Systemic Antibiotics Flashcards
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Metronidazole is
bacteriocidal aganst anaerobic bacteria
Metronidazole inhibits
DNA synthesis
Metronidazole in DNA replication does
inserts itself in the double strand
Metronidazole is used alone or with other ant.?
can be used alone but most of the time with other ant.
Metronidazole used with
PCN
Metronidazole is ineffective alone against
A.A.
side effects of Metronidazole
antabuse type reaction metallic taste orange urine Nausea and vomiting peripheral neuropathy (infrequent)
Clindamycin is used when
PCN doesnt work/allergices
Clindamycin is good
anaerobic coverage
inhibits protein systhesis
bacteriostatic
Clindamycin side effects
risk of pseudomembranous colitis due to growth of clostridium difficile, skin rash
Azithromycin is
- effective against anaerobes and gram neg bacilli
- penetrates fibroblastsand phagocytes
- concentration are sig higher in periodontallesions compared to normal gingiva
if systemic antimicrobials are indicated as part of periodontal therapy, they should be_____ to mechanical debridement.
adjunctive
there is____ to recommend a specific protocol for the use of adj. systemic antimicrobial with nonsurgival mech debridement
no direct evidence
there is ____ that antibiotitcs in take should start on the day the debriment completion, debridement should be completed within a ___
indirect evidence, short time (
drugs that modulate host respnse
- non steroidal anti inflammatory drugs (NSAIDS)
- subantimicrobial dose of doxyclyclinse (Periostat)
periostate significance
- way below dose used for infectinos
- the mech is for anticollagenase activity alone, inhibiting protein synthesis in bacteria cells
- min risk of bacterial resistance to tetracyclines
chemotherapeutic agents is a term
for a chemical substance that provides clinical therapeutic benifits
clinical benifits of chemotherapeutic agents
- antimicrobial actions
- ability to increase the host’s resistance.
in systemic antibiotics, there is
No evidence that antibiotics alone can arrest
periodontal disease.
in systemic antibiotics, the Greatest benefit in :
- the presence of systemic disease
- immunocompromised patients
- aggressive forms of periodontal disease
- patients who are not good candidates for more complex and invasive treatment
Chronic periodontitis can and should be treated initially ______ systemic antibiotics.
without
The clinical diagnosis and situation dictate theneed for possible antibiotic therapy as an adjunct in controlling __________.
active periodontal disease.
Periodontal disease is predominately a gram _____ anaerobic infection
negative
When should you consider the use of systemic antibiotics during periodontal therapy?
- Aggressive periodontitis
- Necrotizing ulcerative periodontal disease
- “Refractory Periodontitis” or patients who are considered to be high risk
- Generalized severe chronic periodontitis
- Periodontal patients who are immunocompromised
- Heavy smokers
- In conjunction with certain surgical procedures (implants, bone grafting, sinus lifts, Guided tissue regeneration)
Penicillians MOA, spectrum, effect
Inhibits cell wall syn, narrow, bacteriocidal
Frequently used penicillins (PCNs) in periodontal therapy include
- Amoxicillin
- Pen VK
- Amoxicillin with clavulanic acid Augmentin)
Tetrcyclines moa, spectrum and effect
inhibits protein synthesis, broad, bacteriostatic
Tetrcyclines indications
- “Refractory” Periodontitis
- Aggressive Periodontitis (EOP)
Tetrcyclines advantages
-Ability to concentrate in the tissues and
destroy A.a.
-Anticollagenase activity
tetrcyclines contraindications
- dont give with milk/dairy, Fe containing vitamins and minerals orantacids
- photosensitivity
- avoid use in children, preg/nurs (may cause discoloration of teeth)
forms of tetracyclines used in perio
doxycyline
minocycline
doxycyline is _____ on the stomach than mino. and tetr.
eaiser
can you take dairy with doxycyline
yes
