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Dental Pharmacology > Antibiotics > Flashcards

Flashcards in Antibiotics Deck (64):
1

G+ cocci and bacilli; some G- cocci; spirochetes (streptococcus, treponema pallidum, neisseria gonorrhoeae): penicillins G and penicillins V

natural penicillins

2

B lactamase producing staph (penicillinase resistant): nafcillin, oxacillin, dicloxacillin

anti-staphylococcal

3

same as Pen G, plus some G- rods and bacilli; not resistant to broad spectrum B lactamases in G- organisms (H. influenzae, E coli): ampicillin, amoxicillin, cyclacillin

extended spectrum

4

enteric G- rods, G- bacilli; usually combined with an aminoglycoside for serious infections (pseudomonas aeruginosa, H. influenzae): ticarcillin, mezclocillin, piperacillin

anti-pseudomonal

5

clavulanic acid, sulbactam, tazobactam

b lactamase inhibitors

6

amoxicillin and clavulanic acid (oral): B lactamase producing Staph

augmentin

7

ampicillin and sulbactam (parenteral)

unasyn

8

ticarcillin and clavulanic acid (parenteral)

timentin

9

piperacillin and tazobactam (parenteral): gram neg. bacilli; not pseudomonas

zosyn

10

penicillins that have biliary excretion

nafcillin and oxacillin

11

treat MRSA with...

vancomycin

12

diarrhea after oral dose is more common with ...

ampicillin and augmentin

13

first gen. cephalosporin; similar spectrum to ampicillin; G+ cocci; some G- bacilli

cephalothin and cefazolin

14

second gen. cephalosporin; less active for G+ and more active for G-; H. influenza, N. meningitidis

cefoxitin, cefotetan, cefaclor

15

third gen. cephalosporin; enteric G-; reserve for very serious infections; crosses BBB; h. influenza, serratia

cefotaxime, ceftriaxone, ceftazidime, cefixime

16

b. fragilis

cefoxitin and cefotetan

17

pseudomonas

ceftazidime only

18

fourth gen cephalosporin; increase activity for G+, B lactamase producing organisms, broad spectrum

cefepime and ceftaroline

19

which 4th gen ceph? p. aeruginosa, klebsiella, e coli, enterobacter, citrobacter, proteus mirabilis

cefepime

20

which 4th gen ceph? s aureus (MRSA and MSSA), s pneumoniae, E coli, klebsiella, enterobacter, citrobacter

cerftaroline

21

no current cephs have activity for ...

enterococcus

22

3rd gen; penetrate to CSF sufficiently to be useful for treatment of meningitis

cefotaxime and ceftriaxone

23

extra dose required after hemodialysis except for ...

ceftriaxone

24

disulfiram like effects w/ alcohol for cephs with N-methylthiotetrazole side chain --> i.e. ...

cefotetan

25

B lactam ring; more resistant to beta lactamase enzymes than penicillins and cephalosporins; broadest spectrum of any b lactam; IV

carbapenems-imipenem

26

carbapenems-imipenem is administered with ... which inhibits dehydropeptidase and prevents breakdown in kidney and renal toxicity

cilastatin

27

fixed combo of carbapenem and cilastatin

primaxin

28

active against p. aeruginosa, resistant nosocomial gram negatives, role in empiric therapy

carbapenems

29

carbapenem that doesnt require co administration with cilastatin; slightly less likely to cause seizures; active against imipenem resistant p. aeruginosa and extended spectrum b lactamases producing E coli and klesbsiella

meropenem

30

carbapenem with longer serum half life; once a day dosing

ertapenem

31

inhibits cell wall synthesis but with different site from other B lactams; narrow spectrum-primarily against G+; glomerular filtration half life a lot longer with renal impairment; nephrotoxicity which increases when in combo with aminoglycoside, cyclosporin, amphotericin; used against MRSA

vancomycin

32

erythromycin, clindamycin, azithromycin

macrolides

33

binds to 50s subunit and inhibits protein synthesis; bacteriostatic; narrow spectrum- high uptake in G+ and low in G-; oral but in protected form; concentrated in liver and excreted in bile; renal failure has no effect; inhibits cytochrome P450; can trigger heart arrhythmia; 2nd after Pen G for G+ infections

erythromycin

34

more acid stable than erythromycin; absorption of oral dose increases with food; longer half life; slightly better activity against G+; similar in effectiveness to Pen Vs; slightly less inhibiting of cytochrome P450 than erythromycin but still does inhibit it;

