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Pharmacology > Exam 2: Antibiotics-Chephalosporins, Macrolindes) > Flashcards

Exam 2: Antibiotics-Chephalosporins, Macrolindes) Flashcards

1
Q

What class of drug is said to be the ‘sister’ drug to penicillin?

A

Cephalo-sporins

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2
Q

Good news! Cephalosporins are resistant to penicillinases! Bad news, they are still broken down by ______ :(

A

cephalosporases

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3
Q

Cephalosporins are synthesized from ______ _____ mold in seawater!

A

Cehpalosporium Acremonium

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4
Q

Since Cephalosporins are like penicillin, they kill bacteria by inhibiting _______ synthesis.

A

cell wall

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5
Q

PharmacoKinetics of Cephalosporin: Absorption-Most absorbed well through _____, Some may be delayed by _____ in stomach = results in lower and delayed peak conc….Distribution-Cross the _______; found in high conc in synovial and pericardial fluids…Excretion-Do not undergo appreciable metabolism, Most are excreted in _____

A

GI Tract…food…placenta..urine

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6
Q

________ reactions are most common for Cephalosporins.

A

Hypersenitivity

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7
Q

What are two ORAL inflammations that can because by Cephalosporins?? _______ = inflamed tongue; smooth, shiny red…. _______ = inflammation, ulcerations on buccal mucosa

A

Glossitis, Stomatitis

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8
Q

What are our 2 main concerns for adverse reactions with Cephalosporins?!

A

1.Superinfection (candidiasis) 2.Nephrotoxicity

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9
Q

While unlikely, it is probably wise to not give cephalosporin someone with an allergy to penicillin: If patient had full blown Type I (IgE) mediated allergic reaction (anaphylaxis) = contraindicated (up to ____% of these patients will be cross-sensitive)..SO STEER CLEAR

A

20%

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10
Q

Cephalosporins are _____ the first choice for an oral facial infection! (although it is effective against: gram ____, gram ____, and _____ bacteria)

A

NEVER…gram +, gram -, and anaerobic

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11
Q

For Cephalosporin, the spectrum of kill depends on its Generation. The higher the generation, the more _____ the spectrum of kill.

A

Broad

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12
Q

What are the two cephalosporin drugs we need to know?

A

cephal-exin (Ke-flex), cef-a-droxil

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13
Q

What do all cephalosporin drugs begin with?

A

cef or ceph

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14
Q

What class of antibiotics is Erythromycin? It is ____ in size, and is synthesized by _______ ______.

A

Its a Macrolide…large size..Strep Erythraeus (bacteria in soil)

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15
Q

Erythromycin is bactri_____. So its only effective against _______ dividing organisms.

A

bacterioStatic…actively (can be bactericidal at high doses)

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16
Q

What is the mechanism of action for Erythromycin?

A

Inhibits protein synthesis by binding to 50s ribosomal subunit

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17
Q

Erythromycin penetrates the cell wall of gram ______ bacteria more readily than that of gram _______ bacteria

A

positive…negative

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18
Q

Erythromycin is most effective against gram + ______ and gram + _____.

A

cocci & bacilli, but also effective against some gram negative cocci (Neisseria species) and some gram negative bacilli

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19
Q

PharmoKinetics of Erythromycin-Absorbed from the stomach to the ____, Metabolized and excreted into the
_____, As it goes through the duct, it causes the smooth muscle to constrict, causing ____ back up into the liver, Results in the POTENTIALLY FATAL: cholestatic hepatitis

A

liver…bile…bile…cholestatic hepatitis (chole=bile, static=stop)

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20
Q

What is the primary excretion of erythromycin?

A

feces (large molecule!)

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21
Q

As erythromycin passes through the GI tract, it kills bacteria and causes ______, which affects Pt compliance.

A

diarrhea

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22
Q

Erythromycin is no longer effective against oral organisms due to _______!! It is NO LONGER USED IN the field of ______.

A

resistance…dentistry

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23
Q

Erythromycin-indications (4)

A

1.Tetnaus 2.Syphilis 3.gonorrhea 4.Acne

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24
Q

Erythromycin is a “_____” drug in dentistry, it adversely interacts with many drugs.

A

“RED FLAG”

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25
Q

What are 3 reasons why we don’t use erythromycin in dentistry?

A

1.Oral bugs are resistant to the drug 2.GI side effects 3.dangerous drug interactions

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26
Q

Who am I? Bacteriostatic in low doses,Bactericidal at doses used for SBE prophylaxis, An alternative drug to use for antibiotic premedication (see AHA guidelines), Primary indication: used to treat Helicobacter pylori (bacteria that causes gastric and duodenal ulcers)

A

Clarithromycin (Biaxin)

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27
Q

Who am I? Drug of choice for upper respiratory tract infections; also used for STDs, Alternate drug for antibiotic premedication (see AHA guidelines), Half-life of 70 hours = because of half-life, drug can be taken for only 5 days instead of usual 7-10 days (dose form = _____). Time to reach peak blood level = 4 hours

A

AZithromycin (Zithromax)….(Z PACK)

28
Q

What drug comes from the family of Lincosamide? How is it made?

A

Clindamycin..from Strepomyces lincolnesis (lincoln, NE)

29
Q

Is clindamycin a macrolide?

A

NO, its a linocsamide

30
Q

Cindamycin is produced by adding a ______ group to lincomycin.

