Antibacterial Agents - Penicillins

Front 1

Safe agents for pregnancy?

Back 1

most penicillins, cephalosporins, erythromycin base, probably aztreonam

Front 2

Agents to avoid in pregnancy?

Back 2

Tetracyclines, quinolones, erthromycin estolate, chloramphenicol, TMP-SMX

Front 3

Aminoglycosides should NOT be used with people who have?

Back 3

Liver cirrhosis

Front 4

What are the beta lactam antibiotics?

Back 4

Penicillin, cephalosporin, monobactum, carbapenem

Front 5

Resistance mechanims to penicillin are?

Back 5

1. In activation by beta lactamase enzyme (s. aureus, h. influenzae)
2. Alteration in target PBP's as seen in penicillin-resistant s. pneumoniae
3. A permeability barrier preventing penetration of antibiotic to the target like in some gram - bacteria.

Front 6

Overview of penicillins characteristics?

Back 6

Modest penetration into CSF, high IV dose for meningitis. Poor penetration to prostate. Renal excretion so must adjust in renal failure EXCEPT nafcillin/oxacillin which are bile-hepatic excreted

Front 7

Penicillin activity against?

Back 7

DOC: gram + such asGAC, viridan strep (common in endocarditis)
Gram - good for N. meningitides
Good for oral anaerobes not GI anaerobes
Good against Treponema pallidum

Front 8

List of penicillins and route of administration?

Back 8

IV aqueous penicillin G
Procaine penicillin G (IM)
Benathine penicillin G (IM)
Penicillin V (oral)

Front 9

IV aqueous penicillin G use?

Back 9

Enterococci endocarditis. add low dose gentamicin for synergy.

Front 10

Procaine penicillin G use?

Back 10

Not used often at all, repository form due to increased half life.

Front 11

Benathine penicillin G use?

Back 11

Mixed with an insoluble salt which means its very low serum levels for 3-4 weeks.
Used for:
syphillis
DOC = Strep A pharyngitis more so though penicillin V
Rheumatic fever prophylaxis
shot is painful =)

Front 12

Penicillin V use?

Back 12

Resists gastric acid breakdown.
DOC = Goup A strep pharynigitis

Front 13

Side effects of regular penicillins?

Back 13

Allergic/hypersensitivity rxns.
Anaphylaxis, delayed rash (maculopapular)
Interstitial nephritis
Myclonic twitching/seizures rare unless in high IV doses
Drug fever

Front 14

Antistaphylococcal penicillins are?

Back 14

Nafcillin (IV)(no dose reduction in renal failure)
Oxacillin (IV) (")
Dicloxacillin (oral, tastes bad)

Front 15

Antistaphylococcal penicillins uses are?

Back 15

Active against MSSA & strep A
NOT GOOD against MRSA and gram - anaerobes

Front 16

Side effecets of antistaphylococcal penicillins?

Back 16

Methicillin - interstitial nephritis
Oxacillin - hepatitis occasionally
Nafcillin - leukopenia occasionally

Front 17

Antistaphylococcal penicillins are DOC for?

Back 17

MSSA

Front 18

Extended spectrum penicillins are?

Back 18

Ampicillin and amoxicillin?

Front 19

Avoid nafcillin in what kind of patients?

Back 19

Neonates

Front 20

Spectrum of coverage for extended spectrum penicillins?

Back 20

Like penicillin with group A strep etc. but also against
-NON beta-lactamase H. influenzae
-active against most enterococci but NOT VRE.
-modest activity against community acquired gram - bacilli (e. coli)
-NOT for hospital acquired gram -

All of them adjust in renal failure
Higher % of maculopapular rash as opposed to regular penicillins

Front 21

Amoxicillin DOC for and characteristics?

Back 21

DOC: Otits media and sinusitis
Add wtih clavulanate to increase spectrum of activity. Useful in peds.
ORAL ONLY

Front 22

Ampicillin characteristics?

Back 22

IV only
Used for:
-pyelonephritis
-with aminoglycosides (gentamicin specifically) to increase activity for gram - and synergy for enterococci

Front 23

CAP = ?

Back 23

community acquired pneumonia

Front 24

Antipseudomonas penicillins are?

Back 24

-piperacillin (+tazobactum)
-ticarcillin
-mezocillin

Front 25

Piperacillin characteristics?

Back 25

NO MONOTHERAPY selects out for resistance quick.
Use with aminoglycoside for synergy.
Increased activity against many gram - including hospital acquired gram -'s like P. aeruginosa.
MSSA
Side effects like penicillin but beware of hypokalemia.

Front 26

Piperacillin with tazobactum AND ampicillin-sulbactum is also good for mixed infections such as?

Back 26

aerobic-anaerobic infections
intraabdominal/pelvic infections
aspiration pneumonia

Front 27

Amoxicillin-clavulanate DOC for?

Back 27

DOC: Bite wounds
Also used for Otitis media, sinusitis, CAP.
Good for beta-lactamasa MSSA and H. influenzae
NOT GOOD FOR penicillin resistant s. pneumoniae
Good for ampicillin resistnat H. influenzae (h. flu) in mixed infections.