Chills penicillins

Cloxacillin sodium salt (sodium 3-o-chlorophenyl-5-methyl-4-isoxazolyl penicillin monohydrate) [642-78-4] M 457.9, m 170°, [a]J, +163° (HjO pH 6.0-7.5), pKe, 2.8 (COOH). Purified by dissolving in isoPrOH containing 20% of H2O, and diluting with isoPrOH to a water content of 5% and chilled, and recrystd again in this manner. The sodium salt is collected and dried at 40° in air to give the colourless monohydrate. It is soluble in H2O (5%), MeOH, EtOH, pyridine and ethylene glycol. [Doyle et al. J Chem Soc 5838 I 963 Naylor et al. Nature 195 1264 1962.]... 

Additionally, some patients may experience fever, chills, tachycardia, and tachypnea, a condition commonly known as the Jarisch-Herxheimer reaction. Postulated to occur secondary to spirochete lysis and proinflammatory cytokine cascades, this reaction may transpire as early as 2 hours after penicillin administration and usually resolves within 24 hours. Treatment is supportive and may include antipyretic and antiinflammatory agents, as well as fluid resuscitation and bed rest. 

The purification and recovery of harvest CPC broth begins with the rapid chilling of the active broth to 3-5 °C followed by removal of the mycelial solids either by filtration or by centrifugation. The active broth contains not only the desired CPC component, but also small quantities of the biosynthetic precursors, penicillin N, DAOC, deace-tylcephalosporin C, and the degraded CPC product, 2-(D-4-amino-4-carboxybutyl)-thiazole-4-carboxylic acid. 

When acetone is used as an eluant, it is separated from the filtrate by distillation in a vacuum or by extraction with a solvent that is not miscible with water. The resulting aqueous concentrate of penicillin is chilled to 0° C, acidified to pH 2.0, and extracted with an organic solvent. Penicillin, a fairly strong acid, is very soluble in a number of organic solvents, e.g., ethyl acetate, alcohol, ether, amyl acetate, cycloxhexanone, dioxane, chloroform. 

Most patients with secondary syphilis develop the Jarisch-Herxheimer reaction, including chills, fever, headache, myalgias, and arthralgias occurring several hours after the first dose of penicillin. This is likely due to release of spirochetal antigens that induce a host reaction. Reactions usually persist for a few hours to days but do not recur with subsequent penicillin injections penicillin therapy should not be stopped. 

Rena Felya, a 9-year-old girl, complained of a severe pain in her throat j and difficulty in swallowing. She had chills, sweats, headache, and a fever of 102.4- F. When her symptoms persisted for several days, her mother took her to the pediatrician, who found diffuse erythema (redness) in her posterior pharynx (throat) with yellow exudates (patches) on her tonsils. Large, tender lymph nodes were present under her jaw on both sides of her neck. A throat culture was taken, and therapy with penicillin was begun. 

A 77-year-old woman with a penicillin allergy had a recurrent fever, malaise, rigor, chills, and a leukocytosis after several exposures to nitrofurantoin no further inflammatory episodes occurred after nitrofurantoin with-chawal [142 ]. 

The separation scheme for penicillin starts with the broth from the reactor, which is chilled to reduce the rate of natural decomposition of the desired product, and then filtered to remove the solids. From there to the finished product the steps are ... 

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