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6.PENICILLIN (clinical indication (both G+ve & G-ve except MRSA &…

- - - - cell bacteria (Trepanema pallidum) lyse, release endotoxin
- - - - active:G+ve
      - not so:G-ve rod
        
        except G-ve cocci
    - - pen G (benzyl pen)
      - pen VK
  - - - both
    - - amoxicillin
        
        oral better than ampicillin
        
        better bioavailability
        
        less diarrhea
      - ampicillin
        
        1gm=3 mmol Na+
  - - - little activitiy: G+ve
      - inactive:G-ve
    - - methicillin
      - nafcillin
      - oxacillin
      - cloxacillin
      - dicloxacillin
  - - - carboxypenicillin
        
        carbapenicillin
        
        s/e: hypokalemic metabolic alkalosis due to
        
        byk anion dkt distal tubule yg x absorb
        
        alter H+ excretion
        
        loss byk K+
        
        body jadi alkali--->weakness, muscle cramp
        
        ticarcillin
        
        x absorb oral
        
        IV/IM
        
        induce bleeding
        
        s/e: hypokalemic (kurang Ca2+) metabolic alkalosis
        
        hati2 kidney & heart impairment
      - ureidopenicillin
        
        azlocillin
        
        piperacillin
        
        induce bleeding
        
        mezlocillin
    - - most G-ve especially pseudomonas
  - - - .+amoxicillin
      - .+ticarcillin
        
        in form disodium salt
        
        can pseudomonas
    - - .+ampicillin
      - .+cefoperazone
    - - .+piperacillin
        
        can pseudomonas
        
        producing PSE (pen. sensitive enzyme)-class B lactamase