Pharmacology Flashcards
What is paul ehrlich known for? (2)
- treatment of syphillis
- discovery & development of sulfonamide / sulfa drugs
What is alexander fleming known for?
Penicillium mould = penicillin
Define antibiotic:
Natural or synthetic chemical substance that kills or inhibits the growth of bacteria
Define bactericide:
kills bacteria
Define bacteriostatic:
Changes the characteristics of bacteria so it is no longer pathogenic
Define selective toxicity:
inhibition or death of pathogenic microorganisms without damaging the host
Define wide-spectrum antibiotics
Can attack a variety of germs but may not be the best against that specific germ
Define narrow-spectrum antibiotics
effective against limited variety of pathogens but very effective
What is MIC?
Minimum inhibitory concentration of antibiotic able to inhibit growth of specific pathogen
What is MLC?
Minimum lethal concentration of ATB to kill a pathogen
Define therapeutic dose:
dose necessary for treatment of certain infection
Define toxic dose:
dose producing undesirable and harmful effects for patient
Aerobic bacteria?
- Gram + cocci
- facultative anaerobic
Anaerobic bacteria?
- Gram + cocci
- Gram - bacillus
Strict and facultative anaerobic?
Betalactamics (penicillin and cephalosporin)
antibiotic treatments shorter than ___ days is not effective
5
antibiotic treatments longer than ___ days can cause…
10 days can cause unwanted reactions
What was the first antibiotic to be discovered?
Penicillin. Alexander fleming
What is amoxicilin? (3)
- Penicillin drug
- betalactamic group
- wider spectrum of action than penicillin and fewer side effect
Amoxicillin is derived from?
ampicillin from chemical synthesis
Amoxicilin bacteriostatic or bactericide?
bactericide
Amoxicillin mechanism of action?
inhibits cell wall synthesis and kills bacteria
Amoxicillin antibacterial spectrum? (4)
Gram + and - and others
effective against streptococcus (gram +)
Amoxicillin absorption? (2)
- oral: better absorbed than ampicillin
- absorption not modified by presence of food in stomach
Where is amoxicillin metabolized?
liver
Amoxicillin excretion?
kidney
Amoxicillin at the same dose of ampicillin reaches…
a higher concentration
The maximum concentration of amoxicillin?
1-2.5hours
Amoxicillin indications? (3)
- Useful in SHORT ORAL TREATMENTS (mild or moderate infections).
- Efficient in prophylaxis of endocarditis.
- Other indications: Urinary infections, abdominal infections
Amoxicillin + clauvanic acid? (4)
- clavulanic acid = inhibitor of betalactamases
- widens spectrum and action
- produces diarrhea and digestive alterations
- more powerful action at same dose
What can inactivate amoxicillin
betalactamases
Amoxicillin dose?
50mg/kg per day. Divide this dose into 3 doses per day
Clavulanic acid and amoxicillin dose?
same as amoxicillin
Minimum treatment for amoxicillin?
4 days
Adverse effect of amoxicillin? (2)
- hypersensibillity** (main)
- eruptions (rash
- anaphylaxis with glottis spasm and asphyxia (0.05%)
Avoid giving amoxicillin when the patient has… (5)
- mononucleosis
- hepatic infection
- renal infection
- diabetes (for powder solution)
- phenylketonuria (has phenylalanine)
What is a macrolide?
- Bacteriostatic (inhibits protein synthesis)
Macrolides work on…?
- works on gram +, -, and anaerobic
Macrolides adverse effects?
- nausea
- vomitting
- diarrhea
When do we use macrolides? (2)
When allergic to amoxicillin or cephalosporin
What was the first macrolide? when do we use it? (3)
- Erythromycin
- almost not used anymore
- replaced by more potent one (azithromycine)
What was azitromycine derived from?
erythromycin
Half life of azitromycine?
Much longer half-life (up to 68h): single dose / 24 h
How do we administer azitromicine?
on an empty stomach
Adverse effect of azitromycine? (5)
- mild GI effects (frequent)
- less effects than erythromycin
- heptatoxcity
- ototocity
- hypersensitivity
ATB of choice in Endocarditys prophylaxis in people allergic to penicillin?
- Azitromycin
- cefalexin
- clindamycin
What are the macrolides? (4)
- azitromycin
- clarithromycin
- spiramycin
- josamycin
Azitromycin dosage?
