Pharm Exam #4 Antiinfective, Antifungal, and Antiviral Agents
What is hepatitis?
Inflammation of the liver, which may or may not be caused by a viral infection; can be caused by poisons, drugs, or alcohol.
What is dermatis?
Inflammation of the skin
What is the bacteria that is resistant to most antibiotics called?
MRSA - Methicillin Resistant Staphylococcus Aureus
What is considered a public health problem with resistant organisms?
Many organisms are now resistant to the most commonly prescribed antibiotics.
what is the one anti-infective agent that is not usually used with pregnant women but can be used should an exception exist?
Metronidazole
What kind of spectrum does Penicillin G have?
Narrow Spectrum
When talking about anti-infective agents what does most specific mean?
Narrow spectrum
What are the kinds of resistance of bacteria to antibiotics that occur?
Natural Acquired
Is Vancomycin in the penicillin family?
No it is not
Is there a fear of toxicity with taking penicillin?
No, it is not a problem. Penicillin has a wide therapeutic index
Is Penicillin G used much in dentistry?
No, it is not because of the cost and it doesn't absorb very well in the GI tract.
what is the most known anti-infective agent that is contraindicated for pregnant women?
Tetracycline
How do antibiotics get into the bacteria and kill it?
They attack the cell wall to get in and destroy it
what are the adverse reactions with anti-infective agents and oral contraceptives?
They may have a decreased effectiveness due to increased clearance when using together.
What do all penicillins have?
Beta-Lactum ring and vary based on chemical attached to this ring
What other anti-infective agent may be okay to prescribe to a pregnant woman?
Clindamycin
What anti-infective agent has the highest incidence causing GI symptoms?
Erythromycin
What are the adverse reactions with anti-infective agents and the GI tract?
Stomach pain increased motility diarrhea
What makes up augmentin?
amoxicillin and clavulanic acid
what can of spectrum and cost does Penicillin V have?
narrow spectrum and inexpensive
what are penicillinase-resistant penicillins used to tx against?
used to treat the penicillinase enzyme producing bacteria
What are the 4 groups of penicillin?
1. Penicillin G and V 2. Penicillinase-Resistant Penicillins 3. Ampicillin 4. Extended Spectrum Penicillin
what are the ampicillins used to treat?
1. Upper respiratory tract infections 2. Meningitis 3. Gonorrhea 4. Ear infections 5. Urinary tract infections
What are the factors that determine the likelihood of infection?
1. Virulence of microorganism 2. Inoculum - number of organisms present 3. Resistance of the host - local or systemic
What percentage of patients have a penicillin allergy (type 1-4)?
5-10%
What percentage of the world population will have an allergic response to anti-infective agents?
5-10%
What does bacteristatic mean?
Ability to inhibit or retard the multiplication or growth of bacteria
What does bacteriocidal mean?
Ability to kill bacteria
What antibiotic is most likely to decrease effectiveness of oral contraceptives?
Ampicillin
What are the antibiotics that fall under ampicillins
Ampicillin Amoxicillin
what may need to be prescribed for the patient if a perio pocket does not respond to repeated RP/SC?
An antibiotic may be needed to alter the flora
What anti-infective agents are considered to be the most expensive agents?
Augmentin Cefluroxime
What is the one weird effect that ampicillin have on the body?
Can cause a rash that is not allergic in nature
What is hepatitis A?
Caused by the hepatitis A virus; usually transmitted by contact with contaminated food or water.
What is hepatitis B?
Caused by the hepatitis B virus; transmitted through sexual contact or contact with selected blood or body fluids
What is hepatitis D?
Causes symptoms when hepatitis B is present
what is multiple sclerosis?
Disease in which the protective coverings (myelin) or nerve fibers in the brain are gradually destroyed; symptoms vary from numbness to paralysis and loss of control of bodily function
What is jock itch?
Fungal infection in the groin area
What is Penicillin G usually used for?
IM or IV
What is an opportunistic infection?
Infection by organisms that would be harmless to a healthy person but causes infection in those with a weakened immune system (e.g. persons with AIDS chemotherapy pateints0.
What are genital herpes?
Infection caused by the herpes simplex virus, which causes a painful rash of fluid-filled blisters on the genitals; transmitted through sexual contact
What does clavulanic acid do to bacteria?
Inhibits the Beta Lacramase enzyme that is produced by bacteria.
What does a decrease in antibiotics do?
It decreases resistant organisms
What does an increase in antibiotic use in a given population do?
It increases the proportion of resistance organisms.
What causes the organism to always be resistant to the antibiotic?
It is due to the normal structure of the bacteria, like lipid structures of the cell wall.
What can Penicillin G not be used for?
Kidney disease low sodium diet patients
what is the first drug that is given in the dental office?
Local anesthetic
If patients are not immuncompromised or if drainage can occur do they need to be on antibiotics?
