Question

1. Discuss the Penicillins in relation to effectiveness, safety, spectrum of antibacterial activity, mechanism of action, indications for use, administration, observation of patient response, and teaching of patients?

Answer 1

Penicillins

pencillin is a group of antibiotics used to treat a variety of bacterial infections

Effectiveness

Penicillin is effective against many gram positive bacteria including those that causes syphilis, meningococcal meningis, gas gangrene, pneumococcal pneumonia, and some staphylococcal and streptococcal infections. Most gram negative bacteria are resistant to the antibiotics, but some, such as bacteria that causes gonorrhea , are susceptible and others are responsive only to high penicillin concentration or to only certain class of penicillin s. Tuberculosis bacteria, protozoan, viruses and most fungi are not affected by penicillin. Penicillins include ampicillin and amoxicilln with clavulanic acid is active against gram negative and gram positive bacteria such as haemophilus influenzae and E coli. All penicillins act by interfering with synthesis of cell wall.  

safety

Do not use this medicine if you are allergic to any of the penicillins

Before using penicillins ask for any history of allergies to cephalosporin.

Penicillins are not safe if the patient is having kidney disease, bleeding disorder or blood clotting disorder, asthmaasthma and a history of diarrhea caused by antibiotics.

Penicillins have drug interactions with other drug including methotrexate, probenecid, vitamin s, minerals.

Stop the medicine immediately after the signs of hypersensitivity reaction.

Use during pregnancy: No evidence of fetal harm.

Lactation : drug excretes through breast milk.  

Use is advisable only when the benefit outweighs the risk.

Spectrum of antimicrobial activity

Gram positive: non beta lactamase producing gram positive cocci(including viridans streptococci, group A streptococci, streptococci pneumoniae, anaerobic streptococci) enterococcus, non penicillinace producing strains of steptococcus aurius, coagulase negative staphylococcus aurius, clostridium spp(excluding c. deficile) , Actinomyces spp

Gram negative; Neisseria meningitedes, non pencillinace producing neisseria gonorrhea, pasterella multocida

Mechanism of action

bactericidal activity via inhibition of cell wall synthesis by binding one or more of the pencillin binding proteins(PBPs) .Exerts bacterial autolytic effect by inhibition of certain PBPs related to the activation of bacterial autolytic process.

Indication s

pneumonia

sreptococcal infection s(group A)

staphylococcal infections

Bacterial endocarditis

syphilis

Antrax

Diphtheria

Vincent's infection

Erycipeloid

Rat bite fever

Whipple s disease

Renal impairment

Administration

preparation are available for oral route, intramuscular, intravenous administration.

Observation of patients reponse

Monitor the patient for therapeutic response

Check for any side effects

Monitor for hypersensitivity reaction s.

Teaching of patient

instruct the patient to report any uneasyness during treatment.

teach about therapeutic outcome

teach patient to avoid over the counter drug.

Instruct the patient about symptoms of allergic reactions