exam 2- lecture 2 Flashcards
(103 cards)
1
Q
invasion of the body by pathologic imcroorganisms but also a reaction of the tissues to their presence
A
infection
2
Q
this is a new analgesic, inhibits reuptake of norepinephrine and serotonin, not schedulued yet, very costly and moving up to the top 200 list of most commonly prescribed durgs
A
Tramadol (Ultram)
3
Q
these depress the respiratory center, usually cause of death from OD, should not be used to treat head injuries
A
opioids
4
Q
antiinfectives of this produce a variety of GI complaints.. erythromycin has the highest incidence of GI complaints
A
Oral anticoagulants
5
Q
how are opioids excreted?
A
excreted by glomerular filtration via urine
6
Q
this type accounts for 80%-90% of allergic reactions to penicillin
A
rash of penicillin
7
Q
what are 3 opioid receptors stimulated by the opioids?
A
mu (u)
kappa (k)
delta (8)
8
Q
extensions arising from either periodontic or endodontic related sources
if adequate drainage can be obtained, antiinfective agents are not indicated unless the patient is immune compromised
A
systemic infections
9
Q
side effects of metrondiazole?
A
xerostomia with an unpleasant or sharp metallic taste has been reported
10
Q
what are some mixed opioids?
A
agonist-antagonist opioids
pentazocine
buprenorphine (buprenex)
opioid antagonists
nalaxone (narcan)
nalmefene
tramadol
11
Q
most commonly used opioid in dentistry, combined with ASA or APAP (Empirin #3 or Tylenol #3)
A
codeine
12
Q
addicts trying to find MD or DMD to prescribe their drugs
A
shoppers
13
Q
these are a broad spectrum of antibiotics, adverse effects on teeth are well documented, taken by mouth, GI side effects include nausea, vomiting and diarrhea
A
TETRACYCLINES
14
Q
types of dental infections?
A
caries
perio disease
localized dental infection
sstemic infections
15
Q
prototype opioid against agonist against which all others are measured, compare to 10 mg of morphine
used parenterally t control post op pain in hospitalized patients and terminally ill patients
A
morphine
16
Q
substances that destroy or supress the growth or multiplication of bacteria
A
antibacterial agents
17
Q
how are opioids metabolized?
A
major route-conjugation with glucronic acid in the liver
4-6 hours
18
Q
used to treat syphyllis and gonorrhea , usual dosage is 250-500 meg every 6 hours
A
erythromycin
19
Q
used primary in treatment of opioid addicts
A
methadone (dolophine)
20
Q
concentration of the antiinfective agent present in the blood or serum
A
blood serum level
21
Q
the ability to kill bacteria, irreversible effect
A
bactericidal
22
Q
what are tetracyclines used to treat?
A
uses: to treat acne, pulmonary infections with COPD, and travelers diarrhea and some perio conditions such as NUG
23
Q
newer, used for upper respiratory infection, disease is 500 mg every 12 hours for 7-10 days
A
CLARITHROMYCIN (Biaxin)
24
Q
what is an effective agent for anaerobic organisms?
A
metrondiazole
25
what effect does opioids causes for pregnancies?
not tetratogenic but may prolong labor or depress fetal respiration if given near term
some newborns experience withdrawal symptoms
morphine/codeine - pregnancy category "C"
apap "B"
26
this is used to reverse opioid OD
NALMEFENE
27
what are the withdrawal symptoms of opioids? can occur with abrupt discontinuation
```
sweating
goose bumps
irritability
tremors
hallucinations
```
28
infection caused by the proliferation of microorganisms different from those causing the original infection
suprainfection
29
this can cause pinpoint pupils which is a sign of an addict
(myosis)
30
natural or acquired ability of an organisms to be immune to or resist the effects of an antiinfective agent
resistance
31
GI effects of this include nausea , diarrhea and vomiting, pregnancy category "B", contraindicated for dental infections during pregnancy, avoid alcohol and can potentiate the effects of warfarin
TEYRACYCLINE
32
substances that destory or suppress the growth or multiplication of fungi
antifungals
33
opioids produce varying degrees of analgesia depending on strength:
after patients reaction to painful stimuli
have additive effects with other CNS depressants
can cause constipation by increasing smooth muscle tone to the intestinal tract thereby decreasing the propulsive contracttions motility (used to treat diarrhea..lomotil)
34
what are symptoms of "shoppers?
