Download Chapter 48 Antidysrhythmic Drugs

Chapter 80
Drugs That Weaken
the Bacterial Cell Wall I:
Penicillins
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Drugs That Weaken the Bacterial
Cell Wall: Penicillins
• Penicillins
– Weaken the cell wall, causing bacteria to take
up excessive water and rupture
– Bactericidal
– Bacterial resistance
• Inability of penicillins to reach their target
• Inactivation of penicillins by bacterial
enzymes
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Classification of Penicillins
Penicillins
• Narrow spectrum
– Pencillinase sensitive
• Narrow spectrum
– Pencillinase resistant
• Broad spectrum
• Extended spectrum
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Penicillin G
(Benzylpenicillin)
• Four forms
– Sodium penicillin
– Potassium penicillin
– Procaine penicillin
– Benzathine penicillin
• Adverse effects
– Allergy—penicillins are the most common
cause of drug allergy
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Penicillin Allergy
• Types
– Immediate
(2 to 30 minutes)
– Accelerated
(1 to 72 hours)
– Late
(days or weeks)
• Anaphylaxis
– Laryngeal edema
– Bronchoconstriction
– Severe hypotension
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Penicillin Allergy (cont.)
• Treatment
– Epinephrine
– Respiratory support
– Prevention—skin testing
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Penicillinase-Resistant
Penicillins
• Four agents
– Nafcillin
– Oxacillin
– Cloxacillin
– Dicloxacillin
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Broad Spectrum Penicillins
(Aminopenicillins)
• The aminopenicillins consist of three agents
– Ampicillin
– Amoxicillin
– Bacampicillin
• Adverse effects
– Rash
– Diarrhea
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Extended Spectrum
Penicillins
(Antipseudomonal
Penicillins)
• The extended spectrum penicillins consist
of four agents
– Ticarcillin
– Carbenicillin indanyl
– Mezlocillin
– Piperacillin
Copyright (c) 2004 Elsevier Inc. All rights reserved.