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59 Cards in this Set
- Front
- Back
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common penicillin features?
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low degree toxicity to pt
high incidence of allergic reaction short duration (rapid excretion in urine) incomplete absorption from GI Time-dependent killing so needs frequent doses |
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what does the renal secretion of penicillins mean?
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be cautious with pts that have compromised kidney function (can lead to seiqures and platelet aggregation)
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how do you extend the half life of pen g?
how given? |
add procaine or benzathine to from insoluble salts. antibiotic is slowly hydrolyed from salt
IM |
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what is the main exs of penicillinase resistant pens?
what spectrum? |
cloxacillin and dicloxacillin
narrow |
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what are the extended release penicillins?
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ampicillin (prototype) and amoxicillin (better absorbed)
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what are the broad spectrum pens?
how taken? |
piperacillin and mezlocillin.
not orally. |
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what are the initial drugs of choise with orofacial infections for non allergic pts?
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amoxicillin and penicillin V
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what are the noteworthy side effects of penicillins?
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can be antagonized by other bacteriostatic antibiotics
Non-steroidal anti-inflammatory drugs (NSAIDS) and probenecid can increase their half life (decrease excretion) |
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which penicillin does not need an initial loading dose?
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amoxicillin.
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when type of allergic penicillin reaction contra-indicates cephalosporins?
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immediate reaction
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what are the first gen cephalosporins?
which has a longer half life? |
cephalexin and cefazolin (longer half life)
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how administer cefazolin? cephalexin?
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parenteral
orally |
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how do second generation cephalosporins differ from 1st?
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second are more stable against beta lactamases from G-bacteria and anaerobes.
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2nd gen cephalosporins are used for?
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respiratory infections
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what is unique about 3rd gen cephalosporins?
used for? |
resistant to most bacterial beta lactamases and used for serious gram - infections
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4th gen cephalosporins differ by?
ex? |
more resistant even than 3rd to beta lactamases and more active against gram +
cefepime |
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how administer carbapenems?
ex? |
parenteral
imipenem with cilastatin combo |
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why is cilastatin given with imipenem?
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inhibits renal imipenem metabolism and prevents renal toxicity
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what is the cross-allergic reaction rate btwn pens and cephalosporins?
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5-10%
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what is the most important glycopeptide antibiotic?
spectrum? |
vancomycin
narrow |
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what is vancomycin used for?
what are its adverse reactions? |
drug of choise for MRSA
ototoxicity, skin rash, "red man" (redneck) syndrome |
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what types of drugs inhibit bacterial protein synthesis?
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1. macrolides
2. lincosamides 3. tetracyclines 4.aminoglycosides 5.chloramphenicol |
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what are the macrolides?
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erythromycin
clarithromycin azithromycin |
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which types bind 50s ribosymes to inhibit protein sythesis?
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macrolides, lincomycin, clindamycin and chlorophenicol.
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which types bind the 30s subunit?
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tetracyclines and aminoglycosides
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what is the absorption life for erythromycin?
how changed? |
not acid stable, so not completely absorbed.
make into salt (stearage, ethyl succinate |
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what are the adverse effects of erythromycin?
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Gi symptoms
reversible liver injury Torsades de points |
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How does clarithromycin differ from erythromycin?
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acid stable, better absorption, and increased half life
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what are the problems with clarithromycin?
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inhibits metabolism of other drugs
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what is unique about azithromycin?
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notrogen atom in macrolide ring
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what are the tissue: plasma ratios for azithromycin in:
lung and tonsils? cervix? skin? |
100
70 35 |
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drug interactions and metabolism of azithromycin?
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not in liver, and rare interactions b/c of altered metabolism
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what was one of the first macrolides on the market?
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troleandomycin
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what are macrolides good for as denists?
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good for acute orofacial infections, (beta lactam allergic pts)
clarith, and azith are for endocarditis |
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absorption of the macrolides?
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eryth: coat it to prevent destruction
Azith: bile!!!!!!! |
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max dose of macrolides?
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4g/day or 1.5g/day if renally impared
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if macrolides are co-administered with fluoroquinolones, pimozide or cisapride?
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get torsades de pointe
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what are teh contraindications for macrolides?
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pts. with history of cholestatic hepatitis
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Lincosamides exs?
spectrum? |
lincomycin and clindamycin
narrow, gram +, and anaerobes |
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properties of lincosamides?
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good penetration into the bone
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adverse effects of clindamycin?
contraindiactions? |
antibiotic associated colitis
to co-administer with neuromuscular blocking drugs |
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tetracycline interferes with?
short or long acting? |
30s subunit
short |
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long acting tetracycline derivative?
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doxycycline
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what are the 3 important properties of tetracycline drugs?
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1. well distributed (skin and saliva)
2. deposited in developing teeth and bones 3. mild and dairy producst,antacids prevent oral absorption |
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how does doxycycline differ from tetracycline?
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better absorbed
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what are the advers reactions/contraindications to tetracyclines?
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1.super infections with candida
2. phototoxicity 3. GI toxicity 4. toxic to kidnyes 5. young children/pregnant women |
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what does tetracyclines do to coumarin?
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increase anticoagulant effects
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what are the indications for tetracyclines in dentistry?
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ANUG (perio stuff)
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aminoglycosides differ from other protein inhibitors b/c?
ex? dental indications? |
bactericidal
gentamicin none |
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what do the quinolones do?
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inhibit DNA gyrase
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what is the original fluoroquinone? the other newerone?
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ciprofloxacin
levofloxacin |
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how does levofloaxacina dn ciprofloxacin differ?
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levo: better against gram +
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downside to quinolones?
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growing cartilage damage (so don't give to kids)
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sulfonamides are ___spectrum?
do? |
broad
inhibit dihydropteroate synthase (stops folic acid production and thus DNA replication) |
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sulfonamide uses in dentistry?
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none
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what is special about metronidaole?
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gets anaerbic bacteria, especiall bacteroides species
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metronidazole uses in detistry?
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anug
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what is the drug of choice for TB?
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isoniazid
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what is the main side effect of isoniazid?
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nervous system toxicity
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