Antibiotics-Systemic

Question 1

What is the general term for a chemical substance that provides clinical therapeutic benefit?

Answer 1

Chemotherapeutic Agent

*Antimicrobial action, ability to increase host resistance

Question 2

Is there evidence that antibiotics alone can arrest periodontal disease?

Answer 2

No

Question 3

In what 4 situations are systemic antibiotics most beneficial?

Answer 3

• Systemic disease
• Immunocompromised
• Aggressive periodontal disease
• If patient is not a good candidate for more complex or invasive treatment

Question 4

Chronic periodontitis can and should be treated initially __________ systemic antibiotics

Answer 4

without

Question 5

Periodontal disease is predominately caused by what organisms?

Answer 5

Gram negative anaerobes

Question 6

What are some general indications for systemic antibiotic use?

Answer 6

• Non responsive to conventional therapy
• Acute periodontal infections with systemic manifestation
• Prophylaxis for medically compromised patient
• Heavy smokers
• Adjunct to surgical and non-surgical periodontal therapy

Question 7

Which antibiotic inhibits cell wall synthesis, is narrow spectrum and is bacteriocidal?

Answer 7

Penicillin

Question 8

What are three common types of penicillin?

Answer 8

1-Amoxicillin
2-Pen VK
3-Amoxicillin with clavulanic acid (augmentin)

Question 9

What antibiotic inhibits protein synthesis, is broad spectrum, and bacteriostatic?

Answer 9

Tetracyclines

Question 10

What are 2 advantages of tetracyclines?

Answer 10

1-Ability to concentrate in tissues and destroy A.a.

2-Anticollagenase activity

Question 11

Why should tetracyclines not be taken with dairy products, iron vitamins or antacids?

Answer 11

is a chelating agent and will bind the divalent cation

Question 12

What are two forms of tetracyclines?

Answer 12

Doxycycline and minocycline

Question 13

Which tetracycline is easier on the stomach, can be taken with dairy products, decreased side effects and is semi-synthetic?

Answer 13

Doxycycline

Question 14

Bactericidal against anaerobes, which antibiotic inhibits DNA synthesis, and has the brand name “Flagyl”?

Answer 14

Metronidazole

*intercalates into DNA and blocks gyrase

Question 15

What are some significant side effects of metronidazole?

Answer 15

• Antabuse reaction
• Metallic aftertaste
• Orange urine
• Nausea/vomiting
• Peripheral neuropathy (rare)

Question 16

Metronizadole is typically paired with what other two antibiotics?

Answer 16

• Amoxicilin

- Augmentin

Question 17

Which antibiotic is often used when a patient is allergic to penicillin, works against anaerobes by inhibiting protein synthesis and is bacteriostatic?

Answer 17

Clindamycin

*side effect of skin rash and pseudomembranous colitis due to over growth of clostridium difficile

Question 18

Also known as Z-pack, which antibiotic is effective against anaerobes and G (-) bacilli, penetrates fibroblasts and phagocytes and concentrates well in periodontal lesions?

Answer 18

Azithromycin

Question 19

What are two drugs that modulate host response?

Answer 19

• NSAIDs

- Subantimicrobial does of doxycycline (Periostat)

Question 20

What drug is taken for its anticollagenase activity at a dose below that used for infections?

Answer 20

Periostat

*may be administered at 20 mg 2x/day for up to 9 months