Penicillin G Procaine: Difference between revisions
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==General== | ==General== | ||
*Type: Natural [[Penicillin]] | *Type: Natural [[Penicillin]] | ||
* | *Routes of Administration: IM | ||
*Common Trade Names: | *Common Trade Names: | ||
| Line 16: | Line 16: | ||
===Neurosyphilis=== | ===Neurosyphilis=== | ||
*2.4 million units/day IM + | *2.4 million units/day IM + 500mg probenecid PO QID x 10-14 days | ||
*Info: [[Penicillin G]] aqueous I.V. is preferred | *Info: [[Penicillin G]] aqueous I.V. is preferred | ||
| Line 24: | Line 24: | ||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
''Avoid use in neonates: increased risk of sterile abscesses and procaine reactions'' | |||
===General=== | ===General=== | ||
*25,000-50,000 units/kg/day divided 1-2 times/day | *25,000-50,000 units/kg/day divided 1-2 times/day | ||
| Line 40: | Line 42: | ||
==Special Populations== | ==Special Populations== | ||
*Pregnancy: | *[[Drug Ratings in Pregnancy|Pregnancy Category]]: B | ||
*Lactation: | *Lactation: Use caution | ||
*Renal Dosing | *Renal Dosing | ||
**Adult | **Adult | ||
| Line 51: | 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)]] | ||
== | ==References== | ||
<references/> | <references/> | ||
[[Category: | [[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
- 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
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