Penicillins

Question 1

PCNs have a long or short half life?

Answer 1

Short half life (< 2 hrs)

Question 2

What could prolong the half-life of PCNs?

Answer 2

Renal dysfunction

Question 3

(T/F) - If someone has a true hypersensitivity reaction to PCNs, other PCNs should be avoided

Answer 3

TRUE

Question 4

(T/F) - If a reaction is not severe of PCNs, cephalosporins and carbapenems can be used

Answer 4

TRUE

Question 5

Are PCNs poorly absorbed?

Answer 5

Yes

Question 6

What side effect could most commonly occur in PCNs when taken orally?

Answer 6

Diarrhea

Question 7

Natural PCNs have a good spectrum over which bacteria?

Answer 7

• Group A and B strep
• Treponema pallidum
• Actinomyces [HACEK]
• Peptostreptococci

Question 8

Natural PCNs are the drug of choice (DOC) for?

Answer 8

Syphillis

Question 9

(T/F) - Natural PCNs are a great empiric choice for most infections

Answer 9

FALSE - not a great empiric choice due to resistance to most infections

Question 10

Other than natural PCNs being used for syphilis, what other condition could it be used for?

Answer 10

• Susceptible strep

endocarditis, pharyngitis

Question 11

Do natural PCNs have a broad or narrow spectrum coverage for susceptible infections?

Answer 11

Narrow spectrum coverage

Question 12

Antistaphylococcal PCNs have a good spectrum over which bacteria?

Answer 12

• Group A and B strep

- MSSA

Question 13

What adverse events can occur with antistaphylococcal PCNs?

Answer 13

• Interstitial nephritis

- Phlebitis

Question 14

(T/F) - Antistaphylococcal PCNs are eliminated by the liver instead of the kidneys

Answer 14

TRUE

Question 15

Are antistaphylococcal PCNs interchangeable therapeutically?

Answer 15

Yes

Question 16

What is the DOC for antistaphylococcal PCNs?

Answer 16

MSSA infections (endocarditis, skin/soft tissue)

Question 17

(T/F) - Vancomycin kills staph quicker than beta-lactams

Answer 17

FALSE - beta-lactams can kill staph quicker than vancomycin

Question 18

If a patient lacks a serious beta-lactam allergy and has an MSSA infection, what should be done?

Answer 18

Switch to an anti-staph PCN or 1st generation cephalosporin when possible

Question 19

Aminopenicillins have a good spectrum over which bacteria?

Answer 19

• Group A and B strep and sensitive S. pneumoniae
• Enterococci
• Listeria monocytogenes
• Peptostreptococci

Question 20

Which aminopenicillin has a great oral bioavailability?

Answer 20

Amoxicillin

Question 21

Aminopenicillin’s are utilized mainly for

Answer 21

• Susceptible enterococci
• Strep, susceptible gram (-) bacilli
• URTIs (pharyngitis, otitis media)

Question 22

Which aminopenicillin is the DOC for susceptible enterococci?

Answer 22

Ampicillin

Question 23

How does ampicillin achieve a bactericidal activity against enterococci?

Answer 23

Ampicillin has to be combined with an aminoglycoside

Question 24

The combination of ampicillin with aminoglycoside should be done when?

Answer 24

In serious infections, such as endocarditis

Question 25

Antipseudomonal PCNs have a good spectrum over which bacteria?

Answer 25

- Pseudomonas - Strep - Enterococci

Question 26

Antipseudomonal PCNs are active against which bacteria?

Answer 26

- Streptococci | - Enterococci

Question 27

Are antipseudomonal PCNs commonly used alone or in combination?

Answer 27

Only in combination with beta-lactamase inhibitor

Question 28

Beta-lactam/beta-lactamase inhibitors have a good spectrum over which bacteria?

Answer 28

- MSSA - Group A and B strep and strep pneumoniae - Anaerobes - Gram (-) bacilli enteric and non-enteric - Pasturalla multicide

Question 29

Which beta-lactam/beta-lactamase inhibitor(s) have a good spectrum over pseudomonas (gram (-) bacilli non-enteric)?

Answer 29

- Piperacillin/tazobactam | - Ticarcillin/clavulanate

Question 30

(T/F) - Beta-lactamase inhibitors combined with beta-lactams are active against ALL beta-lactamases.

Answer 30

FALSE - are not active against ALL beta-lactamases

Question 31

Which beta-lactamase inhibitor has a good activity against acinetobacter (highly drug-resistant GNR that causes nosocomial infections)?

Answer 31

Sulbactam

Question 32

Amoxicillin/clavulanate is mainly utilized for which infections?

Answer 32

URTIs, LRTIs, UTIs

Question 33

Piperacillin/tazobactam and ticarcillin/clavulanate is mainly utilized for which infections?

Answer 33

Empiric Rx's for nosocomial infections

Question 34

Beta-lactams/beta-lactamase inhibitors are greatly utilized for...?

Answer 34

"Mixed infections" because of their anaerobic activity