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APPAC > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

what is the definition of an antibiotic?

A

A substance produced either by micro-organisms or synthetically, which possesses the property of inhibiting the growth of, or of destroying other microorganisms

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2
Q

What are the 2 categories antibiotics are divided into?

A

bacteriostatic

bactericidal

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3
Q

What is the mode of action of a bacteriostatic agent?

Give examples of drugs

A
  • prevent further growth or reproduction of micro-organisms in the host, leaving the body’s natural defence mechanisms to overcome the infection.
  • examples: tetracycline, erythromycin, sulphonamides
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4
Q

What is the mode of action of a bactericidal agent?

Give examples of drugs

A
  • not only inhibit the multiplication of the organisms but also kill bacteria even in the presence of pus.
  • examples: penicillin, streptomycin, cephalosporins
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5
Q

What is the antibacterium spectrum?

A

term used to indicate the range of activity of a particular antibiotic

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6
Q

What does a broad spectrum antibiotic mean?

Give example

A
  • An antibiotic that is effective against a large variety of bacteria.
  • Example: tetracycline, this is effective against gram +ve and gram -ve as well as unknown pathogens
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7
Q

what does a narrow spectrum antibiotic mean?

Give example

A
  • Effective against few types of bacteria
  • Example: basic penicillin, only effective against gram +ve bacteria. Includes original penicillin: Penicillin G or Phenoxymethylpenicillin, also known as penicillin V.
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8
Q

What are the 2 uses of the antibiotics in dentistry?

A

1 - Therapeutic: for acute odontogenic (tooth) infections. For most dental infections/abcesses, except gingival and ANUG (acute necrotising ulcerative gingivitis)

2- Prophylaxis: Prevent infection prior to beginning treatment- usually for patients with cardiac problems

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9
Q

when should antibiotics NOT be used?

A
  • inflammatory conditions (post-op oedema)
  • fibrinolytic (blood-clotting) conditions (dry socket)
  • non bacterial infections (viral/fungal)
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10
Q

What are the 4 main mode of action of antibacterial drugs?

Give examples of each

A

1 - interfere with cell wall synthesis: penicillin, cefalosporin, glycopeptide
2 - inhibit protein synthesis: erythromycin, tetracycline, clindamycin
3 - interfere with bacterial nucleic acid synthesis: metronidazole
4 - anti-metabolic action (inhibit cell metabolism): sulphonamides, trimethoprim

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11
Q

What are the 4 main types of antimicrobials in dentistry?

and what are their modes of action? (bacteriostatic/bactericidal)

A

1 - Penicillins: bactericidal
2 - Macrolides: bacteriostatic
3 - Tetracyline: bacteriostatic
4 - Metronidazole: bactericidal

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12
Q

What is Penicillin V?
MOA?
Use?
Dose?

A
  • Oral penicillin, narrow spectrum, resists destruction by gastric juices
  • bactericidal
  • Used to treat acute infection
  • adult dose: 250mg 4X daily, syrup available for children
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13
Q

What is Amoxicillin?
MOA?
Use?
Dose?

A
  • Penicillin (derivative of ampicillin), broad spectrum, absorption not affected by food, drug of choice for prophylaxis
  • Bactericidal
  • used for oral infections.
  • adult dose: 500mg 3X daily for 5 days, suspension available for children
  • can be used prophylactically: 3g, 1 hour before invasive treatment
  • can be used in conjunction with Metronidazole for aggressive perio: 500mg Amoxicillin and 400mg Metroidazole 3X every day for 7 days after RSD
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14
Q

What is Co-Amoxiclav?
MOA?
Use?
Dose?

A

-Penicillin mixture containing Amoxicilin and Clavulanic acid (betalactamase inhibitor)
-bactericidal
-used for for dental infection that is resisting penicillin
-250mg Amoxicillin and 125mg Clavulanic acid 3X daily, 7 days
severe dental infection: 500mg Amoxicillin and 125mg Clavulanic acid 3X daily, 7 days

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15
Q

What is Erythromycin?
MOA?
Use?
Dose?

A
  • Macrolide drug
  • Bacteriostatic
  • 1st choice to use in Penicillin-sensitive patients. Active against gram +ve organisms. Can cause nausea/vomiting
  • given orally
  • Used for acute infections: 250mg 4X daily
  • Used prophylaxis: 1.5g 2 hours before treatment followed by 500mg 4X daily for 24 hours
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16
Q

What is Clindamycin?
MOA?
Use?
Dose?

A
  • not a true Macrolide drug, works in similar manner.
  • Bacteriostatic
  • Active against +ve cocci including Penicillin resistant cocci. Works well against anaerobes.
  • Strong link to C. difficile.
  • Used for dentoalveolar/salivary gland abscesses that haven’t responded to penicillin/metronidazole.
  • Acute infection: 150mg 4X daily
  • Prophylaxis: 600mg 1 hour before treatment
17
Q

What are the 5 adverse reactions of antimicrobials?

