Utah Systemic Antibiotics

Question 1

What are the three common types of penicillin?

Answer 1

1. Amoxicillin
2. Pen VK
3. Augmentin (amoxicillin with clavulanic acid)

Question 2

What are the regimens for Pen VK?

Answer 2

250 mg or 500 mg
28 tablets
1 cap QID x 7 days

Question 3

What are the regimens for Amoxicillin?

Answer 3

500 mg
21 tablets
1 cap TID x 7 days

Question 4

What re the regimens for Augmentin

Answer 4

250 mg
21 tablets
1 cap TID x 7 days

Question 5

What diagnoses would one prescribe a tetracycline for?

Answer 5

refractory periodontitis or aggressive periodontitis.

Question 6

What are advantages and disadvantages of tetracycline?

Answer 6

Advantages:

1. It is really good at concentrating in the tissues and destroying A.a.
2. Anticollagenase activity

Disadvantages:

1. It should not be given with milk or dairy products, Iron containing vitamins and minerals, or antiacids
2. Photosensitivity
3. Avoid use in children or pregnant or nursing mothers (may cause discoloration of teeth)

Question 7

What are two types of tetracyclines that are used in periodontics?

Answer 7

Doxycycline

Minocycline

Question 8

What are the advantages of doxycycline?

Answer 8

1. It is easier on the stomach than minocycline or tetracycline
2. Can take with dairy products
3. Less side effects than tetra or minocycline

Question 9

What is the common regimen for doxycycline?

Answer 9

100 mg
22 tablets
2 caps stat, then 1 cap QD for 21 days

Question 10

What is metronidazole

Answer 10

A bacteriocidal against anaerobic bacteria

Question 11

What is the brand name of metronidazole?

Answer 11

Flagyl

Question 12

How does metronidazole work?

Answer 12

It inhibits DNA synthesis and is effective against obligate anaerobes

Question 13

How can metronidazole have a synergistic effect?

Answer 13

When it is prescribed with a PCN it works really well against A.a.

Question 14

What are some side effects of metronidazole?

Answer 14

1. antabuse
2. metallic after-taste
3. Orange urine
4. nausea and vomiting
5. (rare) - peripheral neuropathy

Question 15

What is the regimen for metronidazole?

Answer 15

500 mg (when paired with PCN it is 250 mg)
21 caps
1 cap TID for 7 days

Question 16

How does clindamycin work?

Answer 16

it inhibits protein synthesis and is bacteriostatic

Question 17

What are some side effects of clindamycin?

Answer 17

1. Risk of pseudomembranous colitis due to over growth of C. Diff.
2. Skin rash

Question 18

What is a common regimen for clindamycin?

Answer 18

300 mg
30 caps
1 cap TID for 10 days

Question 19

How does azithromycin work?

Answer 19

Penetrates fibroblasts and phagocytes and effects anaerobes and gram negative bacilli

Question 20

What is a common regimen for azithromycin?

Answer 20

500 mg
3 caps
take 1 cap qd for 3 days

Question 21

What is a generic name for azithromycin?

Answer 21

Z-Pak

Question 22

What is the regimen for Z-Pak?

Answer 22

250 mg
6 caps
2 caps stat, the one cap QD for 4 days

Question 23

What are some NSAID that have been shown to be effective against periodontitiis?

Answer 23

Acetalsalicylic acid (aspirin)

meclofenamate

Question 24

What is periostat?

Answer 24

a low dose doxycycline that is used for the anticollagenase activity alone.

Question 25

How is periostat used?

Answer 25

20 mg twice daily for 9 months. Not to be eaten around mealtime. Hard to get compliance.

Question 26

When should you prescribe periostat?

Answer 26

1. high risk patients that are non-responsive to normal treatment
2. patients with severe periodontitis who cannot undergo invasive surgery
3. aggressive periodontitis
4. heavy smokers
5. not commonly prescribed except on very select cases