AB Basics explain it to me like im 4 Flashcards
1
Q
Pen V K class
A
B-lactam (penicillins)
2
Q
Pen V K MOA
A
primary - bactericidal (only when they are actively growing and synthesizing a cell wall)
secondary - bacteriostatic
3
Q
Pen V K SOA
A
- G + cocci
- G + rods
- most oral anaerobes
4
Q
Pen V K metab and excretion
A
excreted by kidneys
5
Q
Pen V K indications in dent
A
- choice for orofacial infections
—-> soft tissue, cellulitis, pupal origins - txs NUG
6
Q
Pen V K how does bacteria become resistant
A
- enzy. inactivation (B-lactamases) **
- altered AB target
- tolerance by loss of cell wall autolysis
7
Q
Amox class
A
B - lactam (penicillin)
8
Q
Amox MOA
A
primary - bactericidal
secondary - bacteriostatic
9
Q
Amox SOA
A
better against G - bacteria than Pen V K
10
Q
Amox metab and excretion
A
- metab. in liver
- excreted 60% unchanged by liver
- better oral absorption than Pen V K
11
Q
Amox indication in dentistry
A
- choice for orofacial infections
—-> soft tissue, cellulitis, pupal origins - txs NUG
- juvenile perio, early onset perio, refractory perio
- AB prophy for bacterial endocarditis
- when Pen & Amox ineffective: add metronidazole
12
Q
Amox adverse rxns:
A
- amp/amox rash
- potential superinfection of vagina and GI tract
13
Q
Augmentin is what combined
A
amox. + clavulanic acid
14
Q
augmentin class
A
B-lactam (penicillins)
15
Q
Augmentin MOA
A
- clavulanic acid binds irreversibly to active site of B-lactamases to stop hydrolysis of ABs
16
Q
Augmentin SOA
A
same as amox. but a few others too:
better against G - bacteria than Pen V K
17
Q
augmentin metab and excretion
A
metab in liver
excreted by kidneys
18
Q
augmentin uses in dentistry
A
- B- lactamase prod. bacteria &/or unresponsive to PenVK or amox.
- adjunctive tx of rapidly progressive perio
19
Q
T/F clavulanic acid has antibacterial activity by itself
A
F. it does not
20
Q
dicloxacillin class
A
B - lactamase (penicillins)
21
Q
dicloxacillin MOA
A
(B-lactam AB so bactericidal)
reistant to inactivation by staph penicillinase***
22
Q
dicloxacillin SOA
A
- same as Pen V K
- most notably effective against: coagulase positive B - lactamase producing staph. **
23
Q
dicloxacillin metab and excretion
A
metab in liver
excreted by kidneys
24
Q
cephalosporins class
A
B - lactam (functionally identical to penicillins)
25
cephalosporins MOA
- inhibit bacterial cell wall peptidoglycan synthesis by inhibition of penicillin sensitive enzymes
- more stable to bacterial beta-lactamses = broader spectrum of activity
26
cephalosporins SOA first gen
G + aerobic cocci
27
cephalosporins SOA second gen
G - anaerobic
28
cephalosporins SOA third gen
G - (with expanded efficacy)
29
cephalosporins excretion
kidney
30
erythromycin, azithromycin, clarithromycin class
macrolides
31
erythromycin, azithromycin, clarithromycin MOA
bacteriostatic via inhibition of RNA-dependent protein sythesis
32
erythromycin SOA
G + anaerobic & aerobic cocci
33
clarithromycin SOA
G + anaerobes
34
azithromycin SOA
G - anerobes
35
erythromycin, azithromycin, clarithromycin metab and excretion
- metab in liver
- excreted in bile, feces (***), and urine
36
what is a notable property of macrolides (& tetracyclines & clindamycin)
selective uptake by phagocytic cells and fibroblasts, which function as repository drug depots and as a drug delivery system to areas of infection
37
erythromycin most common adverse reaction
severe epigastric pain
38
macrolides indication in dentistry
acute orofacial infections in patients that are allergic to penicillins
39
