Dental Infections and Amoxicillin Quiz

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Questions and Answers

Which of the following is NOT considered a red flag symptom that should be assessed before initiating treatment for a dental infection?

Submandibular swelling (correct)

Hot potato voice

Trismus

Drooling

A patient presents with a dental infection and a known penicillin allergy. Which antibiotic would be the MOST appropriate first-line treatment?

Clindamycin

Amoxicillin-clavulanate (Augmentin)

Metronidazole (correct)

Clarithromycin

What is the primary mechanism of action of amoxicillin?

Inhibition of bacterial protein synthesis

Interference with bacterial DNA replication

Disruption of bacterial cell membrane integrity

Inhibition of bacterial cell wall synthesis (correct)

Which of the following is a potential drug interaction with amoxicillin because of its antibiotic properties?

Decreased effectiveness of birth control medication (D) Signup and view all the answers

When is monitoring of a patient on amoxicillin considered most important?

With prolonged use, especially in those with renal or liver disease (A) Signup and view all the answers

A patient is prescribed amoxicillin for a dental infection. What is important patient education regarding this antibiotic?

The need to discuss the use of amoxicillin if they are breastfeeding or pregnant (A) Signup and view all the answers

Which of the following is NOT a typical location where a dental infection may originate?

Maxillary sinus (A) Signup and view all the answers

Besides antibiotics, what other class of medication is recommended for patients with dental infections?

Analgesics (A) Signup and view all the answers

A 7-year-old child presents with acute otitis media. According to the guidelines, which of the following factors would least influence the immediate initiation of antibiotic therapy?

Presence of a fever above 102°F (B) Signup and view all the answers

A patient is diagnosed with bacterial pharyngitis and has a documented penicillin allergy. Which would be the most appropriate first-line antibiotic?

Azithromycin (C) Signup and view all the answers

A patient is diagnosed with otitis externa. Which of the following instructions is MOST appropriate regarding ear care?

Keep the ear canal as dry as possible and avoid inserting objects. (A) Signup and view all the answers

A 35-year-old patient presents with a 5-day history of ear pain, sinus congestion, and sore throat. Besides antibiotics, which of the following would be a recommended at home treatment?

Over the counter pain medication, as prescribed by the doctor (B) Signup and view all the answers

An adult patient with otitis externa is unable to instill ear drops and has diabetes. Which of the following is the MOST appropriate initial treatment?

Oral ciprofloxacin (A) Signup and view all the answers

A patient reports a mild penicillin allergy and requires treatment for bacterial pharyngitis. Which of the following is the MOST appropriate antibiotic?

Cephalexin (A) Signup and view all the answers

Which of the following best describes the primary goal of patient education regarding otitis externa?

To teach patients the importance of proper ear cleaning and dryness. (C) Signup and view all the answers

A patient presents with an odontogenic infection. Which antibiotic would be considered first-line therapy?

Augmentin (B) Signup and view all the answers

A 15-year-old, weighing 120 lbs, is diagnosed with bacterial pharyngitis. What is the MOST appropriate dose and duration of azithromycin?

500 mg once daily for 5 days (A) Signup and view all the answers

For a child with a middle ear infection (otitis media), which dose of amoxicillin is MOST appropriate?

50 mg/kg/day orally in one or two divided doses, maximum of 1000mg/day (D) Signup and view all the answers

A 10 year old is prescribed Amoxicillin for acute otitis media; what is the primary mechanism of action of this medication?

To disrupt bacterial cell wall synthesis (C) Signup and view all the answers

How soon should a patient with uncomplicated otitis media or otitis externa show improvement after starting appropriate treatment?

Within 48-72 hours (C) Signup and view all the answers

Which scenario would be considered high-risk in someone presenting with an ear infection when deciding on treatment approach?

A 6 month old with a history of recurrent ear infections (A) Signup and view all the answers

A patient has been prescribed ciprofloxacin for a suspected resistant bacterial infection. What is a common and key adverse effect to monitor them for?