A

Chlorine

31
Q

What is the mechanism of action for Clindamycin?

A

bacterial protein synthesis (like erythromycin)

32
Q

Who am I? Alternative if penicillin-allergic…Alternative drug of choice for mild to early odontogenic infections, Highly effective against most oral pathogens, Most aerobic gram-positive cocci, Staphylococci, Streptococci, Anaerobic gram-negative and gram-positive organisms- Bacteroides…Not effective against gram-negative aerobes or mycoplasma

A

Clindamycin

33
Q

Clindamycin-indications: infections caused by ______ organisms therefore Orofacial infections and ______ infections caused by anaerobic bacteria..Anerobic ________ (bone infections of the oral cavity)

A

anerobic…PERIODONTAL…osteomyelitis

34
Q

WHAT IS THE DRUG OF CHOICE FOR DENTAL PATIENTS ALLERGIC TO PENICILLIN???

A

Clindamycin

35
Q

What is the name of the Clindamycin drug we need to know?

A

clindamycin HCL (Cleosin)

36
Q

Who am I? Broad spectrum (some say intermediate)…Primarily effective against gram positive
organisms… Bacteriostatic at therapeutic doses….Potential to be bactericidal…Acid stabile…Absorbed into bone

A

Clindamycin

37
Q

Clindamycin has no problem being absorbed with _____, and is mainly excreted in ______.

A

food…feces

38
Q

Which drug is associated with pseudomembranous colitis (C.DIFF)?

A

Clindamycin (& cephalosporin)

39
Q

When does pseudomembranous colitis caused by antibiotics appear?

A

weeks/months after antibiotic exposure

40
Q

80% of C Diff cases are ______ aqured.

A

hospital (nosocomal)

41
Q

In pseudomembranous colitis, ______ _______ acts as an opportunistic pathogen and takes over the GI. It produces a ______.

A

Clostridium difficile…Exotoxin

42
Q

In C. Diff, should the Pt just take some anti-dirrheals and stop bitching?

A

NO! C Diff still makes its exotoxin and could ultimately cause perforation of the GI!

43
Q

What do you recommend to the Pt if you suspect C Diff? (3)

A

STOP the antibiotic, Wait 72 hours, call physician if it don’t stop.

44
Q

Which antibiotic is associated with raised Wheals?

A

Clindamycin

45
Q

Which antibiotic Chelates divalent cations? So don’t eat/drink ______, _____, or ______!

A

Tetracycline….dairy, iron, antacids

46
Q

What is the distinguishing feature of tetracycline’s structure?

A

4 rings!

47
Q

What is the mechanism of action of tetracycline?

A

binds to 30s ribosomes and inhibits bacterial protein synthesis

48
Q

What 2 processes are needed for Tetracycline to reach the ribosome?

A
  1. diffusion through outer cell membrane 2. active transport through inner membrane
49
Q

Tetracycline is ______ spectrum and bacteri______.

A

Broad…bacteriostatic

50
Q

Who am I? Bound to plasma proteins, Widely distributed, Cross placenta, Stored in gingival crevicular fluid, dentin and enamel of unerupted teeth (teratogenic effect)

A

Tetracycline

51
Q

Tetracycline is primarily excreted in ______.

A

urine

52
Q

What are the three main adverse events of tetracycline? What is the FDA teratogen category?

A

1.Photosensitivity 2.Hepatotoxicity 3.Renal Toxicity (FDA pregnancy category D

53
Q

Because of Tetracycline’s chelating effects, it is incorporated into ______ and ______.

A

teeth and bone

54
Q

In tetracycline staining teeth become _____/____ in color. This stain is ______ and cannot be removed.

A

yellow/gray…intrinisic

55
Q

Dental indication for the use of tetracycline:

A

periodontitis

56
Q

What are the three tetracycline drugs to know?

A

De-oxy-cycline, Mino-cycline, tetra-cycline

57
Q

What is the most used tetracycline used in dentistry?

A

De-oxy-cycline

58
Q

Deoxycycline inhibits ________, the enzyme that

breaks down connective tissue and bone.

A

collegenase

59
Q

________ ______ (______) is a subantimicrobial dose that only inhibits collagenase but doesn’t kill bacteria.

A

doxycycline hyclate (Periostat)

60
Q

Doxycycline hyclate (Periostat) is a _________ dose that only inhibits collagenase but doesn’t kill bacteria

A

SUBantimicrobial!!!!

61
Q

What is the tetracycline that is applied subgingivally? (2)

A

Deoxycycline-Atridox, Arestin (minocycline)

62
Q

What is the most potent tetracycline?

A

Mino-cycline (Minocin)

63
Q

Minocycline causes staining in adult teeth! It travels up the dentinal tubules and is deposited at the _____…exposure to light causes the actual staining because it _______ the molecule…_____-dependent response (not duration)

A

DEJ…oxidizes (thank you Dr. W!)…DOSE

64
Q

Which tetracycline is distributed by microsphere sub gingival?

A

Arestin

65
Q

Tetracyclines are CONTRAINDICATED with _______/_______.

A

penicillin/amoxicillin

66
Q

What do we do if Pt requires prophylactic antibiotics, but is on tetracycline and we can’t give good ole penicillin V/clarithromycin?

A

Clinamycin

Pharmacology (23 decks)

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