clarithromycin

35

more acid stable; very long half life; absorption of oral dose reduced with food; concentrates in macrophages, neutrophils and fibroblasts; increased penetration in G-; NO inhibition of CYP enzymes; small increased risk for cardiac death

azithromycin

36

drug of choice for legionella, campylobacter, mycobacterium avium complex

azithromycin

37

inhibition of protein synthesis; binds to 50S; cross resistance to the macrolide antibiotics; penetrates bone; spectrum includes many of the orodental pathogens; G+ cocci; anaerobic G+ and G-; prophylactic coverage with allergic to penicillin

clindamycin

38

inhibition of protein synthesis by binding to 30S; bacteriostatic with reversible binding to ribosome; broad spectrum; G+ and G-; aerobic and anaerobic

tetracycline

39

may be drug of choice for mycoplasma, chlamydia, rickettsiae; spirochetes

tetracycline

40

resistance to one tetracycline provides resistance to ...

all tetracyclines

41

absorption inhibited by di- and trivalent cations; best absorbed in acidic conditions of stomach w/o antacids; concentrates in bone and teeth particularly when undergoing calcification; fetal conc. can be relatively high in bond and dentition; excreted to the bile

tetracycline

42

which tetracyclines use hepatic excretion

minocycline and doxycycline

43

adverse effects: avitaminosis (B vitamins produced by flora in gut); superinfections common; discoloration of teeth during development

tetracycline

44

which tetracyline is more completely absorbed and least likely to cause problem

doxycycline

45

induced staining of dentition in adults; vestibular toxicity

minocycline

46

enzymatic reduction of drug by to cause effects on bacterial DNA replication; penetrates CSF; can by used to treat clostridium difficile; active against G- anaerobes found in acute orofacial infections, refractory/rapidly progressive periodontitis; protozoal infections; inhibits P450 isozyme; disulfiram effect

metronidazole

47

ciprofloxacin, norfloxacin, sparfloxacin

fluoroquinolones

48

inhibition of bacterial DNA gyrase, inhibits DNA synthesis, bacteriocidal; absorption decreases with antacids containing Al+++ and Mg++ and decreases with dietary supplements containing Fe++ and Zn++; accumulates in macrophages and leukocytes-->effective against intracellular organism (legionella); poor CSF penetration; half life increases with renal failure; broad spectrum

fluoroquinolones

49

alterations in DNA gyrase binding is caused by mutation to ... of DNA gyrase enzyme

QRDR gene

50

resistance to fluoroquinolones becoming frequent in ...

S. aureua and P. aeruginosa

51

which generation of fluoroquinolones?: increased G- and systemic activity; improved pharmacokinetics; fewer side effects

2nd gen

52

which generation of fluoroquinolones?: extended activity against G+; broad G- coverage

3rd gen

53

which generation of fluoroquinolones?: activity against anaerobes along with G+ and G- of 3rd generation

4th gen

54

which generation of fluoroquinolones?: ciprofloxacin, enoxacin, lomefloxacin, norfloxacin, ofloxacin

2nd gen

55

which generation of fluoroquinolones?: grepafloxacin, levofloxacin, sparfloxacin

3rd gen

56

which generation of fluoroquinolones?: gatifloxacin and moxifloxacin

4th gen

57

fluoroquinolones have poor CSF penetration except ...

ofloxacin

58

adverse effects: prolongation of QT interval (3rd gen except levofloxacin); articular cartilage erosion (arthropathy) drug interactions: inhibition of P450 system

fluoroquinolones

59

a fluroquinolone with definite risk of QTc prolongation

sparfloxacin

60

fluoroquinolones with possible risk of QTc prolongation

gatifloxacin, gemifloxacin, levofloxacin, moxifloxacin, ofloxcin

61

fluoroquinolone to avoid in patients with or suspected to have congenital long QT syndrome, hypokalemia, or receiving Class IA or Class III antiarrhythmic agents

ciprofloxacin

62

inhibit utilization of PABA in the synthesis of folic acid; bacteriostatic; pass the placental barrier and into breast milk; hematologic disorders in G6PD deficiency; sulfonamide binds serum albumin and displaces other drugs

sulfonamides

63

inhibits reduction of dihydrofolate to tetrahydrofolate; resistance comes from alteration in enzyme affinity; concentrates in prostate and vaginal fluids; synergistic with sulfonamides

trimethoprim

64

trimethoprim-sulfamethoxazole combo

co-trimoxazole