Dental Pharmacology Panavelli 1

Front 1

What kind of organisms usually cause abscesses?

Back 1

Anaerobic organisms that grow slowly

Front 2

T/F: Bacteriostatic and bactericidal organisms are relatively ineffective against old and slow growing bacteria.

Back 2

TRUE - need higher drug concentrations.

Front 3

T/F: Use of narrow spectrum drugs with specificity is preferred over broad spectrum antibiotics

Back 3

TRUE

Front 4

T/F: Abx in dentistry are usually given orally on an empty stomach to prevent gastric destruction and cation mediated decrease in the absorption of the drugs.

Back 4

TRUE

Front 5

Oral infections of bacterial orgin usually require how many days of therapy?

Back 5

5-7

Front 6

What is the mechanisms of penicillins?

Back 6

cell wall synthesis inhibitors

Front 7

T/F: Almost all dental infections can be treated with penicillins

Back 7

TRUE

Front 8

What kind of organisms are fond in carious lesions?

Back 8

Aerobic gram positive cocci and anaerobic microorganisms

Front 9

Which penicillin is ;argely reserved for severe infections in patients in which the oral route is compromised?

Back 9

Penicillin G - poor oral absorption.

*Penicillin V is better absorbed orally

Front 10

What drugs can be used with penicillinase producing organisms?

Back 10

Resistant penicillins or non penicillins such as Erythromycin and Clindamycin

Front 11

What extended spectrum drug can be given for certain periodontal infections that are caused by both gram negative and gram positive organisms?

Back 11

Amoxicillin

Front 12

What kind of organisms are resistant to penicillin in dental infections?

Back 12

bacteroides and streptococci

Front 13

50% of bacteroides are susceptible to what abx?

Back 13

Amoxicillin

Front 14

What are the adverse effects of penicillin?

Back 14

allergic reactions and GI disturbances

Front 15

What are the penicillinase resistant penicillins?

Back 15

Cloxacillin and Dicloxacillin

Front 16

Cloxacillin and Dicloxacillin are penicillinase resistant penicillins but they are not as effective as Pen V against what kind of organisms?

Back 16

Gram (+) cocci.

- not used for MRSA.

Front 17

Klebsiella is the cause of dental infections in what percent of patients?

Back 17

4%

Front 18

Cefaclor, Cefuroxime axetil, and Cefprozil are 2nd generation cephalosporins that may be used against what type of organisms?

Back 18

- G(+)
- G(-) aerobes - acute cellulitis
- anaerobic - periapical abscesses

Front 19

Bacteroides resistant to penicillins have been found to be susceptible to what abx?

Back 19

cefotetan, a second generation cephalosporin.

* 50% bacteroides susceptible to amoxicillin

Front 20

What abx are alternate drugs for the prevention of bacterial endocarditis in patients with a history of non-immediate allergic reactions to penicillin?

Back 20

Cephalexin, Cefadroxil, Cefazolin

Front 21

T/F: Cephalosporins can be prescribed in patients with anaphylactic reactions towards penicillin derivatives.

Back 21

FALSE.

- only non-immediate allergic reaction to penicillin

Front 22

What is the mechanism of macrolides?

Back 22

Protein synthesis inhibitors

Front 23

What abx is 2nd choice to penicillin for tx of dental infections because it is bacteriostatic?

Back 23

erythromycin

Front 24

What are the macrolide abx?

Back 24

erythro-, clarithro-, azithro-, -"MYCIN"

Front 25

Erythromycin is effective against what type of organisms?

Back 25

Aerobic gram positive and many anaerobic.

Front 26

What abx are alternative abx for prophylactic coverage against bacterial endocarditis?

Back 26

Clarithromycin and azithromycin

Front 27

What are considerations to make when choosing a macrolide like Clarithromycin over a Penicillin for endocarditis?

Back 27

-Higher macrolide costs
-GI disturbances
-Drug interactions

Front 28

What is the mechanism of Tetracyclines?

Back 28

protein synthesis inhibitors

Front 29

Tetracyclines are useful in what periodontal disease?

Back 29

Juvenile Periodontitis caused by actinobacillus infections

Front 30

What abx has been shown to arrest the rapid bone loss associated with juvenile periodontitis through tissue regeneration and enhanced repair most likely due to collagenase inhibiting effect?

Back 30

Tetracyclines

Front 31

What abx have the advantage that they are concentrated in gingival fluid?

