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30 Cards in this Set

  • Front
  • Back
*most likely type of organism causing infection (was it gram positive or gram negative)
*sensitivity of organism to a particular antiinfective
*status host's immune system
*likelihood of patients developing hypersensitivity to infective agent
*likelihood of patient compliance
* drug interactions (digoxin, warfarins,theophylline,cyclosporins and oral contraceptives)
The basis for the selection of antiinfectives
bactericidal agent that disrupts or retards synthesis of bacterial cell wall proteins (cannot exist w/o cell wall)
very common dental antiinfective
ususually administered orally but also IM, IV
narrow spectrum antiinfective (some gram+ and some gram-cocci, some spirochetes and anaerobes)
In penicillin bacterial resistance increases with what?
Frequency use
In penicillin resistance is due to
penicillnase- producing organisms
How is penicillin distributed?
to most body tissues including saliva, breast milk and transplacental (execeptions are CSF and bone)
Since toxicity is rare, what happens to the doses
large doses are tolerated
Penicillin's most common adverse effect reaction
Hypersensitivity, it includes rash, edema, stomatitis, delayed hypersensitivity (up to 2 weeks post medication) and anaphylaxis
Superinfection for penicillin?
the prototype for penicillin
Penicillin G
similar to Pen G but produces higher blood levels
Penicillin V
less effective than Pen G and Pen V but effective againist organisms capable of producing penicillanase
Penicillinase- Resistant Penicillin
slightly wider range of action, produces higher blood levels than Pen G, Pen V, and Penicillinase and requires less frequent dosing
*Ampillicins (Principen)
* Amoxillins ( Trimox, Augmentin)
The half-life for oral penicillin
0.5 hours
Where is penicillin metabolized?
Penicillin is metabolized in the liver and excreted in the kidney
consist of erythromycin,clarithromycin, and azithromycin
Macrolides -a broad spectrum
Arythrocin, Zithromax, Erythrocin, Biaxin
Types of Macrolides
Spectrum of activity similar to penicillins but ineffective against the usual dental anaerobes
When are macrolides used?
In patients with penicillin hypersensitivity
bacteriostatic by interferences with protein synthesis
How are Macrolides administered?
Orally (degraded by gastric acids so oral forms ususally enteric-coated) but also IV, IM
What's the half-life for Macrolides?
2 hours
Where are macrolides metabolized?
In the liver and excreted in urine feces
What's the adverse reaction for macrolides?
gastrointestinal resulting in nausea, vomiting, abdominal cramps, diarrhea (frequently results in patient noncompliance)
Macrolides may increase
digoxin, cyclosporin, theophylline, and warfarin serum levels
Types of Macrolides that are newer bacteriostatic macrolides with efficacy against some oral anaerobes and fewer gastrointestional adverse effects
Azithromycin and clarithromycin
Sumycin, Doxycycline, Minocylcine, Minocin, Vibramycin
Types of Tetracyclines
Effective against a wide spectrum of gram+ and gram- aerobes, as well as Rickettsia, spirochetes, some protozoa, Chlamydia, and Mycoplasma organisms