Difference between revisions of "Penicillin G Procaine"

(Created page with "==General== *Type: *Dosage Forms: *Common Trade Names: ==Adult Dosing== ==Pediatric Dosing== ==Special Populations== *Pregnancy: *Lactation: *Renal Dosing **Adult **Pedia...")
 
 
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==General==
 
==General==
*Type:  
+
*Type: Natural [[Penicillin]]
*Dosage Forms:
+
*Routes of Administration: IM
*Common Trade Names:  
+
*Common Trade Names:
  
 
==Adult Dosing==
 
==Adult Dosing==
 +
===[[Anthrax]]===
 +
*Inhalational (Postexposure Prophylaxis)
 +
**1,200,000 units IM q12 hours x 60 days (see below)
 +
**Info: Total treatment duration = 60 days. Do not give IM for over 2 weeks, switching alternative treatment to complete course
 +
*Cutaneous, Nonsevere (Treatment)
 +
**600,000-1,200,000 units/day IM
 +
 +
===[[Endocarditis]] by susceptible [[Streptococcus viridans]]===
 +
*1.2 million units IM q6 hours x 2-4 weeks + [[aminoglycoside]]
 +
 +
===Neurosyphilis===
 +
*2.4 million units/day IM + 500mg probenecid PO QID x 10-14 days
 +
*Info: [[Penicillin G]] aqueous I.V. is preferred
 +
 +
===Whipple's Disease===
 +
*1.2 million units/day + streptomycin x 10-14 days
 +
*Followed by [[trimethoprim/sulfamethoxazole]] or doxycycline x 1 year
  
 
==Pediatric Dosing==
 
==Pediatric Dosing==
 +
''Avoid use in neonates: increased risk of sterile abscesses and procaine reactions''
 +
 +
===General===
 +
*25,000-50,000 units/kg/day divided 1-2 times/day
 +
*First Dose: 25,000-50,000 units/kg x 1
 +
*Max: 4.8 million units/day
 +
 +
===[[Anthrax]]===
 +
*Inhalational (postexposure prophylaxis)
 +
**25,000 units/kg IM q12 hours
 +
**Max: 1,200,000 units q12 hours
 +
**Info: Total treatment duration = 60 days. Do not give IM for over 2 weeks, switching alternative treatment to complete course
 +
 +
===[[Syphilis]] (Congenital)===
 +
*50,000 units/kg/day IM daily x 10 days
 +
*If >1 day of therapy is missed, restart entire course of treatment
  
 
==Special Populations==
 
==Special Populations==
*Pregnancy:
+
*[[Drug Ratings in Pregnancy|Pregnancy Category]]: B
*Lactation:
+
*Lactation: Use caution
 
*Renal Dosing
 
*Renal Dosing
 
**Adult
 
**Adult
Line 20: Line 53:
 
==Contraindications==
 
==Contraindications==
 
*Allergy to class/drug
 
*Allergy to class/drug
 +
*Avoid use in neonates
  
 
==Adverse Reactions==
 
==Adverse Reactions==
 
===Serious===
 
===Serious===
 +
*Procaine reactions: Immediate toxic reactions, particularly when a large single dose is administered (4.8 million units); mental disturbances including anxiety, confusion, agitation, depression, weakness, seizures, hallucinations, combativeness, and fear
 +
*Jarisch-Herxheimer reaction with syphilis treatment
 +
*Pseudomembranous colitis
  
 
===Common===
 
===Common===
 +
*Rash, urticaria, exfoliative dermatitis
 +
*Serum-sickness like reaction
  
 
==Pharmacology==
 
==Pharmacology==
*Half-life:  
+
*Half-life: 30m
*Metabolism:  
+
*Metabolism: Hepatic
*Excretion:  
+
*Excretion: Urinary
*Mechanism of Action:
+
*Mechanism of Action: Bactericidal; Interferes with cell wall mucopeptide synthesis during active multiplication
  
 
==See Also==
 
==See Also==
 
*[[Antibiotics (Main)]]
 
*[[Antibiotics (Main)]]
  
==Source==
+
==References==
 
 
 
<references/>
 
<references/>
[[Category:Drugs]]
+
[[Category:Pharmacology]]
 +
[[Category:ID]]

Latest revision as of 21:26, 23 September 2019

General

  • Type: Natural Penicillin
  • Routes of Administration: IM
  • Common Trade Names:

Adult Dosing

Anthrax

  • Inhalational (Postexposure Prophylaxis)
    • 1,200,000 units IM q12 hours x 60 days (see below)
    • Info: Total treatment duration = 60 days. Do not give IM for over 2 weeks, switching alternative treatment to complete course
  • Cutaneous, Nonsevere (Treatment)
    • 600,000-1,200,000 units/day IM

Endocarditis by susceptible Streptococcus viridans

Neurosyphilis

  • 2.4 million units/day IM + 500mg probenecid PO QID x 10-14 days
  • Info: Penicillin G aqueous I.V. is preferred

Whipple's Disease

Pediatric Dosing

Avoid use in neonates: increased risk of sterile abscesses and procaine reactions

General

  • 25,000-50,000 units/kg/day divided 1-2 times/day
  • First Dose: 25,000-50,000 units/kg x 1
  • Max: 4.8 million units/day

Anthrax

  • Inhalational (postexposure prophylaxis)
    • 25,000 units/kg IM q12 hours
    • Max: 1,200,000 units q12 hours
    • Info: Total treatment duration = 60 days. Do not give IM for over 2 weeks, switching alternative treatment to complete course

Syphilis (Congenital)

  • 50,000 units/kg/day IM daily x 10 days
  • If >1 day of therapy is missed, restart entire course of treatment

Special Populations

  • Pregnancy Category: B
  • Lactation: Use caution
  • Renal Dosing
    • Adult
    • Pediatric
  • Hepatic Dosing
    • Adult
    • Pediatric

Contraindications

  • Allergy to class/drug
  • Avoid use in neonates

Adverse Reactions

Serious

  • Procaine reactions: Immediate toxic reactions, particularly when a large single dose is administered (4.8 million units); mental disturbances including anxiety, confusion, agitation, depression, weakness, seizures, hallucinations, combativeness, and fear
  • Jarisch-Herxheimer reaction with syphilis treatment
  • Pseudomembranous colitis

Common

  • Rash, urticaria, exfoliative dermatitis
  • Serum-sickness like reaction

Pharmacology

  • Half-life: 30m
  • Metabolism: Hepatic
  • Excretion: Urinary
  • Mechanism of Action: Bactericidal; Interferes with cell wall mucopeptide synthesis during active multiplication

See Also

References