PENICILLIN

LIBRE, PRINCESS MELANIE S.

•PENICILLIN G
BENZATHINE
•PENICILLIN G
POTASSIUM
•PENICILLIN G PROCAINE
 PENICILLIN G BENZATHINE
(BENZYLPENICILLIN BENZATHINE)

•Brand Name: Bicillin L-A, Permapen

•Classification: Long-acting antibiotic
INDICATION, DOSAGE, ROUTE AND
FREQUENCY
•Congenital syphilis 
- Children younger than age 2: Give 50,000 units/kg I.M. as single injection
•To prevent poststreptococcal rheumatic fever and glomerulonephritis
- Adults: 1.2 million units I.M. as single injection
- Children who weigh 27 kg or more: 900,000 units I.M. as single injection.
- Children who weigh less than 27 kg: 300,000 to 600,000 units I.M. as single
injection.
•Syphilis of less than 1 year’s duration.
- Adults: 2.4 million units I.M. as single dose
- Children: 50,000 units/kg I.M. up to adult dosage as single dose.
•Syphilis of more than 1 year’s duration
- Adults: 2.4 million units I.M. weekly for 3 successive weeks.
- Children: 50,000 units/kgbup to adult dosage weekly for 3 successive weeks.
•Yaws, bejel, and pinta
- Adults: 1.2 million units I.M. as a single dose.
• to prevent diphtheria
- Adults and children older than age 6 or weighing 30 kg or more: 1.2 million units
I.M. as a single injection.
- Children younger than age 6 or weighing less than 30 kg: 600,000 units I.M. as a
single dose
CONTRAINDICATION
• Contraindicated in patients hypersensitive to drug or other penicillins.
• Use cautiously in patients with other drug allergies, especially to cephalosporins.
• in breastfeeding, don’t use; drug appears in breast milk and may sensitize infant to
drug, cause adverse reactions

MECHANISM OF ACTION
• Inhibits cell wall synthesis during microorganism multiplication.
• Kills susceptible bacteria
DRUG-TO-DRUG INTERACTION
• Aspirin, ethacrynic acid, furosemide, indomethacin, phenylbutazone,
sulfonamides, thiazide diuretics
• Heparin, oral anticoagulants
• Hormonal contraceptives
• Probenecid

ADVERSE EFFECTS
• CNS: neuropathy, pain seizures.
• Hematologic: eosinophilia, hemolytic anemia, leukopenia,
thrombocytopenia.
• Other: hypersensitivity reactions, sterile abscess at injection site.
NURSING RESPONSIBILITY
• Before giving the drug, ask patient about allergic reactions to penicillin,
cephalosporins, and cephamycins. Absence of past reactions is no
guarantee against future allergic reactions.
• Obtain specimen for culture and sensitivity tests before giving first dose.
• Be alert for adverse reactions.
• Observe patient closely.
 PENICILLIN G POTASSIUM
(BENZYLPENICILLIN POTASSIUM)

• Brand Name: Pfizerpen

• Classification: rapid-acting antibiotic
INDICATION, DOSAGE, ROUTE AND
FREQUENCY
• Moderate to severe systemic infection.
- Adults and children age 12 and older: 1 to 24 million units I.M. or I.V. daily in
divided q 4 to 6 hrs.
- Children younger than age 12: Highly individualized; 25,000 to 40,000 units/kg
I.M. or I.V. daily in divided dose q 4 to 6 hrs.
• Anthrax
- Adults: 5 to 20 million units I.V. daily in divided doses q 4 to 6 hrs for atleast 14
days after symptoms subside. Or, maintenance dose of 320,000 units/kg/day.
Average adult dosage, 4 million units q 4 hours or 2 million units q 2 hours.
- Children: 100,000 to 150,000 units/kg/day I.V. in divided doses q 4 to 6 hrs for
atleast 14 days after symptoms subside
• Necrotizing ulcerative gingivitis.
-Adults: 5 to 10 million units I.M. or I.V. daily.
• To eliminate the diphtheria carrier-state.
- Adults: 2 to 3 million units per day I.M. in divided doses 1 4 to 6 hrs
for 10 to 12 days.

