penicillin piont view

8/14/2019 Penicillin Piont View

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PenicillinBy : abdelmnaem elgelia


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Classification:

Cell wall synthesis inhibitorsBeta-lactams (penicillins, cephalosporins,

aztreonam, imipenem)Poly-peptides (bacitracin, vancomycin) Protein synthesis inhibitorsAminoglycosidesTetracyclinsMacrolidesChloramphenicol

Clindamycin Folate antagonistsSulfonamidesTrimethoprim Quinolones


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BACTERIAL CELL WALL

Gram-negative (e.g. E.coli, Salmonella)Few peptidoglycan

layers(Lipopolysaccheride)

Gram-positive (e.g. Staphylococci,Listeria)

Many peptidoglycan layers(Lipoteichoicacid)


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Resistance to PenicillinsResistance to Penicillins

1)Production of -lactamases

2)

3)The occurrence of modified penicillin-

binding sites4)

5)Decreased permeability to the drug


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Narrow spectrum penicillinase sensitive

Narrow spectrum penicillinase resistant

Broad spectrum penicillins

Extended-spectrum penicillins

PenicillinsPenicillins

classificationclassification


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Narrow spectrum penicillinase (=Narrow spectrum penicillinase (= --

lactamase) sensitivelactamase) sensitive

Benzylpenicillin

Naturally occuring

Poor oral availability (sensitive to stomach

acid)

given by injection

Active against gram-positive bacteria

Phenoxymethylpenicillin

Better oral availability (acid resistant)


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Narrow spectrum penicillinase (=Narrow spectrum penicillinase (=

-- lactamase) resistantlactamase) resistant

Methicillin

Semisynthetic

Poor oral availability (only parenteral)

Active against gram-pos bacteria

Mostly used for Staphylococcus aureus

Oxacillin

Good oral availability

Cloxacillin


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Broad spectrum penicillinase (=Broad spectrum penicillinase (= --

lactamase) sensitive(= Aminopenicillins)lactamase) sensitive(= Aminopenicillins)

Ampicillin

Semisynthetic

Good oral availability

Active against gram-pos and gram-neg

bacteria

Active against enterobacteria

Amoxicillin

Excellent oral availability


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Extended spectrum penicillinase (= -Extended spectrum penicillinase (= -

lactamase) sensitivelactamase) sensitive (=(=

Carboxypenicillins)Carboxypenicillins) Carbenicillin

Semisynthetic

Poor oral availability Active against gram-pos and gram-neg bacteria

Active against Pseudomonas aeruginosa,

Klebsiella

Ticarcillin

Mezlocillin

Pipercillin


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PHARMACOKINETIC:

bsorbtion orallyDistrubutionBBBPlacentaenal execretion

etabolizetion


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Therapeutic useTherapeutic use

Treatment of:Treatment of:+r a m o c c i _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ S t a p h, >>>>t r e p t o a b c e s sr a m _ o c c i _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ n i s s e r i a>>>> e n i n g i t i s+r a m a c i l l i _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ a n t h r a x, ,e t a n u s g a s g a n g r e n e>>>>p i r o c h e t e s s y p h i l i s>>>>c t i n o m y c e s e a c t i n o m y c o s i sr a m ,a c i l l i _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ U T I. ,P y l o r i t y p h o i d f e v e r


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impairment ofplatelet aggregation.

irritative responses to penicillin at site

of injection

phlebitis or thrombophlebitis

nausea, with or without vomiting

Intrathecal injection of penicillin G

may produce arachnoiditis


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PROBENECID

Probenecid is an oral drug used for reducingblood uric acid levels in patients with

hyperuricemia (high uric acid)

Probenecid prevents attacks of gout by

reducing uric acid levels in the blood.

It does this by preventing the reabsorption of

uric acid by the kidney and increasing its

excretion from the body in the urine.

Probenecid also blocks excretion by thekidney of penicillin and related antibiotics

and is used for increasing the levels of the

antibiotics in the blood and increasing

their effectiveness when treating


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PRESCRIBED FOR:PRESCRIBED FOR:

Probenecid is used for the treatment

ofhyperuricemia associated with

gout. It also is used for increasing

blood levels of penicillin-type

antibiotics (for example, ampicillin

and amoxicillin).
http://www.medicinenet.com/script/main/art.asp?articlekey=693http://www.medicinenet.com/script/main/art.asp?articlekey=692http://www.medicinenet.com/script/main/art.asp?articlekey=692http://www.medicinenet.com/script/main/art.asp?articlekey=693


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SIDE EFFECTS:

Common side effects of probenecid include

headache, dizziness, nausea, vomiting, skin

rash, sore gums, and fever.

Probenecid may cause a flare of gout and

kidney stones, and it is not started during an

acute attack of gout.Serious but rare side effects include reduced

red blood cell counts (anemia), liver damage

and severe allergic reactions.
http://www.medicinenet.com/script/main/art.asp?articlekey=20628http://www.medicinenet.com/script/main/art.asp?articlekey=97800http://www.medicinenet.com/script/main/art.asp?articlekey=24732http://www.medicinenet.com/script/main/art.asp?articlekey=1992http://www.medicinenet.com/script/main/art.asp?articlekey=361http://www.medicinenet.com/script/main/art.asp?articlekey=2015http://www.medicinenet.com/script/main/art.asp?articlekey=2015http://www.medicinenet.com/script/main/art.asp?articlekey=361http://www.medicinenet.com/script/main/art.asp?articlekey=1992http://www.medicinenet.com/script/main/art.asp?articlekey=24732http://www.medicinenet.com/script/main/art.asp?articlekey=97800http://www.medicinenet.com/script/main/art.asp?articlekey=20628

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