PENICILLINS

Question 1

Indications for benzathine penicillin

Answer 1

Syphilis
Group A streptococcal infections
Prophylaxis for erysipelas
Prophylaxis for rheumatic fever
Prophylaxis for poststreptococcal glomerulonephritis

Question 2

Dose for benzathine penicillin in syphilis

Answer 2

Primary and secondary stage syphilis
2.4million units as a single dose Deep IM

Late-stage syphilis
2.4million units once weekly for 3 weeks Deep IM

Question 3

Dose for benzathine penicillin in Group A streptococcal respiratory infections

Answer 3

1.2million units Deep IM single dose

Question 4

Dose for benzathine penicillin for prophylaxis of rheumatic fever, erysipelas and poststreptococcal glomerulonephritis

Answer 4

1.2million units every 3-4 weks

Without cardiac involvement: For at least 5 years or up to 21 years

Transient cardiac involvement: For at least 10 years or up to 21 years

Persistent cardiac involvement: For at least 10 years or up to 40years

Question 5

Side effects of benzathine penicillin

Answer 5

Risk of infection increased
Oral disorders
Nephropathy
Jarisch-Herxheimer reaction
Encephalopathy

Question 6

Contraindications of benzathine penicillin

Answer 6

Hypersensitivity to penicillins and Peanuts or soya

Question 7

Dose adjustments for benzathine penicillin in renal impairment

Answer 7

15-59ml/min: reduce daily dose
by 25% and give as a single dose

<15ml/min: reduce daily dose by 50–80% and give in 2–3 divided doses

Question 8

Monitoring requirements for benzathine penicillin

Answer 8

Renal function
Hepatic function
Hematopoietic function
Hypersensitivity for at least 30 mins after injection