Back 31

Tetracyclines

Front 32

What abx can be applied sub-gingivally (in a paste or monofilament cord) with no detectable systemic effect?

Back 32

Tetracyclines

Front 33

During periods of active calcification, Tetracycline is deposited with calcium as what in teeth?

Back 33

Deposited with calcium as a tetracycline calciumorthophosphate complex in teeth.

Front 34

Exposure to what causes oxidation of tetracycline to a brown material that permanently discolors teeth?

Back 34

LIGHT

Front 35

Tetracyclines absorption from the GI tract is inhibited by what?

Back 35

Trivalent and divalent cations such as Ca2+, Mg2+, Fe2+, Al3+.

*Should not be given with milk and dairy products, iron supplements, or antacids.

Front 36

What abx should not be given with milk or dairy products, iron supplements, or antacids because they might inhibit it?

Back 36

Tetracycline

Front 37

What abx is effective against gram positive aerobes and BOTH GRAM NEGATIVE AND GRAM POSITIVE ANAEROBES?

Back 37

Clindamycin

Front 38

What abx is indicated in refractory bone infections?

Back 38

Clindamycin

Front 39

Clindamycin can be administered through what routes?

Back 39

oral or IV

Front 40

What abx has been shown to arrest the rapid bone loss associated with juvenile periodontitis through tissue regeneration and enhanced repair most likely due to collagenase inhibiting effect?

Back 40

Tetracyclines

Front 41

What abx have the advantage that they are concentrated in gingival fluid?

Back 41

Tetracyclines

Front 42

What abx can be applied sub-gingivally (in a paste or monofilament cord) with no detectable systemic effect?

Back 42

Tetracyclines

Front 43

During periods of active calcification, Tetracycline is deposited with calcium as what in teeth?

Back 43

Deposited with calcium as a tetracycline calciumorthophosphate complex in teeth.

Front 44

Exposure to what causes oxidation of tetracycline to a brown material that permanently discolors teeth?

Back 44

LIGHT

Front 45

Tetracyclines absorption from the GI tract is inhibited by what?

Back 45

Trivalent and divalent cations such as Ca2+, Mg2+, Fe2+, Al3+.

*Should not be given with milk and dairy products, iron supplements, or antacids.

Front 46

What abx should not be given with milk or dairy products, iron supplements, or antacids because they might inhibit it?

Back 46

Tetracycline

Front 47

What abx is effective against gram positive aerobes and BOTH GRAM NEGATIVE AND GRAM POSITIVE ANAEROBES?

Back 47

Clindamycin

Front 48

What abx is indicated in refractory bone infections?

Back 48

Clindamycin

Front 49

Clindamycin can be administered through what routes?

Back 49

oral or IV

Front 50

What abx is indicated in purulent osteitis caused by anaerobic organisms such as bacteroides when other antibiotics cannot be used?

Back 50

Clindamycin

Front 51

Where is clindamycin metabolized?

Back 51

LIVER.

* major route of excretion is bile, and it is eliminated in Feces

Front 52

What is the major route of excretion of Clindamycin?

Back 52

major route of excretion is bile and it is eliminated in feces.

Front 53

What are adverse effects of Clindamycin?

Back 53

GI disturbances, severe diarrhea, and possible pseudomembranous colitis (overgrowth of C. difficile)

Front 54

What abx has the potential to cause pseudomembranous colitis superinfection?

Back 54

Clindamycin

Front 55

What abx is highly effective against obligate anaerobes and is useful in eradicating B. fragilig infections and infections caused by similar stains and especially in NUG?

Back 55

Metronidazole

Front 56

What is the mechanism of Vancomycin?

Back 56

cell wall synthesis inhibitor

Front 57

Vancomycin is used in what kind of infections?

Back 57

-gram positive infections
-staphylococcal infections (mrsa)
-pneumococcal infections
-clostridial enterocolitis (only ORAL form)

Front 58

What abx is ototoxic and nephrotoxic?

Back 58

vancomycin

Front 59

What is the mechanism of action of Quinolones?

Back 59

DNA gyrase inhibitors

Front 60

What is the mechanism of action of Ciprofloxacin?

Back 60

DNA gyrase inhibitor (Quinolones)

Front 61

What abx is used in the treatment of rare oro-dental pseudomonas infections?

Back 61

Ciprofloxazin

Front 62

What drugs are used for an upper respiratory tract infection?

Back 62

Levofloxacin and Moxifloxacin

*Limited due to cartilage erosion and tendon rupture