45. Conservative Therapy Of Inflammatory Diseases

Question 1

General principles for treating inflammatory diseases in the maxillofacial area (MFA) with antibiotics

Answer 1

• Recognizing selective action of antibiotics against microorganisms
• Appropriate antibiotic concentration
• Minimal inhibitory concentration (MIC)
• Understanding pharmacodynamics and pharmacokinetics

Question 2

Antibiotics main classification

Answer 2

• Bactericidal antibiotics=> Inhibit cell wall synthesis
• Bacteriostatic antibiotics=> Interfere w/ reproduction=>
• Allow the host immune system to eliminate them

Question 3

Types of antiobiotics according to dosage

Answer 3

• 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).

Question 4

Common complications associated with antibiotic therapy

Answer 4

• Hypersensitivity reactions=> mild dermatological to severe anaphylaxis
• Gastrointestinal disturbances
• Microbial resistance

Question 5

Characteristics and clinical uses of β-lactam antibiotics

Answer 5

• Prevention and treatment of MFA infections
• Penicillins, cephalosporins, carbapenems, and monobactams
• Inhibit bacterial cell wall synthesis
• Resistance is a growing issue
• May cause hypersensitivity

Question 6

Penicillins

Answer 6

• Commonly used=>
• Effectiveness and minimal toxicity
• Penicillin G, penicillin V, ampicillin, and amoxicillin

Question 7

Cephalosporins:

Answer 7

• Four generations=> varying spectra of activity
• Newer generations =>broader activity=>
• Vulnerable to resistance from β-lactamase-producing bacteria like Prevotella

Question 8

Carbapenems:

Answer 8

• Broad-spectrum antibiotics
• Resistant to many β-lactamases
• Imipenem and meropenem

Question 9

β-lactamase inhibitors

Answer 9

• Extend activity of β-lactam antibiotics against resistant strains=>
• Clavulanic acid and sulbactam

Question 10

Macrolides and their unique features

Answer 10

• Bacteriostatic antibiotics=> inhibit bacterial protein synthesis
• Effective against many bacteria involved in orofacial infections

Question 11

Benefits and risks of tetracyclines

Answer 11

• 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

Question 12

Clindamycin uses

Answer 12

• Effective against viridans streptococci and anaerobic bacteria
• Inhibits protein synthesis

Question 13

Aminoglycosides and how they function

Answer 13

• 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.

Question 14

How quinolones function and their spectrum of activity

Answer 14

• Aka fluoroquinolones
• Bactericidal antibiotics=>
• Inhibit bacterial DNA replication and transcription.
• Extremely broad spectrum of activity

Question 15

Glycopeptides and how they function

Answer 15

• 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

Question 16

Metronidazole use and spectrum of activity

Answer 16

• Anti-protozoan agent
• Only Anaerobic infections

Question 17

How polyenes like amphotericin B function and their uses

Answer 17

• Disrupting fungal membranes=>
• Binding to ergosterol
• Used intravenously for systemic infections

Question 18

Azoles, and how they compare to polyenes

Answer 18

• 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

Question 19

Aciclovir and infections it treats

Answer 19

• Acyclic guanine nucleoside analog
• Inhibits viral DNA synthesis
• Herpes simplex and varicella zoster infections

Question 20

NSAIDs and their mechanism of action

Answer 20

• 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