Ipapburke Pharm2 Test 1- Penicillins

Front 1

What is the IV form of Penicillin?

Back 1

Pen G

Front 2

What is the oral form of Penicillin?

Back 2

Pen VK

Front 3

What are the two Anti-Staphlycoccal Penicillins on the BCF?

Back 3

Dicloxacillin (Dynapen) and Nafcillin (Unpin)

Front 4

Anti-Staphlycoccal Penicillins- 2 types of resistance

Back 4

Penicillinase resistant and B-lactamase resistant

Front 5

What are the Aminopenicillins?

Back 5

Amoxicillin (amoxil), Ampicillin (Omnipen), Ampicillin/Sulbactam (Unasym), and Amoxicillin/Clavulanic Acid (Augmentin)

Front 6

What are the anti-Pseudomonal Penicillins?

Back 6

Piperacillin/Tazobactam (Zosyn) and Ticarcillin/Clavulanic Acid (Timentin)

Front 7

What do you use anti-Pseudomonal Penicillins in conjunction with?

Back 7

aminoglycosides

Front 8

What are the purpose of Taxobactam and Clavulanic Acid?

Back 8

they battle B lactamase so other component can work on the bacteria

Front 9

What is the IV form of extended spectrum penicillin (a aminopenicillin) that we would use for a GSW victim?

Back 9

Ampicillin/Sulbactam (Unasyn)

Front 10

What are the MOA for Penicillins?

Back 10

inhibit bacterial cell wall synthesis exposing the osmotically less stable membrane which can lead to cell lysis

Front 11

What causes bacterial resistance to Penicillins?

Back 11

mainly due to inactivation of the antibiotic by B lactamase (penicillinase)

Front 12

What is the antibacterial spectrum of penicillins dependent on?

Back 12

depends on the ability to cross the bacterial cell wall

Front 13

Can penicillin cross the cell wall of Gram positive bacteria?

Back 13

yes

Front 14

Can penicillin cross the cell wall of Gram Negative bacteria?

Back 14

GNB have a lipopolysaccharide membrane that acts as a barrier, so entry must be gained by the water filled channel (via a penicillin binding protein)

Front 15

Why is Pen G used as an injection?

Back 15

because it is unstable in stomach acid when given orally

Front 16

What Penicillin is used for Gram negative N. meningitidis causing meningitis?

Back 16

Pen G (injection)

Front 17

What Penicillin is used for Gram Positive Streptococci (Group A,C, G) that causes pharyngitis?

Back 17

Pen V (oral)

Front 18

What Penicillin is used for Gram Positive Viridans Strep that causes infective endocarditis?

Back 18

Pen V (oral)

Front 19

What is the treatment for Treponema pallidum that causes Syphilis?

Back 19

Pen G injection (Drug of Choice)

Front 20

Why is there an issue with patient compliance with Penicillin?

Back 20

they must be taken every 4-6 hours

Front 21

Representative Anti-staphylococcal Penicillins

Back 21

Dicloxacillin (Dynapen) and Nafcillin (Unipen)

Front 22

What organisms are resistant to Antistaphylococcal Penicillins?

Back 22

Enterococcus and MRSA

Front 23

What is MRSA?

Back 23

Methicillin Resistant Staph Aureus---resistant to antistaphylococcal penicillins

Front 24

What is MRSE?

Back 24

Methicillin Resistant Staph Epidermidis

Front 25

What is the MOA of Antistaphylococcal Penicillins?

Back 25

inhibit bacterial cell wall synthesis by binding to one or more of the PBPs

Front 26

Use for antistaphylococcal Pencillins

Back 26

sever infections- osteomyelitis, joint, and cellulitis caused by Staph aureus or group A strep

Front 27

What is used to treat osteomyelitis, joint infections, etc. caused by Staph aureus or Group A strep?

