ever 8 hours
No oral suspension for kids

25
Q

What are the Extended Spectrum antimicrobial agents for cell wall synthesis?

A

Piperacillin
Piperacillin and tazobactam
Ticarcillin and clavulanate potassium

26
Q

Is Piperacillin Penicillinase resistant?

A

No! so bacteria can be resistant

27
Q

How is Piperacillin’s oral absorption?

A

Poor (IV only)

28
Q

What are the Extended Spectrum antimicrobial agents for cell wall synthesis used for?

A

Pneumonias

Gram negative infections:

  • Pseudomonas aeruginosa
  • Proteus (indole-positive)
  • Enterobacter spp.
29
Q

Piperacillin/tazobactam (Zosyn®)

A

o 3.375 g IVPB
o every six (6) hours

Every 3.375 g get 3 g Piperacillin and 0.375 g tazobactam

2.25 g is lower dose

30
Q

What are the Beta lactamase inhibitor combinations (BLICs)?

A

Oral:
Amoxicillin/clavulanate potassium (Augmentin™)

Injectable:
Ampicillin/sulbactam (Unasyn™)
Piperacillin/tazobactam (Zosyn

31
Q

Worst offender of hypersensitivity reactions?

A

Ampicillin

32
Q

What are possible hypersensitivity reactions to the penicillins?

A

Manifestation from most likely to least likely:

Maculopapular rash
Urticarial rash
Fever
Bronchospasm
Vasculitis
Serum sickness
Exfoliative dermatitis
Stevens-Johnson syndrome
Anaphylaxis
33
Q

What are possible side effects due to the oral route of the penicillins?

A

Change in gastrointestinal microflora:

Most patients bounce back after therapy discontinued.

Superinfection
Pathological changes to the microflora
Clostridium difficile incidence?

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