45. Conservative Therapy Of Inflammatory Diseases Flashcards
General principles for treating inflammatory diseases in the maxillofacial area (MFA) with antibiotics
- Recognizing selective action of antibiotics against microorganisms
- Appropriate antibiotic concentration
- Minimal inhibitory concentration (MIC)
- Understanding pharmacodynamics and pharmacokinetics
Antibiotics main classification
- Bactericidal antibiotics=> Inhibit cell wall synthesis
- Bacteriostatic antibiotics=> Interfere w/ reproduction=>
- Allow the host immune system to eliminate them
Types of antiobiotics according to dosage
- Time-dependent antibiotics=> Require serum concentration above MIC for a significant portion of the dosage interval
- Concentration-dependent antibiotics=> Increased bactericidal activity at higher concentrations=>
- May have a postantibiotic effect
-Time dependent-(e.g., β-lactam antibiotics, macrolides, tetracyclines, vancomycin).
-Concentration dependent- (e.g., aminoglycosides, fluoroquinolones).
Common complications associated with antibiotic therapy
- Hypersensitivity reactions=> mild dermatological to severe anaphylaxis
- Gastrointestinal disturbances
- Microbial resistance
Characteristics and clinical uses of β-lactam antibiotics
- Prevention and treatment of MFA infections
- Penicillins, cephalosporins, carbapenems, and monobactams
- Inhibit bacterial cell wall synthesis
- Resistance is a growing issue
- May cause hypersensitivity
Penicillins
- Commonly used=>
- Effectiveness and minimal toxicity
- Penicillin G, penicillin V, ampicillin, and amoxicillin
Cephalosporins:
- Four generations=> varying spectra of activity
- Newer generations =>broader activity=>
- Vulnerable to resistance from β-lactamase-producing bacteria like Prevotella
Carbapenems:
- Broad-spectrum antibiotics
- Resistant to many β-lactamases
- Imipenem and meropenem
β-lactamase inhibitors
- Extend activity of β-lactam antibiotics against resistant strains=>
- Clavulanic acid and sulbactam
Macrolides and their unique features
- Bacteriostatic antibiotics=> inhibit bacterial protein synthesis
- Effective against many bacteria involved in orofacial infections
Benefits and risks of tetracyclines
- Broad-spectrum antibiotics
- Effective against aerobic and anaerobic bacteria
- Bacteriostatic =>interfere w/ protein synthesis
- Periodontitis use
- Risks include GI irritation, photosensitivity, and potential for brown discoloration of teeth in children
Clindamycin uses
- Effective against viridans streptococci and anaerobic bacteria
- Inhibits protein synthesis
Aminoglycosides and how they function
- Bactericidal inhibitors of protein synthesis
- Aerobic Gram-negative bacteria
- Amikacin, gentamicin, kanamycin, streptomycin, and tobramycin
Ineffective against anaerobic bacteria because their transport across the bacterial cytoplasmic membrane is an oxygen-dependent active process, which anaerobes lack.
How quinolones function and their spectrum of activity
- Aka fluoroquinolones
- Bactericidal antibiotics=>
- Inhibit bacterial DNA replication and transcription.
- Extremely broad spectrum of activity
Glycopeptides and how they function
- Inhibit cell wall synthesis of Gram-positive bacteria
- Limited spectrum
- Serious, life-threatening infections unresponsive to other less toxic antibiotics=>
- Effective against methicillin-resistant Staphylococcus aureus (MRSA)
- Vancomycin and teicoplanin
Metronidazole use and spectrum of activity
- Anti-protozoan agent
- Only Anaerobic infections
How polyenes like amphotericin B function and their uses
- Disrupting fungal membranes=>
- Binding to ergosterol
- Used intravenously for systemic infections
Azoles, and how they compare to polyenes
- Class of antifungals => impair fungal cell membrane synthesis=>
- Inhibit sterol synthesis
- Include imidazoles (e.g., miconazole) and triazoles (e.g., fluconazole, itraconazole)
- Broad spectrum and lower toxicity compared to polyenes
Aciclovir and infections it treats
- Acyclic guanine nucleoside analog
- Inhibits viral DNA synthesis
- Herpes simplex and varicella zoster infections
NSAIDs and their mechanism of action
- Anti-inflammatory, analgesic, and antipyretic effects=>
- They inhibit both cyclooxygenase 1 (COX-1) and cyclooxygenase 2 (COX-2)
-COX 1 and 2-=>enzymes responsible for the biosynthesis of prostaglandins involved in inflammation and certain autacoids
-Antipyretic drugs=> prevent or reduce fever