```
requests a certain drug
claims allergies
cancels appointments
pain for days after scaling
moves from office to office bad mouthing
low pain threshold is what they say
keeps asking for refills
```
35
what are the adverse reactions of PENTAZOCINE?
nausea, vomiting, headaches, increase bp and heart rate
36
how are opioids distrbuted?
undergo variable first pass metabolism in liver reducing bioavailability
about 2/3 of codeine administered orally teaches systemic circulation
can be distributed to the fetus in a pregnant woman
37
what are the characterisitcs of hydrocodone?
many combinations but the original is HYDRO 5mg with APAP 500 mg
varies from 2.5 mg - 10 mg
recommended for the majority of dental patients (lorotab, vicodin)
38
consists of erythromycin, clarithromycin, azithromycin
macrolides
39
these bind to receptors located in the CNS and spinal cord producing an altered perception of reaction to pain
opioids
40
they produce systemic symptoms such as fever, maliase, and tachycardia
systemic infections
41
the prototype penicillin is available as sodium, potassium, procaine, or benzathine salts
Penicillin G
42
opioids can release what?
histamine
43
agents of this are used in pregnancy are limited.. Penicillin and erythromycin have not been associated with teratogeneicty and are frequently used
oral anticoagulants
44
substances produced by microorganisms that have the capacity, in dilute solutions, to destroy or supress the growth or multiplication of organisms or prevent their action
antibiotic agents
45
how many deaths occur annually in the US because of allergic reaction to penicillin?
100-300 deaths
46
what is the drug of choice for gram + cocci, unless a penicillin allergy
Pen VK
if allergy to Pen. then clindamycin or erythromycin
47
what are the uses of clindamycin?
drug of choice for some bacteroides species and other anaerobic
endocarditis prophylaxis of penicillin allergy
plelvic infections
dose is 150-300 mg every 6 hours 7-10 days
48
prescribed for small amounts, without refills, and only if treatment has been preformed
opioids
49
the principle behind the guidelines is that dental procedures may cause bacteremia and those bactermea may lodge in previously rough areas in and around the valves, prevents infective endocarditis
prophylactic indications
50
active against most gram positive aerobes (staphylococcus and streptococcus)
effective against typical anaerobes found in dental infections such as bacteroides, peptococcus, and peptostreptococcus
necessary to take with food to minimize GI effects
erythromycin
51
ability to inhibit or retard the multiplication or growth of bacteria; reversible process
bacteriostatic
52
occurs within minutes, most serious danger to patients.. treatment with epinephrine
anaphylactic shock of penicillin
53
this is also known as poor mans augmentation when combining metrondiazole and amoxicillin. cheaper than augmentin
tetracyclines
54
this is essentially pure opioids antagonist, drug of choice for treating agonist or mixed opioid OD, reverses opioid induced respiratory depression
NALOXONE(Narcan)
given IV or IM
avg. adult dose is 2 mg
effects should occur within 1-2 min, doses repeated 2-3 min intervals, if no response in 10 min. then may not be overdose
55
short acting parenterally administered, used during sedation or anesthesia, post op ventilation and observation are needed
fentanyl
56
when should tetracyclcine not be given?
should not be used during the last half of pregnancy or in children less than 9 years of age, if administered between 2 months and 7-8 years of age the permanent teeth will be affected
57
what are the 4 major groups of penicillin?
penicillin G/V
penicillinase(resistant penicillins)
amoxicillin
extended (spectrum penicillins)
58
synthetic opioid, Darvocet N-100=no more effacious than 2 tablets of ASA or APAP, death from OD with alcohol
propoxyphene
59
substances that destory or supress the growth or multiplication of viruses
antiviral agents
60
delayed serum thickness of penicillin effects?
fever, skin, rash, lymphadenopathy
61
bacteriostatic against gram positive and anaerobic bacteroides species, food does not interfere with the abosorption, effective against strep. pyogenes, strep. viridans and strep. aureus
CLINDAMYCIN (Cleocin)
62
only one in oral form, produces CNS effects, OD treated with narcan
PENTAZOCINE (talwin)
63
this affects both gram + and gram -
clindamycin
64
used to treat gonococcal infections
ampicillin
65
these can be administered orally or parenterally but not topically, most common cause of drug allergies, resistance occurs
penicillin
66
2nd most frequently prescribed drugs in dentistry?
