Types of Penicillin Quiz
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Questions and Answers

What is the mechanism of action of A1-adrenergic blockers?

  • Inhibit type 1 beta-adrenergic receptors
  • Decrease HDL cholesterol
  • Inhibit smooth muscle contraction (correct)
  • Increase heart rate

    • Which adverse effect is specifically associated with the first dose of prazosin?

  • Insomnia
  • Nausea
  • Sexual dysfunction
  • Postural hypotension (correct)

    • What is the primary mechanism of action of beta-adrenergic blockers?

  • Promote smooth muscle contraction
  • Increase heart rate
  • Block the effects of adrenaline (correct)
  • Increase blood pressure

    • Which population should beta-adrenergic blockers be used with caution in?

    <p>Patients with diabetes (B)</p> Signup and view all the answers

    What is a common adverse effect of combined alpha- and beta-adrenergic blockers?

    <p>Asthma (D)</p> Signup and view all the answers

    What do peripheral adrenergic antagonists target in the nervous system?

    <p>Presynaptic adrenergic neurons in the peripheral nervous system (D)</p> Signup and view all the answers

    Which adverse effect is commonly associated with peripheral adrenergic antagonists?

    <p>Sexual dysfunction (C)</p> Signup and view all the answers

    Why should alpha- and beta-adrenergic blockers not be used in patients with sick sinus syndrome?

    <p>Potential worsening of sinus node function (B)</p> Signup and view all the answers

    'They make your heartbeat slower and relax the blood vessels' refers to which class of medication?

    <p>-olol drugs (A)</p> Signup and view all the answers

    Flashcards

    Penicillin G

    A natural penicillin, administered via IM, often combined with Probenecid to delay excretion. Used for syphilis and gram-positive infections.

    Amoxicillin

    An aminopenicillin with an extended effect, often taken orally and combined with Clavulanate. Used in triple therapy for H. pylori GI infections.

    Methicillin

    A penicillinase-resistant penicillin, previously used in the US to treat infections caused by penicillinase-producing staphylococci, including MRSA.

    Ticarcillin

    A carboxypenicillin, used to treat various infections, including skin infections, UTIs, and bacterial sepsis.

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    Piperacillin

    A ureidopenicillin typically administered intravenously with Tazobactam, addressing skin infections, UTIs, and bacterial sepsis.

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    Cefazolin

    A first-generation cephalosporin used in various infections.

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    Carbapenems

    A broad-spectrum antibiotic class, often used for serious infections. Thienamycin was an early example.

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    Imipenem

    A carbapenem often combined with cilastatin due to its susceptibility to degradation, used to treat serious infections. Use cautiously in patients with epilepsy.

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    Aztreonam

    Monobactam effective against gram-negative bacteria. It's a useful alternative or first choice treatment against these.

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    Vancomycin

    A polypeptide antibiotic that inhibits cell wall synthesis in bacteria. Used for serious infections, including MRSA.

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    Methotrexate

    An antimetabolite that inhibits Dihydrofolate reductase (DHFR). Used in various cancers.

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    6-Mercaptopurine

    An antimetabolite inhibiting de novo purine synthesis. Used for treating some leukemias.

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    5-Fluorouracil

    Inhibits thymidylate synthase and used in cancer treatment.

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    Indomethacin

    A non-steroidal anti-inflammatory drug (NSAID) frequently used to treat arthritis. Often taken with food to reduce stomach irritation.

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    Ibuprofen

    A common pain reliever, and anti-inflammatory medication widely used.

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    Docusate

    Stool softener that increases water absorption in the gut, making stools easier to pass.

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    Glycerin

    Saline laxative. Draws water into the stool, stimulating bowel movements. Often a rectally administered medication.

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    Alpha-1 Adrenergic Blockers

    Drugs that block alpha-1 adrenergic receptors, used to treat high blood pressure and other conditions.

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    Beta-Adrenergic Blockers

    Drugs that block beta-adrenergic receptors. Often used to treat high blood pressure and certain cardiac conditions.

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    Study Notes

    Penicillins

    • Natural Penicillins: Benzyl Penicillin (Penicillin G)
      • ROA: IM, combined with Probenecid to prevent early excretion
      • Indications: Syphilis, treatment of infections caused by gram-positive agents
    • Aminopenicillins: Amoxicillin
      • Extended effect due to amino group
      • ROA: Oral, combined with Clavulanic Acid (Co-Amoxiclav)
      • Indications: Part of triple therapy for H. pylori GI Infection
    • Penicillinase Resistant: Methicillin
      • Not used clinically in the US due to cases of interstitial nephritis
      • Indications: Treatment of infections caused by penicillinase-producing staphylococci, including MRSA
    • Antipseudomonal Penicillins:
      • Carboxypenicillin: Ticarcillin
      • Ureidopenicillin: Piperacillin
        • ROA: IV, combined with Tazobactam (Piptaz, Tazocin)
        • Indications: Skin infections, UTI, Bacterial sepsis
        • ADR: Hypersensitivity (5%), Diarrhea, Nephritis

    Cephalosporins

    • 1st Generation: Cefazolin, Cephalexin
    • 2nd Generation: Cefuroxime, Cefaclor
    • 3rd Generation: Cefdinir, Cefotaxime, Ceftriaxone
    • 4th Generation: Cefepime
    • MOA: Beta-lactam rings bind to the penicillin-binding protein and inhibit its physiological activity
    • Indications: Syphilis, Uncomplicated Gonorrhea, potentially indicated in treating Lyme disease caused by B. burgdorferi
    • ROA: IV, IM
    • ADR: Acute renal failure, Gl upset, Pain at injection site

