Antibiotic Lecture Part 2 Flashcards

1
Q

Ampicillin:

  • Bacteriostatic or Bactericidal
  • Acid stable or incomplete
  • Penicillinase-resistant?
A

Bactericidal
Acid stable
Penicillase-reistant

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2
Q

Hos is Ampicillin administered?

A

Parenterally or injection

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3
Q

T or F, Amoxicillin is one of the most commonly prescribed drugs in the U.S.?

A

True

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4
Q

Which has better bioavailability: Ampicillin or Amoxicillin?

A

Amoxicillin

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5
Q

What makes up Augmentin?

A

Amoxicillin is combined with clavulanic acid to broaden spectrum

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6
Q

What is Clavulanic acid and how does it work?

A

An antibacterial agent (not an antibiotic)

- Synthetic = inhibits the penicillinase enzyme

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7
Q

Why doesn’t the patient respond to penicillin V

A
  1. Patient compliance
  2. Microorganisms are producing penicillinase
  3. Bacteria causing infection is outside of the narrow spectrum of kill
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8
Q

Augmentin is prescribed in what 3 ways?

A

250 mg, 500 mg and 875 mg

- 875 mg is used for a severe infection every 12 hours

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9
Q

Why is it better to prescribe 1- 500 mg capsule rather than 2- 250 mg capsules of Augmentin

A

Regardless of the size of the capsule, there is a consistent 125 mg of clavulanic acid. By prescribing 2 capsules instead of 1, the patient receives double the dose of clavulanic acid. This might produce side effects of diahrrhea

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10
Q

T or F, 10% of population gets maculopapular rash. Rash responds to Benadryl and is considered an allergic reaction

A

False! It is NOT an allergic reaction. It is a Toxicity reaction

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11
Q

T or F, if you are allergic to one penicillin, you are allergic to all penicillins

A

True

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12
Q

Are cephalosporins broken down by penicillinase like penicillins?

A

No, destroyed by cephalosporinase. (very similar mechanism though)

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13
Q

Cephalosporins are well absorbed through what medium?

A

Through GI tract

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14
Q

What are some adverse reactions to Cephalosporins:

A
  1. Hypersensitivity reactions
  2. Gastrointestinal effects (NVDs)
  3. Superinfection (fungal infection; oral or vaginal)
  4. Nephrotoxicity
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15
Q

What are some oral side effects to Cephalosporins?

A

Glossitis: inflamed tongue; smooth, shiny red
Stomatitis: inflammation, ulcerations on buccal mucosa

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16
Q

T or F, Patients who are intolerant to penicillins may be intolerant to cephalosporins

17
Q

Is Cephalosporins the first choice for any orofacial infections?

A

Never the first choice

18
Q

Cephalosporins are active and effective in what indications

A
  1. Active against many gram positive aerobic bacteria
  2. Active against some anaerobic bacteria
  3. Effective against gram negative organisms
19
Q

Describe how generations work on spectrum of kill

A

The higher the generation, the more broad the spectrum of kill

20
Q

What generation of cephalosporins are used most in dentistry

A

First generation = active against gram positive cocci; limited activity against gram negative bacteria

21
Q

What are common cephalosporin drugs in first generation

A

Cephalexin (Keflex)
Cefadroxil

  • cephalosporin drugs begin with either “cef” or “ceph”
22
Q

Erythromycin is bacteriostatic or bacteriocidal

A

Bacteriostatic

- Bactericidal at high doses or when used against highly susceptible organisms

23
Q

What is the mechanism of action of Erythromycin

A
  • Inhibits protein synthesis by binding to the ribosome at a site near peptidyltransferase to inhibit peptide bond formation. End result is suppressing bacterial growth due to the lack of protein production
24
Q

Erythromycin is more effective against what type of bacteria

A

Gram positive cocci (Staph and Strep)

25
Erythromycin can cause bile to back up into the liver resulting in what?
Cholestatic hepatitis
26
What about Erythromycin causes poor patient compliance
It causes diarrhea
27
Which drug was formerly an alternate drug of choice for orofacial infections for patients who were allergic to penicillins?
Erythromycin - No longer effective against oral organisms due to resistance - No longer used in dentistry
28
3 reasons why we don't use erythromycin anymore in dentistry
1. Oral bugs are resistant to drug 2. GI side effects (poor patient compliance) 3. Dangerous drug interactions
29
T or F, Erythromycin is a red flag drug in dentistry
True, interacts adversely with many commonly prescribed medications and outcome of interaction is often serious and potentially life-threatening