4. Antibiotics Flashcards
Define bacteriocidal
Any substance that kills bacteria/organism
Define bacteriostatic
Biological or chemical agent that stops bacteria from reproducing (not necessarily killing them)
What are the most frequently used antibiotics in dentistry?
What is their MoA?
What two primary antibiotics are included in this type?
- Beta lactam’s
- Disrupt cell wall
- Penicillins/cephalosporins
Bacteria are resistant to beta-lactams how?
Beta-lactamase production
Penicillin
- Absorption is influenced by what?
- Narrow or wide distribution?
- Excretion how?
- Gastric acid and food
- Wide distribution
- Renal excretion
Pen VK
- MoA (2)
- Absorbed where?
- Inhibits bacterial wall synthesis by binding to 1 or more penicillin-binding proteins
- Bacteria lysis due to ongoing cell wall autolytic enzyme activity
- Absorbed in stomach
Pen Vk
- Dental uses (4)
Orofacial infections including cellulitis, peri-apical abscess, periodontal abscess, pericoronitis
Pen Vk
- What is our main concern with Pen VK?
Multiple resistant bacteria
- S. aureus, S. pneumonia, B. fragilis, B. anthracis
Pen G
- MoA
- Absorption?
Interferes with bacterial wall synthesis during active multiplication, causing cell wall death resulting in bactericidal activity against susceptible bacteria
- Absorbed intra-muscularly
Amoxicillin
- MoA
- Absorption?
- Inhibits bacterial wall synthesis by binding to one or more penicillin-binding proteins
- Bacteria lysis due to ongoing cell wall autolytic enzyme activity
- Absorption via GI tract
Amoxicillin
- Dental concerns and medical concerns
- 4 general uses for it?
- Candiasis and anaphylaxis
- Med: Renal impairment
- Orofacial infections, UTI’s, pneumonia, skin infections
Amox plus Clavulanic acid
- Otherwise known as?
- Dental use?
- Augmentin
2. Treatment of orofacial infections when beta-lacatamase producing staph and bacteroides are present
Amox plus Clavulanic acid
- MoA
Clavulanic acid inds and inhibits beta-lactamase that inactivate amoxicillin resulting in amoxicillin having an expanded spectrum of activity
2. Amox inhibits bacterial cell wall synthesis by binding to 1 or more penicillin-binding proteins; bacterial lysis due to ongoing cell wall autolytic enzyme activity
Penicillin (in general)
- Adverse effects
- Anaphylaxis
- Fever
- Vasculutis
- Rash
- Stevens-Johnson syndrome
Cephalosporin
- Bacteriostatic or cidal
- Excreted how?
- Cross-allergy with?
Bacteriocidal
Excreted via kidneys
Cross-allergy with penicillin
Aminoglycosides
- Include which three?
Gentamycin, neomycin, streptomycin
Neomycin (an amino glycoside)
- Use?
- MoA
- Absorption
- Contraindication
- Surgical prophylaxis
- Interferes with bacterial synthesis by binding to 30S ribosomal subunits
- Oral absorption poor
- GI obstruction (patients with IBD or ulcerative GI disease)
Gentamycin (an amino glycoside)
- Use?
- MoA
- Absorption
- Treatment of serious infections (sepsis, meningitis, UTI’s)
- Interferes with bacterial synthesis by binding to 30S ribosomal subunits
- IM rapid (oral poor)
Streptomycin (an amino glycoside)
- Use?
- MoA
- Absorption
- Treatment of TB, plague, etc
- Interferes with bacterial synthesis by binding to 30S ribosomal subunits
- IM well absorbed (oral poor)
Macrolides
- Bacteriostatic or cidal
- MoA
Bacteriostatic
Inhibit RNA-dependent protein synthesis by binding to 50s ribosomal subunit
Macrolides
- What conditions are they a drug of choice?
- Mycoplasma pneumonia, Legionaire’s disease
2. Subacute bacterial endocarditis
Lincosamide (clindamycin)
- MoA?
- It’s more active against aerobes or anaerobes?
Reversibly binds to 50s ribosomal subunit inhibiting bacterial protein synthesis
More active against anaerobes
Lincosamide (clindamycin)
- Absorption
- Metabolized where?
- Side effects
- How to treat side effect
- Signs/symptoms of side effects
- Absorbed orally
- Hepatic metabolism
- Psuedomembraneous colitis (in 0.01-10%) and metallic taste
- Administer vancomycin or metronidazole
- Diarrhea, ab pain, fever
Fluoroquinolone includes which four drugs?
- Ciprofloxacin (good for anthrax)
- Gemifloxacin
- Levofloxacin
- Ofloxacin
Ciprofloxacin (a fluoroquinolone)
- MoA
- Absorption?
Inhibits DNA-gyrase in susceptible organisms (inhibits relaxation of supercoiled DNA and promotes breakage of double stranded DNA)
- Rapid absorption in GI
Tetracycline medications include? (3)
Tetracycline, doxycycline, and minocycline
What are dental concerns with tetracycline meds?
- Enamel hypoplasia
- Esophagitis
- Glossitis
- Superinfections
- Permanent teeth discoloration
- Candida superinfection
What was the initial “broad spectrum antibiotic?
- MoA?
- Extensive use has led to what?
Tetracycline
Inhibits bacterial protein synthesis by binding to 30s ribosomal submit and possibly 50s ribosomal subunit.
Resistance
Tetracycline - Absorption can be impaired by?
- Narrow or wide distribution?
- Excretion?
- Calcium, dairy, aluminum hydroxide gels
- Wide distribution
- Renal and fecal excretion
buy AT 30, CELL at 50
Aminoglycosides and tetracyclines are 30s ribosomal subunit
Clindaymycin, erythromycin,
