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Case Pres > 4. Antibiotics > Flashcards

4. Antibiotics Flashcards

1
Q

Define bacteriocidal

A

Any substance that kills bacteria/organism

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2
Q

Define bacteriostatic

A

Biological or chemical agent that stops bacteria from reproducing (not necessarily killing them)

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3
Q

What are the most frequently used antibiotics in dentistry?

What is their MoA?
What two primary antibiotics are included in this type?

A
  1. Beta lactam’s
  2. Disrupt cell wall
  3. Penicillins/cephalosporins
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4
Q

Bacteria are resistant to beta-lactams how?

A

Beta-lactamase production

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5
Q

Penicillin

  • Absorption is influenced by what?
  • Narrow or wide distribution?
  • Excretion how?
A
  1. Gastric acid and food
  2. Wide distribution
  3. Renal excretion
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6
Q

Pen VK

  • MoA (2)
  • Absorbed where?
A
  1. Inhibits bacterial wall synthesis by binding to 1 or more penicillin-binding proteins
  2. Bacteria lysis due to ongoing cell wall autolytic enzyme activity
  3. Absorbed in stomach
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7
Q

Pen Vk

- Dental uses (4)

A

Orofacial infections including cellulitis, peri-apical abscess, periodontal abscess, pericoronitis

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8
Q

Pen Vk

- What is our main concern with Pen VK?

A

Multiple resistant bacteria

- S. aureus, S. pneumonia, B. fragilis, B. anthracis

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9
Q

Pen G

  • MoA
  • Absorption?
A

Interferes with bacterial wall synthesis during active multiplication, causing cell wall death resulting in bactericidal activity against susceptible bacteria

  • Absorbed intra-muscularly
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10
Q

Amoxicillin

  • MoA
  • Absorption?
A
  1. Inhibits bacterial wall synthesis by binding to one or more penicillin-binding proteins
  2. Bacteria lysis due to ongoing cell wall autolytic enzyme activity
  3. Absorption via GI tract
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11
Q

Amoxicillin

  • Dental concerns and medical concerns
  • 4 general uses for it?
A
  1. Candiasis and anaphylaxis
  2. Med: Renal impairment
  3. Orofacial infections, UTI’s, pneumonia, skin infections
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12
Q

Amox plus Clavulanic acid

  • Otherwise known as?
  • Dental use?
A
  1. Augmentin

2. Treatment of orofacial infections when beta-lacatamase producing staph and bacteroides are present

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13
Q

Amox plus Clavulanic acid

- MoA

A

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

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14
Q

Penicillin (in general)

- Adverse effects

A
  1. Anaphylaxis
  2. Fever
  3. Vasculutis
  4. Rash
  5. Stevens-Johnson syndrome
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15
Q

Cephalosporin

  • Bacteriostatic or cidal
  • Excreted how?
  • Cross-allergy with?
A

Bacteriocidal
Excreted via kidneys
Cross-allergy with penicillin

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16
Q

Aminoglycosides

- Include which three?

A

Gentamycin, neomycin, streptomycin

17
Q

Neomycin (an amino glycoside)

  • Use?
  • MoA
  • Absorption
  • Contraindication
A
  1. Surgical prophylaxis
  2. Interferes with bacterial synthesis by binding to 30S ribosomal subunits
  3. Oral absorption poor
  4. GI obstruction (patients with IBD or ulcerative GI disease)
18
Q

Gentamycin (an amino glycoside)

  • Use?
  • MoA
  • Absorption
A
  1. Treatment of serious infections (sepsis, meningitis, UTI’s)
  2. Interferes with bacterial synthesis by binding to 30S ribosomal subunits
  3. IM rapid (oral poor)
19
Q

Streptomycin (an amino glycoside)

  • Use?
  • MoA
  • Absorption
A
  1. Treatment of TB, plague, etc
    1. Interferes with bacterial synthesis by binding to 30S ribosomal subunits
  3. IM well absorbed (oral poor)
20
Q

Macrolides

  • Bacteriostatic or cidal
  • MoA
A

Bacteriostatic

Inhibit RNA-dependent protein synthesis by binding to 50s ribosomal subunit

21
Q

Macrolides

- What conditions are they a drug of choice?

A
  1. Mycoplasma pneumonia, Legionaire’s disease

2. Subacute bacterial endocarditis

22
Q

Lincosamide (clindamycin)

  • MoA?
  • It’s more active against aerobes or anaerobes?
A

Reversibly binds to 50s ribosomal subunit inhibiting bacterial protein synthesis
More active against anaerobes

23
Q

Lincosamide (clindamycin)

  • Absorption
  • Metabolized where?
  • Side effects
  • How to treat side effect
  • Signs/symptoms of side effects
A
  1. Absorbed orally
  2. Hepatic metabolism
  3. Psuedomembraneous colitis (in 0.01-10%) and metallic taste
  4. Administer vancomycin or metronidazole
  5. Diarrhea, ab pain, fever
24
Q

Fluoroquinolone includes which four drugs?

A
  1. Ciprofloxacin (good for anthrax)
  2. Gemifloxacin
  3. Levofloxacin
  4. Ofloxacin
25
Q

Ciprofloxacin (a fluoroquinolone)

  • MoA
  • Absorption?
A

Inhibits DNA-gyrase in susceptible organisms (inhibits relaxation of supercoiled DNA and promotes breakage of double stranded DNA)
- Rapid absorption in GI

26
Q

Tetracycline medications include? (3)

A

Tetracycline, doxycycline, and minocycline

27
Q

What are dental concerns with tetracycline meds?

A
  1. Enamel hypoplasia
  2. Esophagitis
  3. Glossitis
  4. Superinfections
  5. Permanent teeth discoloration
  6. Candida superinfection
28
Q

What was the initial “broad spectrum antibiotic?

  • MoA?
  • Extensive use has led to what?
A

Tetracycline

Inhibits bacterial protein synthesis by binding to 30s ribosomal submit and possibly 50s ribosomal subunit.

Resistance

29
Q

Tetracycline - Absorption can be impaired by?

  • Narrow or wide distribution?
  • Excretion?
A
  1. Calcium, dairy, aluminum hydroxide gels
  2. Wide distribution
  3. Renal and fecal excretion
30
Q

buy AT 30, CELL at 50

A

Aminoglycosides and tetracyclines are 30s ribosomal subunit

Clindaymycin, erythromycin,

Case Pres (7 decks)

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