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53 Cards in this Set
- Front
- Back
Penicillins: cidal or static?
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cidal
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Penicillins: synergistic or additive with aminoglycosides?
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synergistic
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Penicillins: synergistic or additive with quinolones?
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additive for some (organism specific)
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What are the 3 mechanisms of resistance for penicillins?
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production of beta-lactamases, altered cell wall penetration, PBP affinity alteration
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Pen G, Pen G potassium or sodium, Pen VK, Pen G Benzathine, Pen G procaine are all examples of what kind of penicillin?
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natural penicillin
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True or False: natural penicillins are active against non-beta-lactamase/non-penase producing gram positive aerobic AND anaerobic organisms.
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true
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True or False: The gram negative spectrum of natural penicillins is very limited today.
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true
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Nearly all strains of Neisseria meningitidis are susceptible to which natural penicillin?
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Pen G.
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Which natural penicillin is still used today for the treatment of strep throat and syphilis?
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Pen G benzathine
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All penicillins penetrate most tissues except _____, _____, and ______, unless ______ exists.
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All penicillins penetrate most tissues except the prostate, the eye and the CSF unless inflammation exists.
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Can I give pencillins to a patient that has meningitis?
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Yes because there is inflammation.
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Do natural penicillins require dose adjustment?
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maybe, but some only do it if clearance is <10ml/min
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Penicillins: concentration independent or concentration dependent?
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concentration independent
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What is a major sign/symptom (1) of an overdose of Penicillin?
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seizures
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Natural Penicillins: with food or empty stomach?
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empty stomach to achieve the best area under the curve
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What is the max dose of natural penicillins?
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2.4 million units/day
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True or False: Natural penicillins are short-half life drugs.
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True. They must be dose q4-6 hours except for Pen G procaine which is given every 12-24 hours.
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Name the 5 penicillinase resistant penicillins.
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methicillin, nafcillin, oxacillin, cloxacillin, dicloxacillin
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Penicilliniase resistant penicillins: with food or empty stomach?
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empty stomach: food decreases absorption.
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Which 2 penicillinase resistant penicillins are associated with hepative function test elevation & thrombophlebitis?
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nafcillin, oxacillin
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Penicillinase resistant penicillins: renal or hepatic excretion?
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hepatic excretion, therefore no adjustment needed for renal dysfunction.
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Penicillinase resistant penicillins are generally used for what kind of infections?
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staphylococcal
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Penicillinase Resistant Penicillins will not be active against 2 specific bacteria listed in Ravnan's handout. What are those two bacteria?
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Enterococcus, Listeria
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Doctor wants to use a penicillinase resistant penicillin for a patient with MRSA. Go or no?
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No. Penicillinase resistant penicillins are only good for MSSA, not MRSA.
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What are the 2 aminopenicillins?
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amoxicillin and ampicillin
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Patient presents with Enterococcal infection. Doc wants to treat with an aminopenicillin. Go or no?
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Go. Both Ampicillina and Amoxicillin are active against Enterococcus.
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Amoxicillin: with food or empty stomach?
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doesn't matter
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Ampicillin: with food or empty stomach?
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empty stomach
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Aminopenicillins: is renal dose adjustment needed?
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yes
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What 3 side effects mentioned in Ravnan's lecture is more prominent with ampicillin than amoxicillin?
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diarrhea, yeast infections, allergic reactions
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What happens when a patient that is taking allopurinol gets put on ampicillin?
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rash will develop. stop allopurinol and rash will be gone.
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Name a carboxypenicillin.
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Ticarcillin
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True or False: Ticarcillin retains it's gram positive activity so it is just as good as ampicillin in combating Enterococcus.
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False. This class of agents loses some of their gram positive activity. Therefore, Ticarcillin will still have activity against Enterococcus but not as good as ampicillins.
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True or False: Ticarcillin has good activity against Klebsiella since it targets the Enterobacteriaceae family.
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False. Ticarcillin has no or limited activity against Klebsiella because it cannot penetrate it's capsule.
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Ticarcillin vs. Piperacillin: which one is better for Pseudomonas?
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Piperacillin
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Ticarcillin causes: hyper or hypo-natremia?
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hypernatremia because the drug is "ticarcillin sodium" and accumulates in renal dysfunction
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Ticarcillin causes: hyper or hypo-kalemia?
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Hypokalemia because sodium overload causes wasting of potassium.
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Ticarcillin: penetrates BBB well or not well?
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does not penetrate the BBB well.
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Ticarcillin has what kind of effect on platelets?
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anti-platelet effect
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Name the 2 ureidopenicillins.
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mezlocillin, piperacillin
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Patient is infected with Enterococcus. Doc wants to give piperacillin. Yay or nay?
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Yay!
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True or False: Piperacillin is most active against Pseudomonas.
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True. *remember they both start with P*
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Piperacillin: renal dose adjustment needed?
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yes
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As mentioned in Ravnan's lecture, long term doses of piperacillin can cause what?
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neutropenia
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Piperacillin is available as a combination product. Name this combination product and what other agent is used.
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Zosyn, Tazobactam
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True or False: Zosyn is much better than Piperacillin against Pseudomonas.
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False. Zosyn doesn't work any better than piperacillin.
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What are the 4 Godzilla Cillins (brand names)?
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Unasyn, Augmentin, Timentin, Zosyn
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Name the 2 agents that make up Unasyn.
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ampicillin, sulbactam
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Name the 2 agents that make up Augmentin.
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amoxicillin, clavulanic acid
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Name the 2 agents that make up Timentin.
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ticarcillin, clavulanic acid
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What drug is the only godzilla cillin that is available orally?
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Augmentin
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Augmentin: with food or empty stomach?
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with food to prevent diarrhea, NOT to increase absorption
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True or False: Unasyn is just as good as Ampicillin in treat intra-abdominal infections.
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False. Unasyn is better for intra-abdominal infections than ampicillin.
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