Pharm Chapter 7 Bbc: Penicillins

Front 1

Penicillin: bacteriostatic or bacteriocidal?

Back 1

bacteriocidal

Front 2

Broad MOA?

Back 2

Interfre with cell wall synthesis, specifically the last step of the bacterial cell wall synthesis
1. PBPs that naturally occur in the periplasmic space bind the penicillin allowing the penicillin to accumulate in the bacterium
2. PCN inhibits transpeptidases; the enymes that work to "cross-link" peptidoglycan
3. PCN stimulates autolysins. These enzymes normally remodel the cell when needed but PCN has them active all the time.

Front 3

Name the first generation penicillins?

Back 3

Penicillin G and V

Front 4

Are the first generation penicillins beta lactamase sensitive or resistant?

Back 4

Sensitive; that is why they need to be used in higher concentrations to reach therapeutic doses

Front 5

Wwhat type of bacteria (gram negative or positive) are the first generation penicillins most affective against?

Back 5

positive

Front 6

Are the second generation penicillins beta lactamase sensitive or resistant?

Back 6

Resistant; so they are particularly useful for Staphylococcus and Streptococcus

Front 7

Name the second generation penicillins

Back 7

Methicillin, Dicloxacillin, oxacillin, cloxacillin, nafcillin and Flucloxacillin

Front 8

Primary use for Dicloxacillin?

Back 8

skin infections including cellulitis
(the other DOC is cefazolin, a first generation cephalosporin)

Front 9

Primary use for oxacillin and cloxacillin?

Back 9

Also used for skin infections

Front 10

How is Nafcillin eliminated?

Back 10

Biliary (which is different because the other penicillins are excreted renally)

Front 11

Primary use of Flucloxacillin?

Back 11

serious infections

Front 12

What bacteria (gram negative or positive) do the third generation penicillins target?

Back 12

Trick question: BOTH!

Front 13

Ampicillin, a third generation penicillin, is primarily the DOC for what species of bacteria?

Back 13

Listeria (like listeria monocytogenes which affects pregnant women, found in unpasteurized dairy products, and is characterized as having a "tumbling" motion, and cuases sepsis and meningitis in neonates- BOOM!)

Front 14

Amoxicillin, a third generation penicillin, is commonly used for what type of infection?

Back 14

Prophylaxis in patients with high risk cardiac conditions who will be undergoing dental procedures that disrupt oral or ginigival mucosa

Front 15

What are the extended spectrum aka antipsuedomonal penicillins or 4th generation penicillins?

Back 15

Ticarcillin, piperacillin, and carbenicillin

Front 16

Because psuedomonas is so hard to treat, it is rarely just treated with monotherapy, like a 4th generation penicillin. What else is REQUIRED to treat a psuedomonas infection?

Back 16

An aminoglycoside (usually tobramycin) or ciprofloxacin

Front 17

For patients unable to take a penicillin, what is typically substituted instead?

Back 17

Erythromycin (macrolide; MOA: protein synthesis inhibitor of the 50s subunit- BOOM!)

Front 18

What patient population (patients that have which disease) should penicillins be used cautiously?

Back 18

Patients with renal disease EXCEPT for NAFCILLIN which is excreted biliary.

Front 19

What risk category for teratogenic potential are penicillins listed under?

Back 19

Category A -- A-ok for mama!