    Carbapenems

    • Thienamycin: First carbapenem produced from S. cattleya
    • Imipenem: Easily degraded dehydropeptidase, usually combined with Cilastatin (DHP inhibitor)
      • Contraindicated in epileptic patients
    • Meropenem: Not easily degraded by DHP, greater potency in gram-negative and anaerobic bacteria

    Monobactams

    • Aztreonam: Effective against gram-negative bacteria

    Polypeptides

    • Vancomycin
      • MOA: Inhibits cell wall synthesis by binding firmly to the D-Ala-D-Ala terminus, preventing further growth and cross-linking
      • Indications: MRSA, Epidermidis, Colitis
    • Other Polypeptides: Not listed

    Antimetabolites

    • Methotrexate
      • MOA: Dihydrofolate reductase (DHFR) inhibitor
      • Indications: Breast cancer, Head & Neck cancer, Bladder cancer, Non-Hodgkin's lymphoma
      • ADR: Mucositis, Diarrhea
    • 6-Mercaptopurine
      • MOA: Inhibits de novo purine synthesis
      • Indications: Acute myelogenous leukemia
      • ADR: Nausea, Myelosuppression, Immunosuppression, Hepatotoxicity
    • 5-Fluorouracil
      • MOA: Inhibits thymidylate synthase and its metabolites
      • Indications: Gl cancers, Breast cancer, Hepatocellular cancer
      • ADR: Nausea, Mucositis, Diarrhea, Hepatotoxicity

    NSAIDs

    • Indomethacin: Must be taken with food, highly irritating
      • Indications: Rheumatoid arthritis, OA, Gout
      • ADR: Edema
    • Sulindac: Prodrug → converted to its active sulfide form
    • Diclofenac Sodium (Voltaren): Analgesic, often used after ophthalmic surgery, minimal to no antipyretic effects
    • Propionic Acid Derivatives: Ibuprofen
    • Fenamates: Mefenamic acid
      • ADR: Flatulence, impaction, excessive bowel activity
      • Contraindications: Hypersensitivity, bowel obstruction, symptoms of appendicitis or acute surgical abdomen, GI ulceration/adhesions, fecal impaction, dysphagia, rectal bleeding

    Laxatives

    • Stool Softeners or Wetting Agents: Docusate
      • MOA: Increases the amount of water the stool absorbs in the gut, making the stool softer and easier to pass
      • ADR: Stomach pain, diarrhea or cramping
      • Contraindications: Intestinal obstruction, symptoms of appendicitis or acute abdominal pain, fecal impaction; concomitant use of mineral oil; nausea or vomiting
    • Saline Laxatives or Enemas: Glycerin
      • MOA: Hygroscopic and/or local irritant action, drawing water from the tissues into the feces and reflexively stimulating evacuation
      • ADR: Hypersensitivity
      • ROA: Rectally
      • Contraindications: Acute abdominal pain, N/V, symptoms of appendicitis or undiagnosed abdominal pain
    • Lubricant Laxatives: Castor oil
      • MOA: Ricinoleic acid acts as an anionic surfactant that reduces net absorption of fluid and electrolytes and stimulates intestinal peristalsis
      • ADR: Stomach/abdominal pain or cramping, nausea, diarrhea, or weakness
      • Contraindications: Hypersensitivity, GI obstruction or perforation, severe impaction, symptoms of appendicitis or acute surgical abdomen, ulcerative colitis, rectal fissures

    Adrenergic Blockers

    • Alpha-1 Adrenergic Blockers: -zosin
      • MOA: Bind to and inhibit type 1 alpha-adrenergic receptors and thus inhibit smooth muscle contraction
      • ADR: Postural hypotension, weakness, palpitations, dizziness
      • Precautions: Use cautiously in older adult patients because of hypotension
    • Beta Adrenergic Blockers: -olol
      • MOA: Block the effects of the hormone adrenaline, making the heartbeat slower and relaxing the blood vessels, which reduces blood pressure
      • ADR: Bradycardia, insomnia, fatigue, sexual dysfunction, bizarre dreams, decreased HDL cholesterol
      • Precautions: Not for use in patients with asthma, COPD, CHF, heart block, and sick sinus syndrome. Use with caution in patients with diabetes and peripheral vascular disease
    • Combined Alpha- and Beta- Adrenergic Blockers
      • MOA: Combined MOA of Alpha-Adrenergic Blocker and Beta-Adrenergic Blocker
      • ADR: Nausea, fatigue, dizziness, asthma, headache
      • Precautions: Not for use in sick sinus syndrome or heart block; used in caution in CHF, bronchial asthma, COPD, and diabetes mellitus
    • Peripheral Adrenergic Antagonists
      • MOA: Target the presynaptic adrenergic neurons in the peripheral nervous system and prevent them from effectively releasing the catecholamines norepinephrine and epinephrine
      • ADR: Sexual dysfunction, nasal congestion, postural hypotension, diarrhea, lethargy
      • Precautions: Use very cautiously in older adult patients because of hypotension

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    Test your knowledge on different types of penicillin antibiotics like Aminopenicillin, Penicillinase Resistant, and Antipseudomonal Penicillins. Learn about their properties, uses, and modes of administration.

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