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43 Cards in this Set

  • Front
  • Back
Which antibiotics are Bactericidal?
Penicillin
Metronidazole
Fluoroquinolones
Cephalosprin

(PMFC=Peace Mother F**king Cells!)

What antibiotics are Bacteriostatic

Clindamycin


Tetracyclin


Erythromycin


(CTE= Cease That Enlargement!)

What are the indications for adjunctive antibiotics?

SYSTEMIC INVOLVEMENT!


Fever


Malaise


Lymphadenopathy


Trismus


Increased swelling


Cellulitis


Osteomyelitis


Persistant infection

What are the situations that do NOT require adjunctive antibiotics?

Paint without signs and symptoms of infection


-Symptomatic irreversible pulpitis


-Acute periradicular periodontitis


Teeth with necrotic pulps and a radiolucency


Teeth with a sinus tract


localized fluctuant swellings

Which antibiotics are most effective at eliminating bacteria from endodontic infections?

Ranked in order from most effective to least effective:


1) Amoxicillin+Clavulanate


2) Clindamycin


3) Amox


4)Clarithromycin


5) Pen VK


6) Metronidazole (should always be used in conjuction with amoxicillin or clindamycin)

What spectrum does Pen VK cover?

Facultative, anaerobes

What spectrum does Amoxicillin cover?

Wide spectrum...(although Manzur claims that the spectrum is not all that different from Pen V)

What spectrum does Amoxicillin +clavulunate cover?
same spectrum as Amox but the clavulunate helps eliminate Beta lactamase resistant bacteria

What spectrum does Clindamycin cover?

Gram + facultatives, anaerobes

What spectrum does Metronidazole+Pen or Clindamycin cover?

Anaerobes

What spectrum does Clarythromycin cover?

Anaerobes

What spectrum does Azithromycin cover?

Anaerobes

What is the loading dose and tx regimen for Pen VK?

Loading dose: 1000mg


followed by 500mg QID for 5-7 days

What is the loading dose and tx regimen for Amoxicillin

Loading dose: 1000mg


followed by 500mg TID for 5-7 days


(TID b/c higher serum half life than Pen VK)

What is the loading dose and tx regimen for Amoxicillin+ Clavulanate?

Loading dose: 1000mg


followed by 500mg TID for 5-7 days

What is the loading dose and tx regimen for Clindamycin?

Loading dose: 600mg


followed by 300mg QID for 5-7 days

What is the loading dose and tx regimen for Metronidazole (+Pen or Clindamycin?)

Loading dose: 1000mg


followed by 500mg QID for 5-7 days

What is the loading dose and tx regimen for Clarythromycin?

Loading dose: 500mg


followed by 250mg BID for 5-7 days

What is the loading dose and tx regimen for Azithromycin?

Loading dose: 500mg


followed by 250mg Once Daily for 5-7 days

What are some conditions that require Antibiotic prophylaxis?

1)Artificial Heart valves


2) History of infective endocarditits


3) Certain specific, serious congenital heart conditions such as:


-Unrepaired or incompletely repaired cyanotic congenic congenital heart disease including those with palliative shunts and conduits


-Completely repaired congenital heart defect with prosthetic material or device by surgery or catheter intervention during the first 6 months after the procedure


-repaired congenital heart defect with a residual defect at the site or adjacent to the site of a prosthetic patch or a prosthetic device


4) Cardiac transplant recipients who develop cardiac valulopathy


For patients who require Antibiotic prophylaxis, which dental procedures require that they take the prophylaxis before hand?

1) All dental procedures that involve manipulation of gingival tissues or PA region of teeth or perforation of mucosa

Which dental procedures can be exempt from antibiotic prophylaxis coverage?

-Routine anesthetic injections through noninfected tissues


-Taking dental radiographs


-Placement of removable prosthodontic or ortho appliances


-Adjustment of ortho devices


-Shedding of deciduous and bleeding from trauma to the lips or oral mucosa

What is the antibiotic prophylaxis dosage for Amoxicillin?

Adult: 2g 30-60 minutes before Procedure


Children: 50mg/kg

What is the antibiotic prophylaxis dosage for Clindamycin?

Adult: 600g 30-60 minutes before Procedure


Children: 20mg/kg

What substances does the Nerve fiber release to propagate inflammation?

Substance P, CGRP

What is the neural pathway does Central sensitization affect?

Dorsal Horn, Thalamus and cortex

How long does it take before Central sensitization occurs?

1-2 weeks after injury

What are the 3 major changes seen in A fiber mechanoreceptors and polymodal C fibers as a result of peripheral sensitization?

Allodynia


Hyperalgesia


Spontaneous discharge of nociceptors (accounts for the spontaneous pain)

In which patients should you be cautious about prescribing NSAID's to?

hypersensitivity to aspirin, renal failure, hepatic disease, Warfarin and ACE inhibitor

What is a typical prescription for Tylenol 3?

2 tablets q4h

How much acetaminophen is in a single tablet of T3?

300mg

How much codeine is in a single tablet of T3?

30mg

In terms of ANalgesic effectiveness, which analgesic has the lowest NNT?

Ibuprofen 600/800mg (NNT of 1.7)

According to NNT numbers, arrange the following medications in order from lowest NNT to highest NNT:


T3, Tylenol 500mg, Ibuprofen 800, Naproxen, Ketorolac (Toradol), Ibuprofen 400

1) Ibuprofen 600/800 (GOLD STANDARD): 1.7


2) Ketorolac (Toradol) 20/60mg: 1.8


3) Naproxen (Aleve): 2.7-3.4


4) Ibuprofen 400mg: 2.5


5) T3: 3.3


6) Tylenol 500mg: 3.7

Patient reports moderate pain, medical Hx non-contributory, what medication should you prescribe to relieve the pain?

600-800mg Ibuprofen q6h

Patient reports mild pain, patient is on dialysis, what medication should you prescribe for pain?

650-1000mg Acetaminophen q6h

A patient who you've previously prescribed 800 mg ibuprofen comes back and says that the previous prescription was ineffective. Med Hx is non-constributory. What would you prescribe instead?

600mg+1000mg Acetaminophen q6h

Patient on Warfarin reports moderate pain, what would you prescribe her?

650-1000mg acetaminophen + a opiate equivalent to 60mg of codeine

Patient is experiencing severe odontogenic pain, They've taken over the counter acetaminophen and ibuprofen for the past couple days and it doesn't work. Med Hx non-contributory. What would you prescribe for the pain?

600mg Ibuprofen + acetaminophen/opiate combo equivalent to 10mg oxycodone

Patient is experiencing severe odontogenic pain. Patient is on ACE inhibitors. What would you prescribe to relieve the pain?

1000mg acetaminophen + opiate equivalent to 10mg oxycodone

What is the biggest issues with Benzodiazepines?

Amnesia!

What is the benzo of choice for dental appointments and why?

Triazolam (Halcion) 0.5mg.


Shortest half life (3 hours) compared to Lorazepam and diazepam

What is the antidote for Benzodiazepines?(that you should have in your emergency kit)

Flumazenil