Aztreonam Coupon: Antibiotics and Tetracyclines in Dentistry Quiz and Flashcards

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Questions and Answers

What is a common side effect associated with the use of antibiotics?

Cough and runny nose

Headache and fever

Abdominal pain

Nausea and diarrhea (correct)

What inhibits the absorption of tetracyclines?

Water

Calcium (correct)

Fiber

Food

Why are tetracyclines useful in the treatment of periodontal disease?

They inhibit collagenase (correct)

They have anti-inflammatory properties

They promote tissue regeneration

They have antibacterial properties

What is a consideration for antibiotic use in lactating women?

Excretion of antibiotics in breast milk Signup and view all the answers

What is a prophylactic use of clindamycin?

Preventing endocarditis before a dental procedure Signup and view all the answers

What is a pharmacokinetic property of tetracyclines?

They are metabolized in the liver Signup and view all the answers

What is a potential side effect of macrolides, especially in pregnant women?

Hepatotoxicity Signup and view all the answers

What can occur when macrolides are combined with penicillin?

Antagonism of bactericidal effect of penicillin Signup and view all the answers

What is the usual dose of Azithromycin for endocarditis prophylaxis?

500 mg PO 1 hour before the procedure Signup and view all the answers

What is the effect of macrolides on oral anticoagulants like warfarin?

Increased effect of anticoagulant Signup and view all the answers

What is the mechanism of action of Clindamycin?

Inhibition of protein synthesis by binding to bacterial ribosomes Signup and view all the answers

What is the role of Azithromycin in the treatment of Syphilis?

Second line treatment Signup and view all the answers

What is the effect of Erythromycin when used in combination with anticoagulant drug Warfarin?

It increases the risk of bleeding Signup and view all the answers

Why is Erythromycin not preferred as a penicillin-alternative drug in certain cases?

It is bacteriostatic and not bacteriocidal Signup and view all the answers

How are macrolides excreted?

Mostly in bile, except Clarithromycin Signup and view all the answers

What is the mechanism of action of macrolides?

Inhibition of bacterial protein synthesis Signup and view all the answers

Why are macrolides safe in renal dysfunction patients?

They are excreted in the bile Signup and view all the answers

What is the characteristic of macrolides in terms of stability in stomach acid?

They are stable in stomach acid Signup and view all the answers

Study Notes

Macrolides

Azithromycin is the preferred penicillin-alternative drug of choice in penicillin allergic patients and those who cannot tolerate clindamycin due to its favourable pharmacokinetics.
Azithromycin is concentrated in neutrophils and macrophages, giving it a long half-life and allowing for once-daily dosing.
Dental uses of Azithromycin include:
- Prophylactic use: endocarditis prophylaxis (oral: 500 mg 1 hour before procedure, parenteral: 500 mg IV 1 hour before procedure)
- Therapeutic uses: second-line treatment for syphilis, treatment of acute orofacial infections (e.g., acute periapical abscess, sinusitis)
Azithromycin can interact with:
- Penicillin: antagonizes the bactericidal effect of penicillin
- Oral anticoagulants: increases the effect of anticoagulants, increasing the risk of bleeding
- Anticonvulsant drugs: can alter levels in the presence of macrolides
- Theophylline: can increase the level of Theophylline, leading to toxicity
Adverse effects of Azithromycin include:
- GIT issues: nausea, vomiting, and diarrhea
- Cardiotoxicity: associated with high serum levels
- Hepatotoxicity: in pregnant women with Erythromycin
- Hearing loss: rare

Lincosamides

Clindamycin is a semisynthetic lincosamide that inhibits protein synthesis by binding to bacterial ribosomes.
Dental uses of Clindamycin include:
- Prophylactic use: in penicillin allergic patients (oral: 600 mg 1 hour before procedure, parenteral: 600 mg IV/IM 1 hour before procedure)
- Therapeutic uses: in penicillin allergic patients (300 mg PO QID for 5 days)
Adverse effects of Clindamycin include:
- Diarrhea
- Nausea
- Abdominal cramps
- Inflammation of the colon or colitis

Tetracyclines

Tetracyclines are broad-spectrum bacteriostatic antibiotics that inhibit bacterial protein synthesis.
Pharmacokinetics:
- Partially absorbed from the stomach and upper GIT
- Poor absorption if taken with calcium (e.g., milk)
- Distributed to all body fluids, but cannot penetrate CSF even in the presence of infection
- Metabolized in the liver
- Excreted in the urine
Dental uses of Tetracyclines include:
- Anticollagenase effect (inhibit the break down of tissue)
- High bioavailability in the gingival sulcus
- Treatment of periodontal and peri-implant disease

Inhibitors of Bacterial Protein Synthesis

Macrolides (Erythromycin, Clarithromycin, Azithromycin) inhibit bacterial protein synthesis by binding to bacterial ribosomes.
General properties of Macrolides:
- Stable in stomach acid and readily absorbed
- Extensively metabolized by the liver
- Excreted in the bile (safe in renal dysfunction patients) except Clarithromycin, which is excreted in the urine
Erythromycin is not preferred as a penicillin-alternative drug when a severe infection exists or when the patient is immunocompromised and requires bacteriocidal activity.

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Description

This quiz covers the use of antibiotics, particularly clindamycin and tetracyclines, in dentistry, including prophylactic and therapeutic uses, as well as pharmacokinetics. It's essential for dental professionals and students.