MIC 541-Exam 4- Antimicrobials IV-2
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What are the advantages of penicillin?
- Very potent
- wide toxic-therapeutic ratio (very safe, very difficult to cause toxicity)
- Penicllins are active over a wide range of pH and pysiological ranges
- Not inactivated by pus
- distribute well
- can be given by many routes
- Very cheap easy to produce
Pen G and ampicillin are not well absorbed well via what administration route?
What penicillins are not well designed for GI administration?
What are the best Penicillins to choose for Oral therapy?
Penicillin V and Amoxacillin are the drugs of choice for what route of asministration?
What areas of the boday are inaccessable to Penicillins?
The CNS and the humor of the eye
What percent of protein binding is needed to have significant antibiotic inactivity?
What percent of Penicillins are bound to proteins in vivo?
Is it best to have high or low protein binding for an antibiotic?
Protein binding of an antibiotic represents what?
Penicillins are excreted where?
Through the kidneys
T/F, penicillin is inactive in pus?
Increases the dose of an antibiotic creates a concentration gradient that has what effect?
Drives the drug into the site of the infection
What method can be used with Penicillins to drive the antibiotic into the site of infection?
Increase in dose, creating a concentration gradient that pushes the antibiotic into cell
Penicillins are broken down prior to and during renal tubular secretion (T/F)?
False, they are excreted in their complete form
Why is it important that penicillins are renally excreted in their complete form?
They are able to treat urinary tract infections
Why are penicillins able to treat urinary tract infections successfully?
They are excreted through the urinary tract in their complete form
What is the time course in teh body for an injection of Penicillin G and Benzathine?
30 days (at a very low level)
What combination of drugs can maintain Penicillin in the body for 30 days at very low levels?
Benzathine with Penicillin G
What combination of drugs and Penicillin has a drug course in the body of about 18 hours at somewhat lower lveles?
Probencaine Penicillin G
How long does Penicillin g remain in the body when injected alone and IM?
What is the time course of Penicillin G in the body when it is administered Orally?
- about 4 hours
- What route of administration leads to a higher level of Penicillin G in the body for a shorter duration?
What route of Penicillin G (and no other drug) administration leads to a lower dose of Pen G for a slightly longer time?
What patient is ideal for a Penicillin G and Benzathine?
What situation would not be ideal for a Penicillin G and Bezathine treatment?
Those that might be allergic to Penicillin (due to the long course of the antibiotic in the drug)
What Gram - microbes do Penicillins have activity against?
- Most Neisseria meningitis
- Some N. gonorrhea
- Most Anaerobes
- Most Spirochetes
- Most Actinomyces
What metabolic types of Gram + bacteria are susceptible to Penicillins?
Anaerobic and Aerobic
What is an ideal candidate bacteria for Penicillin?
- Gram +
- No Beta-lactamases
- Penicillins are only effective against Aerobes (T/F)?
- False, they are effective against both anaerobes and aerobes
What percent of S. aureus contain B-lactamases?
What type of bacteria contains B-lactamases at a rate of >90%?
Penicillins are generally effective against actinomyces, spirochetes and anaerobes (T/F)?
Name a gram - bacteria (covered in class) that are always resistant to Penicillin:
Why is Bacteriodes fragilis (gram - anaerobe)resistant to Penicillin G and V?
Produces a B-lactamase
Prevotella is or is not resistant to Penicillin G and V?
Increasingly resistant due to increasing B-lactamase production
What penicillins are in the group aminopenicillins?
What is the advantage of an amine group on a penicillin?
Enhanced activity against Gram - bacteria
Ampicillin can be given orally, but is not suggested, why?
- 40% of oral dose is absorbed
- The otehr 60% destroys normal flora and selects for resistant strains
It is best to give ampicillin by what route?
What routes can Amoxicillin be given?
It is best to give Amoxicillin IV (T/F)?
False, you can only give Amoxicillin orally
How much of Ampicillin is absorbed PO?
Why is oral amoxicillin acceptable for oral dosing by comparison to Ampicillin?
- More is amoxicillin is absorbed
- Less selection for resistance In the GI
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