Tendon rupture (A) Signup and view all the answers

A child has had 4 episodes of acute otitis media (AOM) in the past year. According to the guidelines, what action should be taken?

Refer them to a specialist (C) Signup and view all the answers

When treating otitis externa, which of these is a valid reason to avoid using ototoxic drops like aminoglycosides?

The tympanic membrane cannot be visualized (D) Signup and view all the answers

A 14-month-old child presents with a suspected case of acute otitis media. Which of the following is the MOST appropriate initial management approach?

Begin high-dose amoxicillin 40-45mg/kg BID without delay. (C) Signup and view all the answers

A 6-year-old patient has otitis media and a known non-type I penicillin allergy. Which of the following is a suitable initial treatment option?

Cefdinir at 14 mg/kg/day divided BID. (B) Signup and view all the answers

Which of the following conditions is NOT an indication for Azithromycin use?

Hyperlipidemia management (D) Signup and view all the answers

A child who was initially managed with observation for acute otitis media returns after 3 days with worsening symptoms. Which of the following is the MOST appropriate next step?

Start high-dose amoxicillin at 40-45mg/kg BID. (A) Signup and view all the answers

What is a potential effect of antibiotics on birth control medications?

Decreases birth control effectiveness (C) Signup and view all the answers

A patient with severe acute otitis media and a known Type I penicillin allergy is not responding to initial treatment. What is the MOST appropriate next step?

Begin clindamycin 30-40mg/kg/day divided TID. (A) Signup and view all the answers

Which antibiotic interaction increases the concentration of the antibiotic in the body?

Probenecid (C) Signup and view all the answers

Which set of criteria is required for diagnosing acute otitis media?

Acute onset, middle ear effusion, and middle ear inflammation. (D) Signup and view all the answers

What is a common adverse effect associated with Azithromycin?

Hepatic effects (C) Signup and view all the answers

Which statement about the mechanism of action (MOI) of Azithromycin is correct?

It binds to bacterial ribosomes to inhibit protein synthesis. (B) Signup and view all the answers

A patient with acute otitis media who is allergic to penicillin was started on azithromycin. They return with persistent symptoms. Which of the following is the MOST appropriate next step?

Change to ceftriaxone 50mg/kg IM x 3 days. (C) Signup and view all the answers

Which of the following is NOT a typical sign or symptom associated with acute otitis media?

Trismus. (C) Signup and view all the answers

A patient presents with an ear infection. Upon examination, the tympanic membrane is found to be intact. Which of the following statements about otic preparations is most accurate?

Otic preparations are safe to use in this case. (C) Signup and view all the answers

Which medication is associated with a risk of QT prolongation?

Ciprofloxacin (A) Signup and view all the answers

What is a major contraindication for the use of ciprofloxacin?

Severe hypersensitivity reaction (A) Signup and view all the answers

What is a significant adverse effect of ciprofloxacin?

Tendon rupture (A) Signup and view all the answers

In patients with a history of hepatic dysfunction, what is advised when using medications?

Discontinue if hepatotoxicity occurs (B) Signup and view all the answers

Which condition is NOT indicated for the use of ciprofloxacin?

Above diaphragm infections (A) Signup and view all the answers

What should patients be educated about regarding common side effects of medications?

They are primarily gastrointestinal in nature (D) Signup and view all the answers

Which medication should generally be avoided in pregnancy?

Ciprofloxacin (C) Signup and view all the answers

What interaction should be monitored when prescribing ciprofloxacin?

QT prolongation with specific medications (D) Signup and view all the answers

What are the common pathogens associated with Otitis Media?

Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis Signup and view all the answers

What antibiotic is safe to give with a non-intact tympanic membrane (TM)?

Ciprofloxacin/Dexamethasone (B) Signup and view all the answers

What is the appropriate amoxicillin dosage for a 3-year-old child weighing 35 lbs with no penicillin allergy, prescribed for otitis media?

