Penicillins 1. Natural penicillins: penicillin G(benzyl penicillin), injection 2. Semi-synthetic penicillins Oral penicillins(acid-resistant) penicillin v(phenoxymethyl penicillin) Antistaphylococcal penicillins (B-lactamase-resistant methicillin甲氧西林, cloxacilin氯噎西林, dicloxacillin双氯西林, nafcillin萘失西林 Extended-spectrum penicillins(B-lactamase-sensitive) ampicillin氣苄西林, amoxicillin阿莫西林, ineffective on staphylococci Anti- pseudomonas penicillins carbenicillin苄西林, piperacillin吸拉西林, injection Anti- G bacilli penicillins mecillinam美西林, temocillin誊莫西林
1. Natural penicillins: penicillin G (benzylpenicillin), injection 2. Semi-synthetic penicillins - Oral penicillins (acid-resistant) penicillin V (phenoxymethylpenicillin) - Antistaphylococcal penicillins (b-lactamase-resistant) methicillin甲氧西林，cloxacillin氯唑西林, dicloxacillin双氯唑西林, nafcillin萘夫西林 - Extended-spectrum penicillins (b-lactamase-sensitive) ampicillin氨苄西林, amoxicillin阿莫西林, ineffective on staphylococci - Anti-pseudomonas penicillins carbenicillin羧苄西林， piperacillin哌拉西林, injection - Anti- G - bacilli penicillins mecillinam美西林,temocillin替莫西林 Penicillins
Penicillins Adverse effects of penicillins: (1) Hypersensitivity reactions itch, rashes fever, serum sickness angioneurotic edema, anaphylactic shock (5-10/100,000) (2) others phlebitis: i.V. inflammatory reactions at injection site, degeneration of nerve tissue(im central nervous system excitability(seizures) (3)Herxheimer reaction; cause by destroyed pathogens like spirochetes
Adverse effects of Penicillins: (1) Hypersensitivity reactions itch, rashes, fever, serum sickness , angioneurotic edema, anaphylactic shock (5-10/100,000). (2) Others phlebitis: i.v. inflammatory reactions at injection site, degeneration of nerve tissue (i.m.) central nervous system excitability (seizures). (3) Herxheimer reaction: cause by destroyed pathogens like spirochetes. Penicillins
Penicillins Prevention and treatment of hypersensitivity reactions of penicillin G (1) detailed clinical history (2 skin test (3 First aid treatment of allergic shock epinephrine andlor dopamine glucocorticoids(dexamethasone) anti-histamines (promethazine)
Prevention and treatment of hypersensitivity reactions of penicillin G: (1) A detailed clinical history (2) Skin test (3) First aid treatment of allergic shock epinephrine and/or dopamine glucocorticoids (dexamethasone) anti-histamines (promethazine) Penicillins
Cephalosporins Generation Examples Features First Cefazolin more active than the 2 u and 3u generation against certain (头孢唑林) gram-posiuve microorganisms Cefradine 2. more impervious than the 2and 3u generation to attack by (头孢拉定) staphylococcal B-lactamase Cefalexin 3. less active than the 2u and ?u generation against gram-negative (头孢氨苄) microorganisms 4. more sensitive to gram-negative p-lactamase 5. lack activity against certain Pseudomonas铜绿假单孢菌, Enterobacter species(耐药肠杆菌), anaerobes(厌氧菌) 6. kidney toxicity
Cephalosporins
Cephalosporins Generation Examples Features Second Cefuroxime 1. more active than the 1 generation against certain (头孢呋辛) gram-negative bacilli and moreimpervious than 1tto gram-negative bacilli p - lactamase Cefamandole 2. somewhat less active than 1 generation against 头孢孟多 gram-positive cocci but more active than 3rd generation Cefaclor 3 active against anaerobes厌氧菌) 头孢克洛 4 lack activity against Pseudomonas铜绿假单孢菌) 5.less toxic than the 1 generation to kidney
Cephalosporins