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43 Cards in this Set
- Front
- Back
Which antibiotics are Bactericidal?
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Penicillin
Metronidazole Fluoroquinolones Cephalosprin (PMFC=Peace Mother F**king Cells!) |
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What antibiotics are Bacteriostatic |
Clindamycin Tetracyclin Erythromycin (CTE= Cease That Enlargement!) |
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What are the indications for adjunctive antibiotics? |
SYSTEMIC INVOLVEMENT! Fever Malaise Lymphadenopathy Trismus Increased swelling Cellulitis Osteomyelitis Persistant infection |
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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 |
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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) |
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What spectrum does Pen VK cover? |
Facultative, anaerobes |
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What spectrum does Amoxicillin cover? |
Wide spectrum...(although Manzur claims that the spectrum is not all that different from Pen V) |
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What spectrum does Amoxicillin +clavulunate cover?
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same spectrum as Amox but the clavulunate helps eliminate Beta lactamase resistant bacteria
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What spectrum does Clindamycin cover? |
Gram + facultatives, anaerobes |
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What spectrum does Metronidazole+Pen or Clindamycin cover? |
Anaerobes |
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What spectrum does Clarythromycin cover? |
Anaerobes |
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What spectrum does Azithromycin cover? |
Anaerobes |
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What is the loading dose and tx regimen for Pen VK? |
Loading dose: 1000mg followed by 500mg QID for 5-7 days |
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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) |
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What is the loading dose and tx regimen for Amoxicillin+ Clavulanate? |
Loading dose: 1000mg followed by 500mg TID for 5-7 days |
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What is the loading dose and tx regimen for Clindamycin? |
Loading dose: 600mg followed by 300mg QID for 5-7 days |
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What is the loading dose and tx regimen for Metronidazole (+Pen or Clindamycin?) |
Loading dose: 1000mg followed by 500mg QID for 5-7 days |
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What is the loading dose and tx regimen for Clarythromycin? |
Loading dose: 500mg followed by 250mg BID for 5-7 days |
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What is the loading dose and tx regimen for Azithromycin? |
Loading dose: 500mg followed by 250mg Once Daily for 5-7 days |
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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
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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 |
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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 |
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What is the antibiotic prophylaxis dosage for Amoxicillin? |
Adult: 2g 30-60 minutes before Procedure Children: 50mg/kg |
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What is the antibiotic prophylaxis dosage for Clindamycin? |
Adult: 600g 30-60 minutes before Procedure Children: 20mg/kg |
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What substances does the Nerve fiber release to propagate inflammation? |
Substance P, CGRP |
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What is the neural pathway does Central sensitization affect? |
Dorsal Horn, Thalamus and cortex |
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How long does it take before Central sensitization occurs? |
1-2 weeks after injury |
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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) |
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In which patients should you be cautious about prescribing NSAID's to? |
hypersensitivity to aspirin, renal failure, hepatic disease, Warfarin and ACE inhibitor |
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What is a typical prescription for Tylenol 3? |
2 tablets q4h |
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How much acetaminophen is in a single tablet of T3? |
300mg |
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How much codeine is in a single tablet of T3? |
30mg |
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In terms of ANalgesic effectiveness, which analgesic has the lowest NNT? |
Ibuprofen 600/800mg (NNT of 1.7) |
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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 |
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Patient reports moderate pain, medical Hx non-contributory, what medication should you prescribe to relieve the pain? |
600-800mg Ibuprofen q6h |
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Patient reports mild pain, patient is on dialysis, what medication should you prescribe for pain? |
650-1000mg Acetaminophen q6h |
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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 |
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Patient on Warfarin reports moderate pain, what would you prescribe her? |
650-1000mg acetaminophen + a opiate equivalent to 60mg of codeine |
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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 |
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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 |
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What is the biggest issues with Benzodiazepines? |
Amnesia! |
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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 |
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What is the antidote for Benzodiazepines?(that you should have in your emergency kit) |
Flumazenil |