PENICILLINS

P R E PA R E D B Y:
M R . S H R E YA S S . WA LV E K A R
MSC NURSING (MEDICAL SURGICAL NURSING)
PENICILLIN
Discovered by Sir Alexander Fleming in 1928.

Used as Antibiotic, obtained from culture media of mold, fungi, known as Penicillium Chrysogenum,
Penicillin Notatum.

Benzyl Penicillin , Procaine Penicillin, Phenoxymethyl Penicillin are commonly used.

CLASSIFICATION
A. Natural Penicillins

B. Semisynthetic Penicillins

C. Synthetic Penicillins

D. Broad Spectrum Penicillins

NATURAL PENICILLIN
 Obtained from fungi penicillium notatum and penicillium chrysogenum.

 crystalline penicillin (Benzyl Penicillin) is most common.

It is administered in form of injections and has very short duration of action (4 to 6 hrs)

Procaine penicillin has long duration of action (12 to 24 hrs)

SEMISYNTHETIC PENICILLIN
 Not destroyed by acidic secretions of stomach.

Examples are

Phenoxy methyl Penicillin

Phenoxy ethyl Penicillin

Phenoxy propyl Penicillin

 SYNTHETIC PENICILLIN
Penicillinase destroys natural and semisynthetic penicillin

The synthetic penicillin have been synthesized to be more effective and are not destroyed by penicillinase.

Examples are :

Methicillin sodium

Cloxacillin sodium

Oxacillin sodium

Naficillin Sodium
BROAD SPECTRUM PENICILLIN
 Synthesized as the synthetic penicillin, are effective only for gram +ve micro-organism.

Examples are

Ampicillin

Hetacillin

Carbenicillin
MECHANISM OF ACTION
Bactericidal antibiotics (kill bacterias)

Prevent cell wall formation

Also helpful in preventing multiplication of bacteria

Penicillin are effective for bacteria like spirochetes and certain fungi, not against viruses.
INDICATION OR USES
Drug of Choice for pneumonia caused by streptococcus.

Crystalline penicillin (IM, 4hrly 4 to 10 lakh units) in severe infections.

Also effective for meningococcal meningitis infections.

 effective against actinomycosis, streptococcus sore throat.

 Effective for STD like Syphillis, Gonorrhea.

 ADVERSE EFFECTS
High dose is nephrotoxic

Most common is hypersensitivity reaction.

Most severe reaction is anaphylactic shock.

Abscess may occur at site due to irritation of drug.

Synthetic penicillin (ampicillin) causes diarrhea due to continuous oral administration.

When administered with drugs like tetracycline and erthyromycin it decreases antimicrobial action of penicillin.
 NURSES RESPONSIBILITY
Assess for hematuria, oliguria

Blood studies WBC, RBC, Hb, Bleeding time, Clotting Time, LFT Should be monitored.

Bowel pattern during and after treatment.

Skin eruptions after administration.

Respiration status, rate, wheezing chest tightness, pain.

Oral penicillin should be administered empty stomach.

Intradermal test or scratch test may be performed first before administration of penicillin