Mechanism and toxicity

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Mechanism: Penicillins are P-lactams that erode bacterial cell walls by inhibiting mucopeptide synthesis.

Toxicity: Gastrointestinal (nausea, vomiting, diarrhea) > allergic manifestations > CNS: Allergy: 5% manifest penicillin sensitivities = local pruritus, asthma; 1% develop ana-phylaxis. Treatment: O2, epinepherine-nor-epinepherine, P2-agonists, steroids, H1- and H2-blockers, theophylline, fluids. Consider glucagon for severe hypotension. CNS: Seizures due to inhibition of GABA-to-receptor binding. Treatment: benzodi-azapines > barbiturates.

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