Master Penicillin with Picmonic for Nursing RN

Penicillin is bactericidal due inhibition of bacterial cell wall synthesis and interference with cell wall replication of susceptible organisms resulting in cell lysis and death.

Penicillin is used in the treatment of many gram-positive associated respiratory infections, meningitis, infectious endocarditis, scarlet fever, gas gangrene, and otitis media. It is also administered for syphilis caused by a spirochete.

Prophylactic administration of penicillin can prevent recurrent attacks of rheumatic fever, proliferation of bacterial endocarditis in patients with prosthetic heart valves, congenital heart disease and/or mitral valve prolapse. Prophylaxis is usually initiated prior to dental procedures or other surgical procedures to prevent septicemia.

Penicillin derivatives (e.g. Penicillin-G) are administered as deep IM or using the Z-track method to reduce pain at injection site. Localized pain is a common side effect following some IM injections.

An allergic reaction can range from a localized rash to systemic anaphylaxis. Anaphylactic reactions are often immediate and occur within 2 to 30 minutes following administration of the medication. Education prior to administration and advising the patient to remain at the doctor's office for 15-30 minutes after receiving an injection to monitor for a reaction is important.

Allergic skin tests can help determine the presence of an allergy to penicillin for certain patients. There is a small risk of cross sensitivity with cephalosporins.

Patients with a true allergy to penicillin should wear a medic alert bracelet, update their phone with pertinent health information or carry some type of ID notifying health care personnel of this allergy in case they are incapacitated.

Education for the patient focuses on indication for, side effects, duration or frequency and complications of administering penicillin. Taking penicillin with food can help with gastric distress, and some patients may need to supplement intake of probiotics (preferably through whole foods like kombucha, kefir or fermented foods). Patients need to complete the entire course of treatment. Oral suspensions need to be thoroughly shaken and stored in the refrigerator.