No, they don't need to be
What is antagonism?
Occurs when a combination of two agents produces less effect than either agent alone.
What is natural immunity (resistance)?
Occurs when an organism has always been resistant to the antibiotic
What does superinfection or suprainfection mean?
Overgrowth of an organism, normally not present. Cause is usually iatrogenic, usually by using a wide spectrum antibiotic
What are some of the general adverse reactions and disadvantages with superinfections?
Overgrowth of other organisms Can be minimized by using the most specific agent possible
What is neuralgia?
Pain along the course of a nerve
How are extended spectrum penicillins administered?
Parenterally
What is an infection?
Pathogen can be present, but not be an infection. Depends on the virulence (disease producing power), number of organisms present (inoculum), and host resistance (immunologic response both locally and systemically)
What are the most often used anti-infective agents prescribed to pregnant women?
Penicillin and Erythromycin
What does penicillin V come in?
Potassium salt form
What are the adverse reactions with anti-infective agents and oral anticoagulants?
Potentiate effects of the anticoagulant (increase bleeding)
What are interferons?
Proteins produced by body cells that fight viral infections and certain cancers.
What does spectrum mean?
Range of activity of a drug. Example: narrow spectrum or wide spectrum.
What is morbidity?
State of being ill or having a disease
What does anti-infective mean?
Substances from any source that act against or destroy infections
What does antibacterial mean?
Substances from any source that destroy or suppress the growth or multiplication of bacteria
What are antibiotics?
Substances that are produced by microorganisms that destroy or suppress the growth or multiplication of bacteria.
What does antifungal mean?
Substances that destroy or suppress the growth or multiplication of fungi
What does antimicrobial mean?
Substances that destroy or suppress the growth or multiplication of microorganisms
What does antiviral mean?
Substances that destroy or suppress the growth or multiplication of viruses
Why are penicillin and erythromycin the most often precribed for pregnant women?
They are not teratogenic
How do organisms become resistant to antibiotics without being exposed?
They can pass DNA (genetic material) to a second organism which is then resistant but never encountered the antibiotic.
What medications fall under Extended spectrum penicillins?
Ticarcillin Piperacillin Carbenicillin
What is hepatitis C?
Transmited through sexual contact or contact with infected blood or body fluids
What is an antibiotic that has been found to be effective against MRSA?
Vancomycin
What do anti-infective agents reduce within the body?
Vitamin K producing flora
What is acquired immunity (resistance)?
When a bacteria previously sensitive to an antimicrobial agent develops resistance
What is synergism?
When the combination of two antibiotics produce more effect than would be expected if their individual effects were added.
Are the adverse reactions with anti-infective agents and the GI tract considered to be dose related?
Yes they are
What is amoxicillin best used to treat in the dental field?
acute periapical infections pre-medication
What is penicillin used for in the dental field?
acute periapical infections pre-medication prior to dental tx
What does the clavulanic acid do to help the amoxicillin?
allows the amoxicillin protection from the breakdown by the enzyme so it can destroy the bacteria
What anti-infective agents are the least expensive?
amoxicillin cephalexin doxycycline erythromycin metronidazole penicillin tetracycline
What do many dental infections not require?
antimicrobial agents
Why are anti-infective agents important?
because infection is the second most common dental problem for which drugs are given.
What anti-infective agents are slightly more expensive than the least expensive agents?
ciprofloxacin clindamycin
What is Vitamin K used to synthesize?
clotting factors
What does penicillin do specifically to the bacteria?
destroys the cell wall and leads to lysis
what is penicillin V good for in the dental field?
good against bacteria that is found orally and good for acute periapical infections
What medications fall under Penicillinase-Resistant Penicillins?
methicillin cloxacillin dicloxacillin
What is the best way to administer penicillin to avoid an allergic reaction?
orally
How can penicillin be administered?
orally parentally
what is penicillin most effective against?
rapidly growing organisms
What is Penicillin G available in?
sodium potassium procaine benzathine salt forms
What bacteria are resistant to penicillins?
some staphylococcus bacteria produce and release enzymes 1. beta lactamase 2. Penicillinase
What else needs to be considered when using the resistance of the host as a factor to determine likelihood of infection?
systemic disease sleep deprivation; anxiety
What do Erythromycin and metronidazole inhibit?
the enzymes that break down warfarin increasing blood levels of warfarin
What do the two enzymes do to the penicillins
they cleave the beta lactam bonds or penicillin making it infective
What kind of spectrum do extended spectrum penicillins have?
wide spectrum
What does penicillin do to make it a potent bactericidal?
works by attaching to the bacterial enzymes that are involved in synthesis of the bacterial cell wall
Does penicillin V absorb in the GI tract well?
yes it does
Are penicillins bactericidal?
yes they are
Can organisms become resistant without being exposed to the antibiotics?
yes they can
