Term
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Definition
| penicillin G, penicillin V potassium, penicillin G procaine, penicillin G benzathine |
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Term
| penicillinase resistant penicillins - antistaphylococcal penicillins |
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Definition
| methicillin, nafcillin, oxacillin |
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Term
| extended spectrum penicillins (aminopenicillins) |
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Definition
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Term
| antipseudomonal penicillins |
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Definition
| ticarcillin + clavulanate potassium (Timentin), piperacillin + tazobactam (Zosyn) |
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Term
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Definition
| aztreonam, imipenem + cilastatin, clavulanic acid, tazobactam |
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Term
| Mechanism of Action of Penicillins |
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Definition
inhibits bacterial cell wall synthesis by inhibiting transpeptidase enzyme & subsequent production of highly cross-linked peptidoglycan cell wall;
bactericidal effect only on actively dividing cells that are producing cell wall;
little or no effect on dormant bacteria or on bacteria that lack cell walls |
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Term
| aminoglycosides (gentamycin, etc) |
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Definition
| penicillins are often used in combo with these antibiotics for a SYNERGISTIC killing effect |
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Term
| increase concentration of penicillins |
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Definition
| to overcome resistance due to structural differencesin PBPs - high molecular weight PBPs w/ low affinity for antibiotic |
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Term
| enzymatic destruction of penicillins |
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Definition
| most important form of resistance; use beta-lactamase inhibitors to overcome |
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Term
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Definition
| bacteria without cell walls are NOT killed by penicllins |
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Term
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Definition
| only penicillin that does not impair oral absorption |
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Term
| Administration of Penicillins |
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Definition
| food impairs oral absorption, so administer 1-2 hrs before or after a meal |
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Term
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Definition
| drug that blocks tubular secretion of penicillins, causing an increase in penicillin concentration |
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Term
| nafcillin, oxacillin, dicloxacillin |
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Definition
| eliminated by biliary excretion mostly, some kidney excretion; DON'T need to adjust dose in renal failure |
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Term
| Symptoms of Type I Hypersensitivity to Penicillins |
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Definition
skin rxns - rash, angioedema, urticaria, pruritus;
GI - nausea, abdominal pain, vomiting, & diarrhea;
dyspnea, wheezing;
hypotension, tachycardia, arrhythmias;
Fatality due to laryngeal edema, cardiovascular collapse |
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Term
|
Definition
| time it may take for a Type 1 Hypersensitivity rxn to penicillins |
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Term
|
Definition
| most common cause of acute allergic interstitial nephritis |
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Term
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Definition
| used to determine if pt will have Type 1 hypersensitivity rxn to penicillins; DOES NOT detect for Type II, III, or IV type rxns |
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Term
| Side Effects of Penicillins |
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Definition
non-allergic skin rashes;
GI - upset, nausea, vomiting, diarrhea;
CNS toxicity - seizures;
excess Na & K - cardiac & renal toxicity; |
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Term
|
Definition
PK: oral absorption is only 33%, available for IV or IM;
Used w/ aminoglycosides for SYNERGISTIC effect;
Probenecid increases plasma levels;
DRUG OF CHOICE - IM or IV for syphillis (Treponema pallidum);
Used for: non-resistant Staph & Strep infections, use w/ aminoglycoside against Enterococcal infections, |
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Term
| Third gen. cephalosporin (ceftriaxone) |
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Definition
| DRUG of CHOICE for Gram-negatives such as Neisseria meningitidis |
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Term
| penicillin G procaine & pencillin G benzathine |
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Definition
slow release forms; give IM in gluteus maximus or midlateral thigh area;
Used for:
strep. pyogenes infections, strep. pharyngitis, prophylaxis for rheumatic fever, and for treating syphilis |
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Term
|
Definition
| for serious systemic STAPH infections; do NOT need to adjust dose in renal failure |
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Term
| nafcillin, methicillin, oxacillin |
|
Definition
DRUG of CHOICE for penicillinase-producing Staph. aureaus: skin infections, soft tissue infections, osteomyelitis, acute endocarditis;
NOT EFFECTIVE against Gram (-) aerobes (E.coli, klebsiella, enterobacter) |
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Term
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Definition
| drug of choice for pts w/ MRSA |
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Term
|
Definition
extended spectrum penicillins that treat:
Haemophilus influenzae - URTIs (sinusitis, otitis);
E. Coli - UTIs
Listeria monocytogenes - MENINGITIS in immunocompromised & in kids <2 months, bacteremia;
Proteus mirabilis - UTIs;
Salmonella, Strep. pyogenes & pneumoniae - URTIs;
Moraxella - RTIs
Enterococcus |
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Term
| piperacillin + tazobactam (Zosyn) |
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Definition
| use in combo with a fluoroquinolone (cipro or levo) to treat Community-Acquired Pneumonia (CAP) |
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Term
| piperacillin + tazobactam (Zosyn) |
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Definition
used to treat:
higher dose used to treat nosocomial pneumonia;
septicemia by gram (-)'s;
UTIs - may use aminoglycoside with to treat;
gynecologic & obstetric infections;
intra-abdominal infections |
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Term
| ticarcillin + clavulanate potassium (Tiementin) |
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Definition
| used to treat susceptible Psuedomonas aeuruginosa infections such as septicemia & UTIs |
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Term
|
Definition
highly resistant to enzymatic inactivation by beta-lactamases produced by gram (-) bacteria;
ONLY active against GRAM (-) RODS;
use with gram (-) infections that have previous allergic rxns to beta-lactam antibiotics (penicillins, cephalosporins);
NO CROSS-REACTIVITY with penicillin or cephalosporin allergies |
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Term
| imipenem + cilastatin (Primaxin) |
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Definition
extremely BROAD spectrum & activity and VERY POWERFUL antibiotic; SHOULD NOT BE ROUTINELY USED to prevent resistance;
Reserved for SERIOUS HOSPITAL ACQUIRED (nosocomial) INFECTIONS that include: resistant microorgansims or infections with multiple microorganisms |
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Term
| amoxicillin + clavulanic acid (Augmentin) |
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Definition
DRUG CHOICE for acute otitis media and sinusitis and for human & animal bite wounds;
also used to treat: RTIs, UTIs, Skin & Skin structure infections |
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