Antibiotics Flashcards
Antibiotics on bacterial metabolism
Drugs:
SULFAMETHOXAZOLE + TRIMETHOPRIM → COTRIMOXAZOL = Urinary, Respiratory, Intestinal infection
SILVERSULFADIAZINE → TOPICAL USE FOR BURNS
Antibiotics on bacterial cell wall: Beta-lactams Penicillins
PENICILLINS:
1st gen (natural penicillin): PENICILLIN G & PENICILLIN V
Beta lactamase resistant penicillins: OXICILLIN & METHICILLIN (S.aureus)
2nd gen (aminopenicillins): AMOXICILLIN & AMPICILLIN
3d gen (Carboxypencillins):TICARCILLIN & CARBENICILLIN
4th gen (Ureidopencillins): PIPERACILLIN & MECLOCILLIN
Antibiotics on bacterial cell wall: Beta-lactams Monbactam drug
- Monbactam: AZTREONAM
Antibiotics on bacterial cell wall: Beta-lactams Carbapenem drug
- Carbapenem: IMIPENEM, CARBAPENEM
Antibiotics on bacterial cell wall: Beta-lactams cephalosporins drugs
- Cephalosporins
1st gen: CEPHAZOLINE, CEPHALEXIN, CEPHALOTHIN
2nd gen: CEFUROXIME, CEFACLOR, CEPHONICIDE
3rd: CEFOTAXIME, CEFOTIME, CEFTRIAXONE, CEFIXIME
Could be useful in the treatment of odontogenic infections caused by resistant bacteria.
Nephrotoxicity (1st generation)
Antibiotic on bacterial cell wall: Glycopeptides
VANCOMYCIN & TEICOPLANINE
Teicoplanin dont need dose regulation when kidney failure
Antibiotic on bacterial protein synthesis: Macrolides
Macrolides: ERYTHROMYCIN, AZITRHOMYCIN, SPIRAMYCIN, CLARITHROMYCIN, TELITHROMYCIN (new family)
Antibiotic on bacterial protein synthesis: Lincosamides
CLINDAMYCIN
Good bone penetration
o Bone infections
o Perialveolar abscesses
Antibiotic on bacterial protein synthesis: Tetracyclines
TETRACYCLINE, OXYTETRACYCLINE, DOXYCYCLINE, MINOCYCLINE
In dentistry uses = PERIODONTAL DISEASES (broad spectrum + reduce inflammation)
Gradually reduced activity due to overuse!
Antibiotic on bacterial protein synthesis: Aminoglycosides
Aminoglycosides: GENTAMYCIN, TOBRAMYCIN, STREPTOMYCIN & NEOMYCIN
Antibiotic on bacterial nucleic acid function & synthesis: Quinolones
Quinolones:
1st gen: NALDIXIC ACID & PIPEMIDIC ACID
2nd gen: NORFLOXACIN & CIPROFLOXACIN
3rd gen: LEVOFLOXACIN
4th gen: MOXIFLOXACIN & GATIFLOXACIN
Not used in dentistry
Antibiotic on bacterial nucleic acid function & synthesis: Nitroimidazoles
Nitroimidazole: METRONIDAZOLE måste administreras tillsammans med penicillin, macrolide eller cepaholsporin
Use: Oral infections by ANAEROBS!
Penicillin G
NARROW SPECTRUM
Main disadvantage: High incidence of hypersensitivity
Rare in dentistry but still used for dental infection
Use: ear, throat, STD infections
Intramuscular injection
Pencillin V
aka phenoxymethylpenicillin
Tolerate gastric acid
Methicillin
Oxacillin
Cloxacillin
Dicloxacillin
In infections with staphylococci that produce beta-lactamases
S.aureus
AMOXICILLIN
AMPICILLIN
BACAMPICILLIN
METHAMPICILLIN
Number 1 used in dentistry.