Back 27

IV Nafcillin and oxacillin

Front 28

What antistaphylococcal penicillin is used to treat minor skin infections like impetigo and cellulitis (caused by S. aureus and strep Group A

Back 28

oral Dicloxacillin

Front 29

What pregnancy category are antistaphylococcal penicillins?

Back 29

Category B

Front 30

How is Dicloxacillin administered?

Back 30

on an empty stomach (1 hour before meal or 2 hours after)

Front 31

What drug do Antistaphylococcal penicillins interact with?

Back 31

Warfarin- so monitor bleeding times

Front 32

Spectrum for Aminopenicillins

Back 32

Gram positive and some Gram negative

Front 33

Why do Aminopenicillins have better activity against Gram negative bacteria?

Back 33

due to their ability to penetrate outer membrane

Front 34

What must aminopenicillins be combined with to avoid be inactivated by B Lactamase?

Back 34

B Lactamase inhibitor like Tazobactam, Sulbactam, or Clavulanic Acid

Front 35

Where is Amoxicillin best absorbed from?

Back 35

the gut

Front 36

What is the difference between Amoxicillin and Ampicillin?

Back 36

Amoxicillin is converted to ampicillin in the liver, Just makes it more stable.

Front 37

These are powerful inhibitors of B lactamase combined with other pencillins in order to extend their spectrum to include B lactamase producing bacteria

Back 37

Clavulanic acid, Sulbactam, and Tazobactam

Front 38

What is the place of Amoxicillin (amoxil) in therapy?

Back 38

otitis media, cultured B lactamase negative H influenzae pneumonia, and endocarditis prophylaxis

Front 39

What 2 bugs cause otitis media the majority of the time?

Back 39

Strep pneumoniae and H. influenzae

Front 40

Ampicillin- place in therapy

Back 40

meningitis, neonatal pneumonia

Front 41

When Ampicillin is used to treat meningitis, what drug is it combined with?

Back 41

a gram negative agent like Cefotaxime pr Gentamicin)

Front 42

When Ampicillin is used to treat neonatal pneumonia,what drug is it combined with?

Back 42

a gram negative agent

Front 43

What is the use for Ampicillin/sulbactam (Unasyn)?

Back 43

infected wounds with sepsis, esp.,. thoracic wounds AND in peritoneum/peritonitis secondary to bowel perforation

Front 44

What conditions is Amoxicillin/Clavulanate (Augmentin) used to treat?

Back 44

otitis media resistant to Amoxicillin, sinusitis, animal bites, infected wounds

Front 45

What route is Unasyn given?

Back 45

IV

Front 46

What is the form of Augmentin for children?

Back 46

chewable tablets or oral suspension

Front 47

What are anti-pseudomonal penicillins (4)?

Back 47

Piperacillin (Pipracil), Piperacillin/Tazobactam (Zosyn), Ticarcillin (Ticar), Ticarcillin/Clavulanic Acid (Timentin)

Front 48

What is the coverage for anti-psuedomonal Penicillins?

Back 48

Pseudomonas aeruginosa and several other gram negative bacteria

Front 49

What route of administration are all anti-pseudomonal Penicillins?

Back 49

all IV

Front 50

Why are Piperacillin (Piperacil) and Ticarcillin (Ticar) not used alone?

Back 50

they are not resistant to B lactamase when used alone

Front 51

Spectrum for Timentin and Zosyn

Back 51

B lactamase producing S. aureus and some gram negative B lactamase producing bacteria

Front 52

Why can you give relatively high doses of Penicillins?

Back 52

they are relatively non toxic

Front 53

Why do some patients taking Penicillin get diarrhea?

Back 53

interruption of normal flora in GI tract (not an allergy, just an adverse effect)

Front 54

What secondary infection may Penicillin cause?

Back 54

vaginal candidiasis

Front 55

Why should Pen V and Dicloxacillin be taken on an empty stomach?

Back 55

they are sensitive to acid in the stomach

Front 56

How are Penicillins excreted?

Back 56

by the kidney