A patient with mitral valve replacement will require which of the following preoperatively

# A patient with mitral valve replacement  will require which of the following preoperatively?
A. Benzathine Penicillin
B. Tetracycline
C. Procaine penicillin
D. Vibramycin

The correct answer is A. Benzathine Penicillin.

Benzathine and procaine penicillins are formulated to delay absorption, resulting in prolonged blood and tissue concentrations. A single intramuscular injection of 1.2 million units of benzathine penicillin maintains serum levels above 0.02 mcg/mL for 10 days, sufficient to treat β-hemolytic streptococcal infection. After 3 weeks, levels still exceed 0.003 mcg/mL, which is enough to prevent β-hemolytic streptococcal infection. A 600,000 unit dose of procaine penicillin yields peak concentrations of 1–2 mcg/mL and clinically useful concentrations for 12–24 hours after a single intramuscular injection.

Reference: Basic and Clinical Pharmacology, 13th Edition, Katzung, Page 773

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