Maxillofacial Infections Flashcards
General principles for Antibiotics.
NETCC
Necessary Efficacy Toxicity Compliance Cost
Easiest way to tell if there’s an infection.
Take temperature
Abs that can make the patient deaf.
Aminogylcoside abs
These can getrid of cellulitis, but NOT an abscess.
Antibiotics
Only way to get rid of an abscess.
Drain it.
Difference between cellulitis and an abscess.
Cellulitis is generalized inflammation WITHOUT pus.
An abscess has pus.
Local signs of an infection
Pain, edema, erythema, heat, loss of function
A typical odontogenic infection is pure or mixed?
Mixed infection containing 10-15 different bacterial species.
These types of bacteria make penicillinases to break down penicillin.
Gram negatives
Animal studies are positive and no human studies have been done.
FDA Class C drug
Most antibiotics are what FDA class?
C
Metabolizes 50% of all clinical drugs.
CYP3A
Inhibits CYP3A
grapefruit juice
A generalized inflammatory response.
Cellulitis
Localized accumulation of purulent exudate in an anatomic space.
Abscess
Most common reason why an antibiotic is not working.
Compliance
3 factors FDA looks at to determine if a generic drug can be used in place of a brand-name drug.
1) Bioequivalence
2) Reliability
3) Therapeutic equivalence
When do drugs expire by the expiration date listed on the bottle?
Once they’re opened
The expiration date on the bottle means almost nothing, with the exception of ____.
Epinephrine
These drugs cause the kidney tubules to necrose if taken after the expiration date.
Tetracyclines
This drug loses 90 % of its potency 10 months after the expiration date.
Epinephrine.
Esp. important in an EpiPen
Antibiotics and pregnancy.
Can increase chances of getting pregnant bc it prevents the oral contraceptives from working properly.
This antibiotic DEFINITELY DECREASES the effect of oral contraceptives to increase chances of getting pregnant.
Rifampin
Ab used for Tuberculosis.
Rifampin
Must tell this to women before you give them antibiotics.
Increased chance of pregnancy bc oral contraceptives aren’t as effective.
BacteriCIDAL Antibiotics
1) Beta Lactam antibiotics
(Penicillin and Cephalosporins).
2) Clindamycin
3) Metronidazole
4) Fluoroquinolones
Types of beta lactam antibiotics.
1) Penicillins
2) Cephalosporins
An aminopenicillin
Amoxicillin
This ab has a broader spectrum against gram negatives, but is more toxic.
Aminopenicillins.
Augmentin contains what?
Amoxicillin with clavulanic acid.
Role of clavulanic acid.
Binds to beta lactamases so that Amoxicillin can kill it quicker.
These antibiotics inhibit bacterial cell wall synthesis.
Beta-lactam antibiotics
How are penicillins eliminated from the body?
Kidneys mostly
Ab of choice for pregnant patients.
PENICILLIN
Are penicillins distributed in the breast milk?
YES, so baby can get candidiasis.
How are penicillins given to the geriatric population?
As Na and K salts, which can increase BP, decrease the effects of diuretics, and worsen heart failure.
Bactericidal abs only work if the microorganism is actively ______.
Growing
Why should you never combine bacteriostatic and bactericidal abs in a patient?
Bc bactericidal abs need actively growing organisms in order to work.
The bacteriostatic abs would stop the bacterial growth, so the bactericidal abs would be useless.
How do Penicillins interact with anticoagulants.
Alter Vit K synthesis by gut flora.
Low dose Clindamycin is bacterio____.
static
High dose Clindamycin is bacterio_____.
cidal
Penicillins and other abs can cause this life-threatening disease.
Lots of bloody diarrhea.
pseudomembranous colitis
Enzymes made by bacteria to break down beta lactam antibiotics.
Beta lactamases
The only ab that causes bad side effects when taken with alcohol.
Cephalosporins
Less likely to cause pseudomembranous colitis, andused if allergic to penicillins.
Clindamycin
Only works against obligate anaerobes, which are rarely present in an odontogenic infection.
Metronidazole.
Patient cannot drink alcohol with these two antibiotics.
Cephalosporins and Metronidazole
Causes metallic taste and altered taste sensations, and dark urine.
Metronidazole
