Finals Flashcards
Importance of Anti-Infectives
Revolutionized, Treat, Give & Perform…
Antti infectives: How do microorganisms cause infection?
- Virulence of Microorganisms
- Number of Organisms present
- Resistant of Host
clinical situation requires the use of antibiotic for prevention than treatment of infection
Prophylactic Antibiotic
clinical situation requires the use of antibiotic for prevention than treatment of infection
Prophylactic Antibiotic
- ______ Antibiotic: prevention; 2. _________ Antibitoic: curing particular disease
- Prophylactic; 2. Therapeutic
Conditions for using prophylactic antibiotic
1) For pretreatment of patients undergoing dental extraction w implanted prosthetic device
(artificial heart valve - prevent seeding of prosthesis)
2) For patients w history of rheumatic heart disease or congetical heart disease
(cannot be treated w/o med clearance)
3) For prophylaxis against infective endocarditis
Antibiotic for caries
Vancomycin & Kanamycin
Organism responsible for Caries
Streptococcus Mutans
In gingivitis, there is an increase in gram-negative microorganisms in form of _______
Bacteriodes, Haemophilus, Fusobactrium
Antibiotic for ANUG (___________)
acute necrotizing ulcerative gingivitis
1 penicillin, 3 metronidazole
2 tetracycline 4 clindamycin
Antibiotic for LJP (___________)
localized juvenille periodonditis has (-) actinomycetin-comitans
1 tetracycline
2 minocycline
Antibiotic of choice oral infections
Penicillin V
Oral Infections examples:
1 Osteomyelitis
2 Soft Tissue Infections
3 Abscess
FACTORS INVOLVED IN APPROPRIATE SELECTION OF ANTIMICROBIAL DRUGS:
1) Microorganism must be isolated & identified (culture & swab)
2) Microogranism’s susceptibility to the drug
3) Location of infection
4) Cost of drug, adverse effect (possibility: pt allergic reaction)
WHEN DO YOU GIVE ANTIBIOTIC?
If symptoms are fever, body malaise & lymphadenopathy
procedure of lymphadenopathy
palpation of lymph nodes,
swollen glands or swelling of the lymph nodes
In prophylactic indication, oral pen is given if allergic (1) ________; parenteral ampicillin + gentamycin if allergy ((2) _________.
(1) Erythromycin, (2) Vancomycin
In prophylactic indication, healthy indiv w infection
Without high risk
In prophylactic indication, Indiv w medical conditions or medically compromised
With high risk
In prophylactic indication, medication given for w/o high risk is
oral pen, erythromycin
In prophylactic indication, medication given for w high risk is
ampicillin + gentamycin, vancomycin
Therapeutic indication, the px best defense against pathogen is ______
Host respone
Infection according to therapeutic indication, localized infection should be ____
drained
____ is used for rapidly spreading infection of therapeutic indication
Treated w anti microbial agents
_____ & _____ of etiologic microorganisms produce an infection
Virulence & Invasiveness
Refers to species of organism affected by the drug (susceptibility of the microorganism to the drug)
Therapeutic spectra
_____ fast killing; ______ slow killing
Bactericidal; Bacteriostatic
act on only a single or limited grp of m (given first)
Narrow spectrum
effective against (-) & (+)
Extended spectrum
(+) & significant num of (-)
Broad spectrum
Duration of dosage is based on ________ & _______.
the type of organisms & severity of the infection
Give 2 duration of dosage
(1) A pt should be given a sufficient amount of anti infectives to last for 2 days (48 hrs) after resolution of symptoms of infections or after symptoms are absent
* It is given for 7 days because the resolution is on 5 days where symptoms would start
(2) Anti infective chosen should be given long enough to cure the original infection BUT not so long as to produce SSD
* Side effects (e.g. nausea, acid reflux, diarrhea, fungal infect)
* Suprainfection, Developmental of resistant organism
Dental infection w/o complication
5 - 7 days
B hemolytic strep(infection on throat)
10 days
Immuno-compromised host
2 weeks theraphy
antibiotics should be continued for at least 14 days; absent fever & tenderness; drainage: ceased
Osteomyelitis
Best treated w Penicillin for an additional 10 days after all the symptoms are gone.
BETA-HEMOLYTIC STREPTOCOCCI
Treatment for hypersensitivity reaction (urticaria - anaphylactic shock)
parenteral administration epinepherine
Choose: Immediate, Accelerated, Late
serum sickness & laryngeal edema
Accelerated
Choose: Immediate, Accelerated, Late
rashes & oral lesion, stomatitis, cheilosis, furred tongue
Late
Choose: Immediate, Accelerated, Late
presents the most serious danger to pt
Immediate
Choose: Immediate, Accelerated, Late
3 or more day
Late
Choose: Immediate, Accelerated, Late
2 - 48 hrs
Accelerated
Drug loses its effectiveness due to (1) (2)
(1) Indiscriminate use
(2) Unnecessary exposure
resistance where there is lack the metabolic process or target site (affected by the particular drug)
Natural resistance
resistance developed resistance of organism due to use of AMA over a period of time
Acquired Resistance
Antibiotic that is toxic at therapeutic dose is ______, & under ______ toxicity
Amphotericin, Pooor Selective
Penicillin is high selective toxicity or ____
good therapeutic index
selectively suppress the growth or kill other microorganisms at very low concentrations.
Antibiotic
reaction of tissues to their presence (pm) & to toxins
Infection
caused by proliferation of microorganisms different from those causing original infection
Superinfection
invasion of the body by pathogenic microorganisms
Infection
Common organisms of superinfection
1 Clostridium difficile
2 MDR (-) rods
3 MRSA
4 Candida / fungi
PROCESS OF SUPERINFECTION
1) Normal microbiota keeps oppoturistic pathogens in check
2) Broad spectrum antibiotic kills non resistant cells
3) Drug resistant pathogens proliferate & cause superinfection
Antibacterial Drugs are designed to kill bacteria
but no drug kills all bacteria
True
To treat infections whenever possible broad spectrum antimicrobial drug should be selected
Narrow & Specific spectrum, False
causes some alteration in the normal microbial flora of the body
Antimicrobial Agent (AMA)
more prone than amoxicillin to cause superinfection diarrheas
Ampicillin
test that kills 99.9% of inoculum
Minimum Bactericidal Concentration
gold standard in identification of organism
Culture test
test: antibiotic concentration prevents growth of culture
Minimum Inhibitory Concentration
Give the 3 senstivity test
1 Minimum Inhibitory Concentration
2 Minimum Bactericidal Concentration
3 Disk Diffusion Methodg
CLASSIFICATION OF ANTI INFECTIVES
1 Chemical Structure 4 Spectrum of Activity
2 Mechanism of Action 5 Type of Action
3 Type of Organism 6 Source
CLASSIFICATION OF ANTI INFECTIVES
1 Chemical Structure 4 Spectrum of Activity
2 Mechanism of Action 5 Type of Action
3 Type of Organism 6 Source
CLASSIFICATION OF ANTI INFECTIVES
1 Chemical Structure 4 Spectrum of Activity
2 Mechanism of Action 5 Type of Action
3 Type of Organism 6 Source