Antiinfective agents
67
exceptional action against most obligate anaerobes such as bacteroides, anti infective and anti inflammatory effects,
METRONDIAZOLE (Flagyl)
68
what are the two forms of erythromycin
estolate and ethylsuccinate
69
exposing the organism to certain test antibodies and determining whether the organism is sensitive or resistant
sensitivity testing
70
produces blood levels, better absorbed, requires less frequent dosing (3 times daily) and it's absorption is not impaired by food
amoxicillin
71
what is amoxicillin used to treat?
upper resp. tract infections
urinary tract infections
meningitis
72
agents can potentiate the effect of oral anticoagulants, erythromycin inhibits the enzymes that metabolize warfarin (increase levels of warfarin)
oral anticoagulants
73
substances that act against or destory infections
antiinfective agents
74
protects the amoxicillin from enzymatic inactivation. also mixed with clauvanic acid (augmentation)
amoxicillin
75
what type of penicillin is absorbed orally better than G?
Pen V
76
substances that destroy or suppress the growth or multiplication of microorganisms
antimicrobials
77
this is the agent of choice for the prophylaxis of infective endocarditis
amoxicillin
78
range of activity of a drug
spectrum
79
what are tetracyclines uses for?
treat lower respiratory tract infections
treat endocarditis
treat perio infections
80
this reduces the effectiveness of oral contraceptives and increases the effectiveness of oral anticoagulants.
TETRACYCLINES
81
this causes GI effects of diarrhea, nausea, vomiting and abdominal cramps.. can lead to the development of pseudomembranous colitis and can be fatal
CLINDAMYCIN
82
what is a major symptom of opioid over dose?
respiratory depression
treat overdose with naloxone (narcan)
83
this is for severe pain, more potent than morphine, favorite of the addict, use in dentistry is rare
hydromorphine (diluadid)
84
growing the bacteria from a sample of infective exudates
culturing
85
how are opioids absorbed?
most absorbed when taken orally, occurs from lungs and nasal oral mucosa
86
combination of two agents produces less effect than their agent alone
antagonism
87
the organisms responsible for a dental infection are primarily gram + cocci
streptococci viridans
88
what are tetracyclcines incorportated in?
calcyfying structures
89
dairy products containing calcium, anti acids, and mineral supplements should not be taken within 2 hours of a dose of this, reduces intestinal absorption
TETRACYCLINES
90
what are some specific opioids?
```
morphine
oxycodone
hydrocodone
codeine
propoxyphene
meperidine
hydromorphone
methadone
fentanyl
```
91
produced by streptococcus mutans, 1st important dental infection that newly erupting teeth of young pt. faces
caries
92
combination of two antibiotics produces more effect than would be expected if their individual effects were added (1+1>2)
synergism
93
this suppresses morphine withdrawls, schedule V drug
BUPRENORPHINE (Buprenex)
94
oxycodone is used in comob with?
used alone or in combo with:
oxy+asa-percodan
oxy+apap-percocet,tylox
provides relief of moderate to severe pain
bridges the gap between codeine and morphine
95
most agents will interact with the contraceptives thus reducing their effectiveness, use additional means for protection
oral contraceptives
96
what are some adverese effects of tetracyclines?
liver damage increased with IV use, oral and vaginal candidiasis can result from the administration of orally, patients taking this are more photosensitive and can sunburn easily
97
favorite drug of abuse of medical personnel, 100 mg of this=10 mg morphine poor choice for oral route = usually IV or IM
Meperidine (Demerol)
98
what are the 3 groups of endogenous substances with opioid like action?
enkephalins, endorphins, dynorphins
99
stomatitis, hair tongue. usually occurs with topical application
oral lesions of penicillin
100
what types of allergic reactions occur with penicillin?
anaphylactic shock
rash
delayed serum thickness
oral lesions
101
produces higher blood levels than an equivalent amount of Pen G
the potassium salt of this is more soluble than free acid and is therefore better absorbed when taken orally
Penicillin V
102
amount of codeine by?
1-7.5 mg
2- 15 mg
3- 30 mg
4- 60 mg
60 mg of codeine=650 mg ASA or APAP +200 ibuprofen
103
what is the usual dose of tramadol?
50-100 mg every 4-6 hours
| do not exceed 400 mg a day
