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19 Cards in this Set
- Front
- Back
What drug can go with this following structures
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-Need to be accompany by a + charged molecule when it in ionized form:
1. Procaine +: 24 hrs 2. Benzthine +: 1 week |
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What drugs are refered to as Depot forms?
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-Procaine, Penzathine penicillin
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How is Pen G. metabolized?
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-Metabolism: minimal
-Kidney excreted: 10% Glomerular 90% Tubular secretion |
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What is the usage of Probenecid?
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-Inhibit tubuler secretion: help to maintain blood level of Pen G longer
-Treatment of gout- inhibit uric acid uptake |
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What is the toxicitiy relating to Pen G.?
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-Hepersensitivity
-Neurotoxicity |
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How does hypersensitivity occur with Pen G.?
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-Protein in the body form a covalent bond w/ Pen G.
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What causes Immediately hypersensitivity?
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-RXN that temporary occur w/in 20min-1hr (Most serious)
-Occurs of anaphylaxis, caused by minor determinants -IgE causes this: If not treated --> Death will occur |
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What is the Treatment of Immediate Hypersensitivity?
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-Epi --> Repeated IM for 15 at thigh
-2nd: Give antihistamine or Glucocorticoids |
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What is minor determinant?
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-Less concentration w/in blood and will RXN with the side chain of the thiazolidine ring.
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What causes Non-immediate hypersensitivity?
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-Happen b/t 1hr -weeks
-Caused by Major determinants -IgG + IgM -Manifested by rash & hives |
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What is major determinant?
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-Occur in highest [ ] w/in blood and will RXN with the B-lactam bond of Pen. G. to cause Non-Immediate Hypersensitivity
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What dosage of Pen G. must be given to induce Neurotoxicity (convulsions)?
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-20-60 million unit
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What is Pen G. used for on the Gram Positive Cocci and Gram Positive Bacilli?
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Gram Positive Cocci:
-Streptococcus Groups A (pyogenes), B, C, G -Streptococcus enterococcus (endocarditis) -Streptococcus pneumoniae Gram Positive Bacilli: -Bacillus anthracus-anthrax -Clostridium perfringens -Clostridium tetani (not Clostridium difficile) |
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What is Pen G. used for on the Gram Negative Cocci, Enteric Gram Negative Bacilli and other?
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Gram Negative Cocci
-Neisseria meningitidis -Neisseria gonearrhea Gram Negative Bacilli -Bacteroides of oropharynx (oral cavity but not of GI tract) Other -Treponema pallidum (syphilis): Bacteria have NOT develop resistance. One shot is enough -Borellia burgdorfiri: Lyme disease |
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Most Staph. aureus infection is resistant to Pen G. (T/F)
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True
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How does Staph. aureus become resistant to Pen G.
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-Production of B-Lactamase (Penicillinase): This enzyme break up the B-lactam bond by forming an unstable bond with C=0 and being replaced by H2O (hydrolyze)
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What are some drugs of choose if bacteria resistant to Pen G.
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Penicillinase-Resistant Pen
-Methicillin: acid-labile, Parentally ONLY -Nafcillin: parentally, 90% excreted by Bile -Oxacillin, Cloxacillin, Didoxacillin: acid stable, given orally |
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How does Gram + bacteria develop Methicillin resistant?
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-Change the shape of Pencillin Binding Protein. So it can't block Transpeptidase from removing the 5th a.a and linking two NAM-NAG strand
-Or make B-Lactamase |
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How does Gram - bacteria develop Methicilin resistant?
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-B-lactamase
-Penase -Change shape of PBP. |