A 
1- superinfection
2- allergic reaction
3- drug interaction
4- GI complaints
5- harm to foetus during pregnancy
18
Q

What is Doxycline?
MOA?
Use?
Dose?

A
  • Tetracycline
  • bacteriostatic, inhibits protein synthesis
  • effectiv against gram -ve bacteria, including A.a (aggressive perio).
  • used for aggressive periodontal disease alongside RSD
  • 200mg orally for first day, then 100mg orally daily for 21 days during RSD treatment

Also admistered as Periostat (low dose and longer treatment adjunct to RSD and fine scaling)
-20mg, twice daily for 3 months

Also be used for recurrent aphthae (mouth ulcers).
-Dissolve contents of 100mg capsule in 10-15ml water and rinse around the mouth for 2-3 minutes as soon as the ulcer becomes apparent. Continue for 3 days.

19
Q

What is Flagyl?
MOA?
Use?
Dose?

A
  • Metronidazole
  • bactericidal, narrow spectrum against obligate anaerobic bacteria but highly effective
  • used to manage aggressive periodontitis and periodontal infection, particularly NUG
  • Dose for NUG: 400mg for 3X daily for 3 days
  • Dose for acute oral infection: 400mg 3X daily for 5 days
  • Dose for severe infections: 500mg 3X daily for 5 days and taken alongside Amoxicillin
  • Dose for aggressive periodontal disease: 400mg Metronidazole with 500mg Amoxicillin both taken 3X daily for 7 days. Starting on the final day of RSD.

Warning: do NOT give to pregnant patients/breastfeeding
do NOT take with alcohol

20
Q

What 4 antifungal agents are used in dentistry?

A

1-Nystatin
2-Amphotericin

Azole Agents. 2 types:
3-Imidazole: Miconazole
4-Triazole: Fluconazole

21
Q

what is Nystatin?
MOA?
Use?
Dose?

A
  • antifungal agent
  • active against fungal/yeast infections
  • disrupts osmotic function of cell membrane and causes cell death. Not absorbed by mucous membranes, ideal for local effect in treatment of candida infections.
  • Used for acute candida/denture stomatitis
  • 1ml of 100,000 U/ml suspension swilled around mouth every 6 hours for 7 days
22
Q

what is Amphotericin B?
MOA?
Use?
Dose?

A
  • antifungal agent
  • disrupts osmotic function of cel membrane. Must be used for some time after symptoms are resolved to ensure infection is cleared.
  • used for acute pseudomembranous candidosis/ denture stomatitis
  • 10mg lozenge dissolved in mouth every 6 hours for 10-15 days OR
  • 1ml of SF suspension held against lesion every 6 hours for 14 days
23
Q 
what is Miconazole?
MOA?
Use?
Dose?
What warning is given with Miconazole?
A

-antifungal agent, of the Azole kind.
-suppresses the synthesis of ergosterol (interferes with fungal membrane function)
-used for chronic hyperplastic candidiasis, denture stomatitis, angular cheilitis
-25mg of oral gel held against lesion every 6 hours.
OR
-applied to surface on denture before insertion
OR
-for angular cheilitis use 25mg of oral gel in conjunction with hydrocortisone cream every 8 hours.
-avoid topical Miconazole in patients who are on Warfarin due to potential to for systemic absorption. IT POTENTIATES THE EFFECT OF WARFARIN = ↑ INR = ↑ BLEEDING

24
Q

What is Fluconazole?
MOA?
Use?
Dose?

A
  • antifungal agent, of the Azole kind
  • has a long half life and can be administered as a single dose. Used widely with immunocompromised patients.
  • used for severe candidal infections
  • 50mg 1X daily for 7-14 days. (A higher dose for a longer duration is suitable if the patient is immunocompromised.)
25
Q

How do antiviral agents affect viruses?

A
  • immunostimulation of the host
  • inhibition of viral nucleic acid synthesis
  • inhibition of viral proteins
26
Q

What is Aciclovir?
MOA?
Use?
Dose?

A
  • antiviral agent
  • becomes activated by viral enzymes and becomes a potent inhibitor of viral DNA synthesis –> inhibiting the virus from replicating
  • used for primary herpetic gingivostomatitis (herpes virus)
  • dose: 200mg 5X daily for 5 days
27
Q

What other properties does tetracycline have?

A
  • antibacterial properties.
  • collagenase inhibition (stops breakdown of collagen)
  • anti-inflammatory actions
  • inhibition of bone resorption
  • ability to promote the attachment of fibroblasts to root surfaces

APPAC (10 decks)

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