PHARM EXAM 4: Chp 88 Penicillins

PenicillinMOA:

Weaken the cell wall, causing bacteria to take up excessive water and rupture

Penicillin Main adverse effect

allergic reaction

What family are the Penicillins in

In the Bata-Lactam Familyalso includes cephalosporins, imipenem

AmpicillinMOA:

Weaken the cell wall, causing bacteria to take up excessive water and rupture

Amphicillin major and minor AE

allergic reaction rashdiarrhea

Classification of the Penicillins

Narrow-spectrum penicillins Narrow-spectrum penicillins Broad-spectrum penicillins Extended-spectrum penicillins

Narrow-spectrum penicillin

PENICILLIN)Pencillinase-sensitive

Narrow-spectrum penicillins

NAFCILLIN)Pencillinase-resistant

Broad-spectrum penicillins

AMPICILLIN)

Extended-spectrum penicillins

PIPERACILLIN

Is penicillin a narrow or broad-spectrum drug? What does this mean for the patient?

Narrow-spectrum. Meaning it only kills certain bacteria.

Is ampicillin a broader spectrum than penicillin?

Ampicillin is a broader spectrum than penicillin.

Why was clavulanic acid added to amoxicillin to make the drug Augmentin?

Clavulanic acid inactivates beta-lactamase enzymes that are produced by bacteria, therefore preventing enzymatic destruction of amoxicillin

What bacteria can nafcillin kill?

What bacteria can nafcillin kill?

What can the antibiotics piperacillin/tazobactam kill?

One of the broadest antimicrobial spectra of all penicillinsUseful against pseudomonas

Penicillin C (Benzylpenicillin)

Bactericidal to a number of gram-positive and some gram-negative organismsStrep throat

Penicillin C (Benzylpenicillin) AE

Adverse effectsLeast toxic of all antibioticsPenicillins are the most common cause of drug allergy

MRSA

IS NOT AFFECTED BY THE ABOVE DRUGS

Extended-spectrum penicillins

Piperacillin/tazobactam (Zosyn)One of the broadest antimicrobial spectra of all penicillinsThe tazobactam is a beta lactamase inhibitor

in Piperacillin/tazobactam, the tazobactam is

beta lactamase inhibitor

Assessing penicillin allergy

1. If history of mild reaction - consider cephalosporin2. If history of anaphylaxis - avoid administration of penicillin or cephalosporins

If anaphylaxis occurs after the administration penicillin...

TREATMENT IS EPINEPHRINE

what does anaphylaxis look like?

Laryngeal edemaBronchoconstriction- wheezingSevere hypotensionoften systemic hives (urticaria) are present