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Cidal Penicillins
Cidal Cephalosporins
Cidal Monobactams (Aztreonam)
Cidal Carbapenems
Cidal Aminoglycosides
Static Macrolides
Cidal Quinolones
Static Tetracyclines
Static Sulfonamides
Cidal Metronidazole
Cidal Vancomycin
Cidal Daptomycin
Cidal Nitrofurantoin
Cidal Synercid
Static Chloramphenicol
Cidal Fosfomycin
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Beta Lactam Antibiotics
Beta Lactam Antibiotics
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The Penicillins
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The Penicillins
Natural produced from the fermentation
medium used to culture Penicillium such as
Penicillin G which is the only natural
penicillin used clinically
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The Penicillins
Penicillinase, produced by resistant
bacteria, inactivates penicillins by
breaking the beta lactam ring.
Clavulanic acid inhibits this enzyme, so
combined with ampicillin to give good
combination” Augmentin”.
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penicillin nucleus
Structure of penicillins and products of
their enzymatic hydrolysis
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Penicillin Actions
•Peptidoglycan provides
rigid mechanical
stability
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Penicillin Actions
•In gram-positive
microorganisms, the
cell
wall is 50 to 100
molecules thick,
• but it is
only 1 or 2 molecules
thick in gram-negative
bacteria
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Penicillin Actions
Penicillin-binding
last step in proteins (PBPs)
are a group of
peptidoglycan proteins that are
synthesis characterized by
their affinity for
that is inhibited by and binding of
penicillin. They
the β-lactam are a normal
constituent of
antibiotics many bacteria
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β -Lactamase inhibitors.
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The Penicillins
Benzyl penicillin (Penicillin G):
Deep IM injection.
ineffective S. aureus
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The Penicillins
Procain benzylpenicillin:
Painless, prolonged action injection.
Phenoxymethyl penicillin:
Oral, not destroyed by gastric juice.
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The Penicillins
Ampicillin:
Broad-spectrum penicillin, can cause diarrhea,
due to overgrowth of normal flora, and
incomplete absorption.
Frequently administered with a β-lactamase
inhibitor
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The Penicillins
Amoxicillin:
Same, but more completely absorbed than
ampicillin.
So, less diarrhea, and longer acting than
ampicillin.
Azlocillin, Pipercillin, and Ticarcillin: Have
extended spectrum, e.g. Proteus, Pseudomonas,
Klebsiella, and certain other gram-negative
microorganisms
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The Penicillins
Adverse Effects:
Relativley very safe drugs; except:
Pain of injection.
Abscess formation.
Allergic reactions:
Skin rash.
Urticaria.
Anaphylaxis. Anaphylaxis is a serious
rash, allergic reaction that is
rapid in onset and may
fever, bronchospasm, cause death.
dermatitis, Stevens–Johnson syndrome
Stevens–Johnson syndrome, a form of toxic epidermal necrolysis, is a life-threatening
skin condition, in which cell death causes the epidermis to separate from the dermis.
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Management of the Patient Potentially Allergic
to Penicillin.
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