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43 Cards in this Set
- Front
- Back
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What two proteins are the targets for the penicillins that will result in killing of the cell?
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Transpeptidases for peptidoglycan synthesis
Proteins required for cell shape |
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What specific linkage do penicillins block within the cell wall?
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A + K linkage performed by the transpeptidase
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What is the mechanism by which the penicillins inhibit the transpeptidase?
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Slow dissociation from the enzyme; suicide inhition
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Are penicillins bacteriostatic or cidal?
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CIDAL!
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What is the mechanism of resistance to penicillins?
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Degradation of the penicillins by beta-lactamases
Alteration in the penicillin binding proteins resulting in decreased affinity for penicillins Decreased penetration/increased efflux |
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What are the beta-lactamase resistant penicillins?
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Methicillin
Nafcilin Oxacillin |
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What are the beta-lactamase inhibitors commonly combined with penicillins?
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Sulbactam
Clavulanic acid Tazobactam |
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What is the mechanism of penicillin resistance in MRSA?
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Expression of a PBP, PBP2a, encoded by mecA that has a low affinity for penicillins
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What antibiotics are community associated MRSA susceptible to?
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Clindamycin
Trimethoprim/Sulfamethoxazole |
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What antibiotics is hospital-acquired MRSA sensitive to?
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Vancomycin
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What is the absorption of the penicillins?
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Variable, depending on the side chain
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What is the distribution of the penicillins?
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Widely distributed
Doesn't penetrate the CSF |
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What is the metabolism and half-life of the penicillins?
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Liver
T1/2 = 30 - 60 min. |
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What is the excretion of the penicillins?
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Excreted renally.
Exceptions: nafcillin, oxacillin |
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What are the penicillins that aren't excreted renally?
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Nafcillin
Oxacillin |
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What is the excretion of nafcillin and oxacillin?
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Not renally - able to use in px. with kidney failure
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What bacteria are narrow spectrum penicillins effective against?
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Gram positive bacteria
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What bacteria are extened spectrum penicillins effective agianst?
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Gram positive bacteria
Gram negative bacteria |
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What are the beta-lactamase sensitive, narrow spectrum penicillins?
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Penicillin G
Penicillin V |
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What is the use of the beta-lactamase sensitive, narrow spectrum penicillins
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Streptococcal infections
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What is the absorption of penicillin G?
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Parenterally
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What is the absorption of Penicillin V?
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Orally
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What are the beta-lactamase-resistant, narrow spectrum penicillins?
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Methicillin
Nafcillin Oxacillin Cloxacillin Dicloxacillin |
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What beta-lactamase-resistant, narrow spectrum penicillins are absorbed parenterally?
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Methicillin
Nafcillin |
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What beta-lactamase-resistant, narrow spectrum penicillins are absorbed orally?
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Oxacillin
Cloxacillin Dicloxacillin |
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What is the clinical use of beta-lactamase-resistant, narrow spectrum penicillins?
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Staphylococcus aureus infections
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What are the beta-lactamase sensitive extended spectrum penicillins?
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Ampicillin
Amoxacilin Ticarcillin Mezlocillin Piperacillin |
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What are the beta-lactamase sensitive extended spectrum penicillins that are orally absorbed?
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Ampicillin
Amoxacillin |
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What is the clinical use of ampicillin and amoxacillin?
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E. Colia
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What are the beta-lactamase sensitive extended spectrum penicillins that are parenterally absorbed?
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Ticarcillin
Mezlocillin Piperacillin |
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What is the clinical use of Ticarcillin, Mezlocillin, and Piperacillin?
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Pseudomonas aeruginosa
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What are the delayed use penicillins?
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Benzathine penicillin G
Procaine penicillin G |
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What are the clinical uses of the delayed-use penicillins?
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Streptococcal pharygitis
Syphilis |
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What are the four penicillins that are combined with a beta-lactamase inhibitor?
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Augmentin
Timentin Unasyn Zosyn |
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What penicillin is in Augmentin?
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Amoxicillin
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What penicillin is in timentin?
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Ticarcillin
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What penicillin is in usnasyn?
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Ampicillin
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What penicillin is in zosyn?
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Piperacililn
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What is the clinical use of augmentin?
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Otitis media
Sinusitis S. aureus |
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What is the clinical use of timentin?
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S. aureus
Bacteroides |
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What is the clinical use of unasyn?
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S. aureus
E. coli |
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What is the clinical use of zosyn?
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Complicated skin infections
Intraabodominal infections |
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What are the adverse effects to penicillins?
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THEY'RE VERY SAFE!!
Diarrhea after oral dose Super infections With high doses in seizure prone px., renal dysfunction px. (can't eliminate drug) seizures HYPERSENSITIVITY - MOST IMPORTANT! |
