Caution if renal disease high doses may cause cns

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Unformatted text preview: different chemical (R) groups to the 6aminopenicillanic acid nucleus Penicillins Penicillins • Originally - narrow spectrum – chiefly gram positive – effective against organisms causing most common infections – Good Therapeutic Index: large doses may be given (not normally toxic to humans). • Caution if renal disease - high doses may cause CNS stimulation and convulsions. • Semisynthetic derivatives extended spectrum • Other synthetics more resistant to bacterial penicillinase which is also called beta lactamase (oxacillin, nafcillin, etc.) • I.V. forms contain sodium and/or potassium - may cause electrolyte imbalance in patient with kidney failure. • If local anesthetic included is intended for IM not I.V. use (cardiac arrhythmias, etc.) Beta-Lactams Beta-Lactams Safety Considerations • Considered quite safe as a group • Adverse reactions do occur Side Effects and Toxicities Hypersensitivity GI/Biliary/Hepatic Hem atologic Neurological Renal Electrolytes Sites of Enzyme Activity Amidase Lactamase Beta-La...
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