Amoxicillin 90 mg/kg/day BID Signup and view all the answers

What is the prescription for a 4 year old with a penicillin allergy presenting with a rash for otitis media?

Cefdinir 14 mg/kg/day BID Signup and view all the answers

Red flag symptoms before initiating treatment for dental infection include [blank].

trismus, swallowing difficulty, drooling, restricted tongue mobility, swollen floor of mouth Signup and view all the answers

The first-line antibiotic for a dental infection is [blank].

Augmentin: 875 mg every 12 hours or 500 mg every 8 hours Signup and view all the answers

Indications of Amoxicilling

ENT infection, H. pylori, LRTI, Acute sinusitis, Skin and soft tissue, UTI Signup and view all the answers

What is the main adverse effect of Amoxicillin?

C. difficle (@) Signup and view all the answers

What drug increases the risk of reaction with Amoxicillin?

Allopurinol (B) Signup and view all the answers

What is the mechanism of action (MOI) of Azithromycin?

Inhibits protein synthesis by binding to the 50S ribosomal subunit (B) Signup and view all the answers

What drug is known to increase the concentration of antibiotics in the body?

Probenecid (B) Signup and view all the answers

What are some common adverse effects of Azithromycin? (Select all that apply)

Nausea (A), Diarrhea (B), Rash (C), QT (@) Signup and view all the answers

What antibiotic increases the risk of hemorrhage?

Azithromycin (B) Signup and view all the answers

What is the mechanism of action (MOA) of Ciprofloxacin?

Inhibits DNA gyrase and topoisomerase IV (C) Signup and view all the answers

Which of the following are major adverse effects of Ciprofloxacin? (Select all that apply)

Tendon Rupture (A), Peripheral neuropathy (B), CNS effects (C), MG patients (D) Signup and view all the answers

Ciprofloxacin can interact with cytochrome P450 enzymes of what type of medications?

Tizanidine (A), Clozapine (B), Theophylline (D) Signup and view all the answers

Study Notes

ENT Infections Pharmacotherapy II

This presentation covers pharmacotherapy for ENT infections.
The learning objectives cover identifying pathogens, treatment algorithms, and patient education.
Key learning points include managing acute otitis media based on age and symptom duration, addressing high-risk patients, choosing first and second-line treatments, and educating patients on prevention and treatment of acute otitis media, otitis externa, bacterial pharyngitis, acute bacterial sinusitis, and dental infections.
Dosage calculations for pediatric patients are also included in the objectives.
Important medications discussed include Amoxicillin, Augmentin, Azithromycin, and Ciprofloxacin, emphasizing their class, mechanism of action, indications, adverse effects, contraindications, interactions, and monitoring, and patient education.
A case study of a 35-year-old female with ear and throat pain is included, with relevant vital signs and physical exam findings.
The different types of Otitis Media are explained: bacterial, viral, treatment and complications
Different criteria for choosing and using antibiotics in Otitis Media are detailed.
The discussion covers patient education, prevention strategies for AOM, including vaccination (Prevnar) and breastfeeding.
The presentation notes the common pathogens for Otitis Externa, symptoms, physical exam findings, treatment options (topical antibiotic options), and patient education strategies for prevention.
Different types and classifications of Otitis Media are highlighted, with their causes, and pathogen identification
The presentation gives guidance on specific steps and approaches for the treatment of Otitis Media (AOM) in different age groups (< six months, 6-24 months, and above 24 months)
The presentation provides information on treatment algorithms for managing Bacterial Otitis Media, and different types of treatments.
The presentation includes information on treatment approach for Bacterial Pharyngitis, including suitable patients, proper dosing, and important patient information regarding this condition
The presentation notes the causative pathogen, symptoms, and treatment for Bacterial Sinusitis (rhinosinusitis).
Different presentation notes important features for evaluating acute Bacterial Sinusitis in adults
The presentation covers treatment considerations for Adults and Children with Bacterial Sinusitis and also notes important information about the use of antibiotics for these purposes.
The presentation notes an important clinical decision-making point noting that if symptoms do not improve with initial treatment, further investigation is needed.
The presentation provides key information about the appropriate use of antibiotics in the treatment of dental infections.
The presentation covers the indications and adverse effects for common antibiotics frequently used in treating dental infections, including Augmentin, metronidazole, Macrolide (or topical).
The study notes provide information about different bacterial infections in the ENT area.
The study notes cover specific drugs with their mechanisms, indications, and adverse effects.
The presentation provides a summary of different drugs such as antibiotics.