Dont tolerate beta-lactamase so needs to be adminstered with clavulanic acid
Amoxicillin general and infections?
Broad spectrum
Orally
Food don’t interact
Disadvantage: not reistant to b-lactamase enzyme
Odontogenic infections:
- Acute Necrotizing Ulcerative Gingivitis
- Pericoronaritis
- Periodontitis
- Periapical and periodontal abscesses
- etc.
General side effects of all penicillins:
Nauseas Dyspepsia and epigastric pain ü Diarrhea Pain in the site of injection Cutaneous exanthema Hypersensitivity
Drugs commonly causing hypersensitivity
Cephalosporins
Penicillin
Sulfonamides
3rd and 4th gen penicillins
Carboxypenicillins:
TICARCILILNE
CARBENICILILN
Ureidopenicillins:
PIPERACILLIN
MECLOCILLIN
Hospital setting
IV administration
NOT resistant to lactamase enzyme
SERIOUS INFECTIONS
Monobactam and carbepenem
Mono: Aztreonam
Carbe: Imipenem & Carbapenem
Hospital use
Cephalosporins use:
Substitutes for penicillins in respiratory or urinary infections, in situations of allergy or bacterial resistance.
Alternative to penicillin G or amoxicillin
Could be useful in the treatment of odontogenic infections caused by resistant bacteria.
Cephalosporins 1st gen spectrum
Gram + staphylococci and streptococcus
Nephrotoxicity 1st generation
Cephalosporins 2nd gen spectrum
Spectrum expanded to gram - and some anaerobes
Cephalosporins 3rd gen
Hospital use (serious nosocomial infections) Spectrum expanded
Glycopeptides drugs and indications
Vancomycin and Teicoplanine
Low TI: Extremely nephro- and ototoxic!!!
Vancomycin and teicoplanine are widely used in the treatment of infections caused by methicillin-resistant Staphyloccus aureus (MRSA).
Macrolides
ERYTHROMYCIN
CLARITHROMYCIN
AZITHROMYCIN
SPIRAMYCIN
New family: TELITHROMYCIN = Don’t need renal adjustment!
Odontological infections!!!
ERYTHROMYCIN
Potent enzymatic inhibitor
Clarithromycin
Fewer interactions than erythromycin
Oral infections
Prophylaxis
Azitrhromycin
Prophylaxis in dental surgery
Spiramycin
Used in Dentistry associated with metronidazole for the treatment and prevention of acute, chronic or recurrent oral infections
TELITHROMYCIN
DOES NOT NEED ADJUSTMENT OF DOSES IN RENAL INSUFFICIENCY
Lincosamides: CLINDAMYCIN
Alternative to patient with beta-lactam allergy
Very good bone penetrability.
Adverse effect: pseudomembranous colitis ( C.difficile)
Tetracyclines
In Dentistry, they are used in some periodontal diseases because of their broad spectrum and because they contribute to the IMPROVEMENT OF INFLAMMATION
Tigecycline
IN DENTISTRY, IT MAY BE USED IN SERIOUS INFLAMMATIONS OF SOFT PARTS IN WHICH ORAL ANAEROBES ARE INVOLVED.
Aminoglycosides: GENTAMICIN TOBRAMYCIN STREPTOMYCIN NEOMYCIN
Aminoglycosides are bactericidal antibiotics, which bind to ribosomes by preventing protein
synthesis..
Adverse effects:
Nephrotoxicity
Ototoxicity
Neurotoxicity: neuromuscular blockade
Quinolones
Not drugs of choice in dental infections
Metronidazole
ORAL INFECTIONS:caused by ANAEROBES!
main indication of metronidazole is as antiprotozoal
Since metronidazole has little effect on aerobic bacteria, it must be co-administered with a penicillin, cephalosporin or macrolide.
Tetracylines adverse effects:
Can affect calcium in teeth and bone and should
absolutly not be taken with diary product!
CARIES, MALOCCLUSION, DISCOLORING
