Pharmacology Penicillins 2

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Pharmacology Penicillins 2
2014-01-22 09:53:42
Pharmacology Penicillins
Pharmacology Penicillins 2
Pharmacology Penicillins 2
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  1. Which class of penicillins do Penicillin G and V fall into?
    Natural Penicillins
  2. How must Penicillin G be administered and why?
    IM/IV, because acid labile, so unstable in the GI
  3. What are the usual indication for Penicillin G?
    Endocarditis or syphilis
  4. Is penicillin G usually used prophylactically or for acute treatment?
  5. What does it mean to be an intramuscular repository formulation?
    Given intramuscularly and deposit enters blood stream slowly over a matter of weeks
  6. If high levels of Penicillin G are needed, by what route would you give it?
  7. What are the intramuscular repository formulations of Penicillin G?
    Benzathine and Procaine
  8. What are the benefits for Benzathine penicillin G?
    Anesthetic effect and long duration of 2-3 weeks
  9. Benzathine penicillin G is usually used prophylactically or acutely?
  10. What are the benefits of Procaine penicillin G?
    Painless and extended duration with a high conc. at 24 hours
  11. What are the cons of Procaine penicillin G?
    Some may be allergic
  12. How do procaine penicillin G mixtures work to reduce rate of absorption of Penicillin?
    Procaine is positively charged and Penicillin is negatively charged, they bind together to act as a repository
  13. Penicillin V has been stabilized to withstand what?
    Acid in the stomach
  14. How is penicillin V given?
  15. What is the main indication for Penicillin V?
    Dental abscesses or infections
  16. What is the downside of Penicillin V?
    Very frequent dosing
  17. By what route is Penicillin V excreted?
  18. What is the t1/2 of penecillins?
    ½ hour
  19. What percent of penicillin clearance is tubular secretion and what is glomerular filtration?
    tubular secretion: 90% glomerular filtration: 10%
  20. What is probenecid?
    Gout treatment
  21. Why should penicillin and probenecid not be given together?
    Probenecid reduces the clearance of Penicillin, causing a higher blood level
  22. Penicillin distributes well to what tissues?
    Most everywhere except the CNS (meningitis is exception to this) and humor of the eye
  23. Why can penicillin enter the CNS with meningitis?
    B/c the membranes become inflamed and allow Penicillin to enter
  24. Would you choose a natural penicillin to treat Streptococcus or a Staphylococcus infection better and why?
    Streptococcus, penicillin does not treat Staph because there are B-lactimases and penicillinases in the Staph
  25. Does natural Penicillin treat gram-positive or negative better?
    Positive, poor to no treatment of gram negatives
  26. What gram negative bacteria can natural Penicillin treat?
    Neisseria meningitides and non-penicillinase producing N. gonorrhoeae
  27. What gram positive cocci can be treated with natural Penicillin?
    Streptococcus pneumonae and viridians
  28. What gram positive bacilli can be treated with natural Penicillin?
    Clostridium perfringens(gangrene), Clostridium tetani, bacillus anthracis (anthrax)
  29. If you have heart issues and you visit the dentist, what drug might you be given prophylactically and why?
    Natural Penicillins to prevent Strep viridians causing endocarditis
  30. What spirochete can be treated with natural Penicillin?
    Treponema pallidum (syphilis)
  31. Is syphilis resistant to natural penicllins?
    No, not usually
  32. Do natural penicllins treate gram negative rods?
  33. Do natural penicillins treat Pseudomonas aeruginosa?
    No, because it is a gram negative rod
  34. Can you treat enterococci with natural penicillins?
  35. Can Cephalosporins treat enterococci?
  36. What is another term for Penicillinase resistant penicillins?
    Antistaphylococcal penicillins
  37. Are natural penicillins or Penicillinase resistant penicillins more efficient at killing gram positive bacteria?
    Natural penicillins
  38. Are Penicillinase resistant penicillins or natural penicillins more narrow spectrum?
    Penicillinase resistant penicillins
  39. Penicillinase resistant penicillins have what feature that helps inhibits penicinillinases?
    Large hydrophobic group
  40. Do Penicillinase resistant penicillins have high or low activity?
  41. What group do Penicillinase resistant penicillins have no activity against?
    Gram negative rods
  42. Will Penicillinase resistant penicillins treat an MRSA infection?
  43. Nafcillin, oxacillin, isoxazolyl penicillins, and methicillin all below to what class of penicillins?
    Penicillinase resistant penicillins
  44. What were Penicillinase resistant penicillins developed and used for?
    To treat Penicillin resistant strains of Methcillin susceptible staph aureus (MSSA) with Beta-lactimases
  45. Why don't we use methicillin anymore?
    Greater toxicity than other Penicillinase resistant penicillins, causes interstitial nephritis
  46. If a bacteria is resistant to methicillin, will it be resistant to other Penicillinase resistant penicillins?
  47. Which Penicillinase resistant penicillins are given IV and can cause phlebitis?
    Nafcillin and oxacillin
  48. Which Penicillinase resistant penicillins are given orally and cause GI effects?
    Isoxazolyl penicillins
  49. Which Penicillinase resistant penicillins can cause interstitial nehritis?
  50. What is the advantage of Aminopenicillins over natural and penicillinase resistant penicillins?
    Broader spectrum, mainly because they are able to be effective on more gram negative bacteria (some bacilli)
  51. The positively charged amino group on the R side chain of Aminopenicillins enhances what activity?
    Activity against gram negative bacteria, by allowing them penetration into the porins of the membrane
  52. Is amoxicillin oral or IV and why?
    Oral, not sensitive to acid degradation
  53. Is ampicillin oral or IV and why?
    IV, sensitive to acid degradation
  54. How can you increase the activity of Aminopenicillins?
    Add aminoglycoside
  55. What limits the spectrum of Aminopenicllins?
  56. How can the issue of B-lactimases be resolved with Aminopenicillins?
    Use of B-lactimase inhibitors
  57. What do Aminopenicillins have no or poor activity against?
    No: Pseudomonas aeruginosa, Poor: Staph and obligatory anaerobes
  58. Other than the enhancement of Gram negative activity, in what other ways is the spectrum of Aminopenicillins enhanced?
    Improved G+ activity against streptococci, enterococci
  59. Primarily, what gram negative bacteria are Aminopenicillins more active against than lower generation penicillins?
    E. coli and H. influenza
  60. Why are Aminopenicillins not active against Staph infections?
    B-laactimases are present
  61. Is Piperacillin or Ticarcillin more potent?
  62. Which antipseudomonal penicillin has an amine group with apositve charge?
  63. By what route are antipseudomonal penicillin given?
  64. Piperacillin and Ticarcillin are what class of penicillin?
    antipseudomonal penicillin
  65. What is the charge of Ticarcillin and why?
    Negative, due to COOH
  66. What is the charge of Piperacillin?
    Neutral because of COOH and amino group
  67. Do antipseudomonal penicillin have activity against Pseudomonas aeruginosa?