Natural Penicillin

Natural Penicillin:

• Natural penicillin include:
  o Penicillin G, the prototype
  o Penicillin V
  o Penicillin G procaine
  o Penicillin G benzathine
  

• Of the above mentioned penicillin, Penicillin V can be given orally only, Penicillin G procaine and benzathine intramuscular only. Penicillin G can be given orally, intravenously and intramuscularly.

• Indications:
  o Mainly gram-positive organisms are targeted
  o Mnemonic: ABSCESS makes All of us MAD (Original Mnemonic: MedPrepOnline.Com)
  
  →Actinomycosis
  →Bacteroides species except fragilis
  →Syphilis
  →Clostridium
  →Enterococci
  →Streptococci
  →Spirochetes
  
  →Anaerobic bacterias lacking beta-lactamase
  
  →Meningococci
  →Anthrax
  →Diphtheria
  

• Absorption
  o Depends on penicillin’s acid stability and protein binding ability
  o Affected by food
  

• Excretion
  o Mostly unchanged
  o Excreted in urine by glomerular filtration and active tubular secretion
  o If probenecid is co-administered with penicillin, penicillin excretion by tubular secretion will be delayed.
  

• Adverse effects:
  o Hypersensitivity reactions such as pruritus, fever, bronchospasm, rarely anaphylaxis
  o Seizures (in renal dysfunction)
  o Gastrointestinal disturbances
  o Hemolytic anemia
  o Cation toxicity