Penicillin G Procaine: Difference between revisions

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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
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==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