which macrolides are preferred for the tx or prevention of acute orofacial infections
azithromycin or clarithromycin
40
which ABs are recommended for the AB prophy for the prevention of bacterial endocarditis in pts allergic to Pen or Amp
azithromycin or clarithromycin
41
which macrolides have the greatest number of significant drug interactions (& what do they do)
erythromycin and clarithromycin
- affect liver drug metabolism (cytochrome p-450)
42
which 4 drugs are erythromycin and clarithromycin NOT to be used with:
- amiodarone (antiarrhythmic)
- fluconazole (antifungal)
- lovastatin
- simvastatin
43
clindamycin class
macrolide
44
clindamycin MOA
functionally equivalent to erythromycin
45
clindamycin SOA
G + cocci
46
clindamycin metab and excretion
- oral absorption
- metabolized in liver
- excreted in bile, feces, liver
47
clindamycin adverse rxns
- has the highest rate of serious and non-serious adverse drug reactions among ABs that dentists prescribe
- highest fatal ADR rate mostly related to C. difficile infection
48
clindamycin drug interactions
- avoid clindamycin and erythromycin concurrent use
- acts synergistically with neuromuscular blocking drugs
49
metronidazole class
nitroimadazole
50
metronidazole MOA
bactericidal
- diffusing into organisms and causes loss of DNA structure
51
metronidazole SOA
- antiprotozoal
- obligate anaerobic bacteria
52
metronidazole metab and excretion
metab in liver
excreted in urine and liver
53
which ABs are considered tetracyclines
- tetracyclines HCl
- minocycline
- doxycycline
54
tetracyclines MOA
bacteriostatic
- inhibit protein synthesis
55
which ABs are fluoroquinolones
- ciprofloxacin
- levofloxacin
- ofloxacin
56
metronidazole most frequent adverse reaction is what
nausea
57
most important mechanism for resistance to tetracyclines
drug efflux
58
T/F complete cross-resistance usually occurs between demeclocycline, doxycycline and minocycline
F.
occurs between demeclocycline, doxycycline, and tetracycline
59
T/F tetracyclines are not usually indicated for the tx of acute orofacial infections
T
60
tetracyclines advers rxns & minocyclines specifically
- superinfections (C. dif-associated diarrhea, vaginal & oral candidiasis, and staph enterocolitis)
- photosensitivity (exaggerated sunburn)
- minocycline:
---> vestibular toxicity
---> blue-gray-black discoloration of the skin, thyroid, nails, sclera, teeth, conjunctiva, tongue and bone
61
which ABs are considered nephrotoxic
tetracyclines
62
T/F tetracyclines are not CI during pregnancy
F. They are relatively CI during pregnancy
63
which ABs are considered fluroquinolones
ciprofloxacin
levofloxacin
ofloxacin
64
fluoroquinolones MOA
bacteriostatic/cidal via inhibition of DNA gyrase and topoisomerase IV
65
which AB is/are in fluoroquinolones group I and what do they target
norfloxacin
- least active against G - and G + organisms
66
which AB is/are in fluoroquinolones group II and what do they target
- ciprofloxacin
- ofloxacin
- levofloxacin
---> excellent G - activity and moderate to good G + activity
---> ****best for orofacial infections
67
which AB is/are in fluoroquinolones group III and what do they target
- moxifloxacin
- gemifloxacin
---> improved G + activity
68
group I fluoroquinolones are generally used to tx what
UTI
69
which group II fluoroquinolones is the most active against G -
ciprofloxacin
70
T/F ofloxacin, followed by levofloxacin have superior activity against G + organisms
F. levofloxacin, followed by ofloxacin
71
fluoroquinolones adverse rxns
- tendon inflammation/rupture (chondrotoxicity)
