student rdh pharmacology - antibacterial, tetracycline, chlorhexidine, tuberculosis

Amoxicillin

penicillin

bacteriocidal

Amoxicillin: brand names

amoxil, trimox

Amoxicillin: pre-med use

yes, first line

adult: 2mg 1hr before appt, 500mg q8h

child: 50mg 1hr before appt

what are the uses of amoxicillin in dental ?

1. premedication

2. abscess

3. celluitis ( bacterial infection of the skin and underlying tissue)

Amoxicillin: types of infection

gram positive

Amoxicillin has a ____ spectrum, ____ absorbed

broad, well

Amoxicillin: side effects

GI upset, rash, cross-allergy

can amoxicillin be used while pregnant ?

yes

Azithromycin

macrolide

bacterostatic

Azithromycin: brand names

zithromax, z-pak

Azithromycin: pre-med use

yes, if allergic to penicillin

adult: 500mg day 1, then 250mg x 4

child: 10mg day 1, then 5mg

Azithromycin: type of infection

intracellular bacteria

Azithromycin has a ______ half life

long

Azithromycin: side effects

GI upset, metallic taste (rare)

can azithromycin be u sed while pregnant?

with caution

when should azithromycin be used ?

if patient cannot tolerate clindamycin

Penicillin VK (penicillin)

natural penicillin, B-lactam

bactericidal

Penicillin VK (penicillin): brand name

pen-VK

is Penicillin VK (penicillin) used a pre-med?

no

what is Penicillin VK (penicillin) used for in dental?

mild/moderate oral infections

Penicillin VK (penicillin): type of infection

gram positive

Penicillin VK (penicillin): dosage

adult: 500mg q6h for 7-10 days

child: 25-50mg a day divided

Penicillin VK (penicillin) is effective but ______ dosing

frequent

Penicillin VK (penicillin): side effects

GI upset, rash, allergy

is it safe to use Penicillin VK (penicillin) while pregnant?

yes

Metronidazole

nitroimidazole

bactericidal

Metronidazole: brand name

flagyl

is Metronidazole used as pre-med?

no

what is Metronidazole used for in dental?

anaerobic periodontal pathogens

Metronidazole: dosage

adult: 250-500mg q8-12hrs for 7-10 dyas

child: use with caution

Metronidazole is very effective with ______

amoxicillin

Metronidazole: side effects

metallic taste, black hairy tongue, alcohol reaction

is Metronidazole safe to take while pregnant?

avoid in 1st trimester

do not combine Metronidazole with _____

alcohol

Cephalexin

Cephalosporin

bactericidal

Cephalexin: brand name

keflex

is Cephalexin used as pre-med?

yes, joint replacements if not anaphylactic

what is Cephalexin used for in dental?

premed for prosthetic joint and mild infection

Cephalexin: type of infection

gram positive cocci

Cephalexin: dosage

adult: 2mg 1hr before appt, 500mg q6h

child: 50mg 1hr before appt

Cephalexin is structurally like ______

penicillin

is Cephalexin safe to use while pregnant?

yes

Cephalexin is only used of no history of what?

anaphylaxis to penicillin

how come Clindamycin is no longer recommended for pre-med by the ADA and AHA?

causes C. diff colitis

superinfection

secondary infection superimposed on an earlier one

antimicrobials are an adjunct to what?

NSPT (nonsurgical periodontal therapy)

Tetracycline

bacteriostatic drug, given in dentistry to treat periodontitis

Doxycycline (systemic antibiotic): brand names

vibramycin, doryx

Doxycycline (systemic antibiotic): formulation

capsule/tablet

Doxycycline (systemic antibiotic): delivery

oral

Doxycycline (systemic antibiotic): dosage

100mg BID

daily

_____ can reduce absorption of Doxycycline

calcium

Minocycline

arestin

Minocycline: formulation

1mg microspheres

Minocycline: delivery

local, syringe is placed into pocket >5mm

Minocycline: dosage

1mg per pocket

sustained release for up to 14 days

after delivery of Minocycline do not _____ for ______ days

brush/floss, 7-10

Doxycycline Hyclate

atridox

Doxycycline Hyclate: formulation

10% doxycycline gel

Doxycycline Hyclate: delivery

local, injected into >5mm pocket

Doxycycline Hyclate: dosage

one dose per pocket

Doxycycline Hyclate: duration

sustained release for 7 days, avoid disturbing this area

Periostat: dosage

20 mg PO BID

long-term use, up to 9 months

Periostat: formulation

capsule

Tetracycline: contraindications

- if pregnant or breastfeeding, this cannot be used because this drug can cross through the placenta to the fetus affecting tooth and bone development.

- photosensitivity, more likely to develop sunburn

- children under 8yrs old because the teeth are still developing into permanent

Chlorhexidine rinse: formulation

.12% rinse

Chlorhexidine rinse: delivery

swish for 30s, twice a day

Chlorhexidine rinse: duration of effect

immediate, short lived

Chlorhexidine rinse: indications

1. post SRP

2. mucositis

3. peri-implantitis

does Chlorhexidine rinse cause staining?

yes, teeth and tongue

does Chlorhexidine rinse cause taste alteration?

yes, bitter or metallic taste

Periochip (chlorhexidine chip): formulation

2.5 mg gelatin chip

Periochip (chlorhexidine chip): delivery

inserted into >5mm pocket

Periochip (chlorhexidine chip): duration of effect

sustained release up to 10 days, avoid disturbing the area

Periochip (chlorhexidine chip): indications

1. localized periodontitis

2. post- SRP

does Periochip (chlorhexidine chip) cause staining or taste alteration ?

no

Tuberculosis is caused by what bacteria?

Mycobacterium tuberculosis

TB primarily affects the ____

lungs

TB treatment requires what ?

multiple drugs taken for 6-9 months due to bacteria's resistance and slow replication

what drugs are used to treat TB?

RIPE (rifampin, isoniazid, pyrazinamide, ethambutol)

PPD (purified protein derivative)/ Mantoux

substance used in the test for tuberculosis.

a positive sign does not mean the pt has TB, requires a chest x-ray to rule out active TB.