Bacterial Pharyngitis

Pharyngitis is the inflammation of the pharynx, leading to a sore throat.
It can be viral or bacterial, with group A streptococcus (GAS) as a common bacterial cause.
The presentation notes important symptoms and physical examination (PE) findings, such as fever, headache, abdominal pain, sore throat, and enlarged tonsils with exudates.
Common pathogens include bacterial organisms like Streptococcus pyogenes.
Appropriate antibiotic treatment (penicillin or amoxicillin) is emphasized.
Different dosing recommendations for adults and children are covered.
The choice of antibiotics is influenced by patient factors such as the presence of penicillin allergy.
The study notes emphasize the importance of penicillin as the drug of choice in the treatment of bacterial pharyngitis.
The notes note that appropriate treatment of bacterial infections (such as strep throat) is important to avoid potential complications like rheumatic fever.
The guidelines note specific bacterial pharyngitis treatments and their use in adults and children.

Bacterial Sinusitis

Sinusitis is an inflammation of the nasal cavity and paranasal sinuses.
Uncomplicated sinusitis is primarily viral in origin.
The presentation describes the features of bacterial sinusitis in terms of symptoms like nasal congestion, discharge, tooth pain, facial pain, and pressure, fever, fatigue, cough, loss of smell, and ear pain, all worsened in certain positions (e.g., bending over) .
Bacterial sinusitis is characterized by longer symptom duration (>10 days) compared to viral sinusitis.
The presentation notes different treatment approaches, including supportive care, analgesics, saline irrigation, intranasal glucocorticoids, and antibiotics.
Information about appropriate antibiotics in different cases, including those with or without penicillin allergies, is covered.
Dosing considerations for children are included in the presentation.
The presentation emphasizes the importance of considering patient education and supportive care.

Otitis Media

Otitis media is an internal ear infection
The presentation notes that Otitis Media is frequently viral but can develop bacterial complications.
Treatment guidelines are given to guide treatment choices for specific patient populations.
Symptoms of AOM: fluid in the inner ear, bulging of the tympanic membrane (TM), possible perforation, and worsening after a viral URI.
Different pathogens, such as Haemophilus influenzae, M. catarrhalis, and Strep pneumo, are noted as common causes for acute bacterial otitis media.
The guidelines cover different treatment approaches and criteria for choosing and using antibiotics based on symptom duration, patient age, and other relevant factors
Different treatment choices and dosing are noted for antibiotic therapies, including high dos amoxicillin, or cephalosporins in case of allergies
Information about patient education and preventive strategies are covered in the presentation covering the case of AOM.

Otitis Externa

Otitis externa, commonly known as swimmer's ear, is an inflammation of the external ear canal, often due to bacterial infection.
Pseudomonas and S. aureus are common causative agents.
The presentation notes rapid onset pain, pruritis (itching), fullness, edema, erythema, and discharge as common symptoms
Treatment choices focus on supportive care (ear drops).
Different patient and treatment scenarios are discussed, such as those that are experiencing excessive moisture or have abrasions.
The presentation also notes information about specific topical antibiotic and oral options.
Key information is provided about the use and appropriate choice of topical antibiotics and other important aspects of Otitis Externa treatment, such as patient education for preventing infections and indications.
The presentation notes the high risks associated with specific patient conditions, such as diabetes or immunocompromised patients.