5-10mg /kg for a day. divide into 3 dosages
oral or IV
Lincosamide act against…? (2)
- Anaerobes (Bacteroids, clostridium)
2. Gramm+ (staphylococcus, streptococcus)
Types of lincosamides? (2)
- Clindamycin ( lincosamide)
- Metronidazole
When do we use lincosamides? (2)
In dentistry: in severe infections or endocarditis prophylaxis
Clindamycin? (3)
- Very effective against cocos Gramm+
- Good tolerance
- Low allergenic potential
Side effects of clindamycin?
- Mild: nausea, vomiting, metallic taste
2. Severe: ataxia, convulsions, encephalopathy
Clindamycin oral dosage?
10-30mg/kg in a day. taken 3 times a day
Clindamycin i.m. or i.v. dosage?
20-40mg/kg/day taken 3 times a day
Endocarditis prophylaxis with no penicillin allergy orally? (2)
- adults: 2gr amoxicillin
- children: 50mg/kg
Adult endocarditis prophylaxis with no penicillin allergy not orally? (2)
- 2gr amoxicillin
- 1gr ceftriaxona
Child endocarditis prophylaxis with no penicillin allergy not orally? (2)
- 50mg/kg amoxicillin
- 50mg/kg ceftriaxona
Adult endocarditis prophylaxis with penicillin allergy orally? (2)
- clindamycin 600mg
- claritomycin 500mg
Child endocarditis prophylaxis with penicillin allergy orally? (2)
- clindamycin 20mg/kg
- claritomycin 15mg/kg
Adult endocarditis prophylaxis with penicillin allergy not orally?
Clindamycin 600mg
Child endocarditis prophylaxis with penicillin allergy not orally?
Clindamycine 20mg/kg
What is an antimycotic?
antifungal
Latest generation antifungals and children?
Latest generation antifungals have very limited use in children
Most used antifungals in pediatrics is? (4)
- Nystatin
- Ketoconazole
- Miconazole
- Others: fluconazole
How is nystatin administered?
topically
Nystatin indications?
- skin/mucous infection with candida albicans
- prevention of candidiasis in immunocomprompised patients
Nystatin side effects?
- nausea
- vomitting
- rash
Nystatin contraindications?
- hypersensitivity
Nystatin treatment time?
2-3 weeks
Nystatin dosage?
500.000-1.000.000 UI /6-8 hours
how is miconazol adminsitered?
topical (low absorption)
Miconazol side effects? (4)
more frequent than other antifungals
- nausea
- tachycardia
- anaphylaxis
Miconazol contraindication?
hypersensitivity
Miconazol treatment duration?
variable
NSAID effects? (3)
- analgesic
- antipyretic
- antiinflammatory
Paractamol effects? (3)
- analgesic
- antipytetic
- greater antipyretic effect than NSAIDS
Ibuprofen is derived from…?
Propionic acid
Most widely used analgesic in pediatrics? why?
- ibuprofen
- mild inflammatory dental processes
Ibuprofen gastrointesinal effect? (2)
- few adverse affects
- lowest risk of all NSAIDs
What are the propionic acid derivatives? (5)
- ibuprofen
- naproxen
- ketoprofen
- diclofenac
- piroxicam
Ibuprofen maximum concentration?
1-2h
Ibuprofen average life?
2-6 hours
ibuprofen contraindications? (6)
- Hypersensibility to any NSAID
- Digestive alterations (ulcers, gastritis,…)
- Asthmatic crisis, angioedema, rash provoked by NSAID
- Heart failure
- Alterations in blood clotting
- Hepatic and renal failure
Ibuprofen dental side effects? (2)
- alveolitis
- osteoitis
Ibuprofen dosage?
20mg/kg. divided into 3 times a day
Paracetamol is derived from..?
fenacetin
Average life of paracetamol?
2-4 hours
Max concentration of paracetamol?
30-60 mins
Paracetamol counterindications? (4)
- Hepatic alterations (It is hepatotoxic)
- Asthmatic (It may produce bronchospasm)
- Leucopenia
- Neutropenia
Paracetamol dosage? (2)
60mg/kg/day. 4-6 times a day
*max dosage of 4g per day
Adult dosage of ibuprofen? (2)
400-600 mg every 6-8 hours
*max dosage of 2.4g
Adult dosage of paracetamol? (2)
325-650 mg / 6 hours
*max dosage of 4g
What antibiotics do not contain sucrose?
- Augmentine drops
- oral suspension 125 mg
- soluble powder 250 mg
- 500 mg (aspartame)
What antiiinflamatory drugs do not contain sucrose?
- Apiretal oral suspension, drops (saccharine)
- Junifen oral suspension (saccharine)
- Gelocatil drops (saccharine)
What antifungals do not contain sucrose?
Mycostatin solution (saccharine)