CONTRAINDICATION
• Contraindicated in patients hypersensitive to drug or other penicillins.
• Use cautiously in patients with other drug allergies, especially to
cephalosporins.
• in breastfeeding, don’t use; drug appears in breast milk and may
sensitize infant to drug, cause adverse reactions
MECHANISM OF ACTION
• Inhibits cell wall synthesis during microorganism multiplication.
• Kills susceptible bacteria

DRUG-TO-DRUG INTERACTION
• Aminoglyceride antibiotics
• Aspirin, ethacrynic acid, furosemide, indomethacin,
phenylbutazone, sulfonamides, thiazide diuretics
• Heparin, oral anticoagulants
• Hormonal contraceptives
• Potassium-sparing diuretics
• Probenicid
ADVERSE EFFECTS
• CNS: coma, neuropathy, seizures.
• CV: thrombophlebitis
• HEMATOLOGIC: Hemolytic anemia, leukopenia, thrombocytopenia
• METABOLIC: severe potassium poisoning.
• Others: Hypersensitivity reactions, over-growth of nonsusceptible
organisms, pain at injection site.
NURSING RESPONSIBILITY

• Assess renal, cardiac, and vascular conditions with physical exams and
laboratory testing before start of therapy. Drug contains 1.7mEq
potassium and 0.3 mEq sodium per 1 million units. If risk of fluid
overload or electrolyte imbalance, decrease dosage and monitor
electrolytes and renal tests frequently during therapy.
 PENICILLIN G PROCAINE
(BENZYLPENICILLIN PROCAINE)

• Brand name: Wycillin

• Classification: long-acting antibiotic
INDICATION, DOSAGE, ROUTE AND
FREQUENCY
• Moderately severe infections of upper respiratory tract including pneumococcal
pneumonia; tonsils; pharynx and skin and soft tissues.
- Adults and children who weighs 27kg or more: 600,000 units or 1.2 million units
I.M. daily in 1 or 2 doses for at least 10 days.
- Children who weighs less than 27kg: 300,000 units I.M. daily in single dose for
at least 10 days
• Anthrax caused by Bacillus anthracis, including prophylaxis after exposure to
inhalation anthrax.
- Adults: 1.2 million units I.M. q 12 hours up to 60 days.
- Children: 25,000 units/kg I.M. q 12 hours for up to 60 days.
• Cutaneous anthrax.
- Adults: 600,000 to 1 million units I.M. daily for 5 to 60 days depending on  
• Necrotizing ulcerative gingivitis.
- Adults: 600, 000 to 1 million units I.M. daily.
•  Syphilis with no CSF test or positive CSF.
- Adults and children older than age 12: give 600,000 units I.M. daily for 10 to 14
days.
•  Neurosyphilis.
- Adults and children older than age 12: 2.4 million units I.M. daily with
probenecid 500mg P.O. q.i.d. for 10 to 14 days.
•  Congenital syphilis
- Children less than 32 kg: Give 500,000 units/kg/day I.M. for 10 to 14 days.
CONTRAINDICATIONS
• Contraindicated in patients hypersensitive to drug or other penicillins.
• Use cautiously in patients with other drug allergies, especially to
cephalosporins.
• in breastfeeding, don’t use; drug appears in breast milk and may
sensitize infant to drug, cause adverse reactions.
• Avoid use in newborns due to concern of sterile abscesses and procaine
toxicity
MECHANISM OF ACTION
• Inhibits cell wall synthesis during microorganism multiplication.
• Kills susceptible bacteria

NURSING RESPONSIBILITY
• Before giving the drug, ask patient about allergic reactions to penicillin,
cephalosporins, and cephamycins.
• Obtain specimen for culture and sensitivity tests before giving first dose.
• Be alert for adverse reactions.
• Observe patient closely.