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Pharmacology

Pharmacology
Third Year

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7 antibiotic-dental 7 antibiotic-dental Presentation Transcript

  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved.
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved.
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved. AntibioticsAntibiotics TetracyclinesTetracyclines QuinoloneQuinolone ChloramphenicolChloramphenicol MiscellaneousMiscellaneous
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved. AntibioticsAntibiotics • Medications used to treat bacterial infectionsMedications used to treat bacterial infections • Ideally, before beginning antibiotic therapy,Ideally, before beginning antibiotic therapy, the suspected areas of infection should bethe suspected areas of infection should be cultured to identify the causative organismcultured to identify the causative organism and potential antibiotic susceptibilities.and potential antibiotic susceptibilities.
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved. AntibioticsAntibiotics • Bactericidal: kill bacteriaBactericidal: kill bacteria • Bacteriostatic: inhibit growth of susceptibleBacteriostatic: inhibit growth of susceptible bacteria, rather than killing them immediately;bacteria, rather than killing them immediately; will eventually lead to bacterial deathwill eventually lead to bacterial death
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved. Antibiotics: TetracyclinesAntibiotics: Tetracyclines • demeclocycline (Declomycin)demeclocycline (Declomycin) • oxytetracyclineoxytetracycline • tetracyclinetetracycline • doxycycline (Doryx, Doxy-Caps, Vibramycin)doxycycline (Doryx, Doxy-Caps, Vibramycin) • minocyclineminocycline
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved. Antibiotics: TetracyclinesAntibiotics: Tetracyclines • Natural and semi-syntheticNatural and semi-synthetic • Obtained from cultures of StreptomycesObtained from cultures of Streptomyces • Bacteriostatic—inhibit bacterial growthBacteriostatic—inhibit bacterial growth • Mechanism of actionMechanism of action • Inhibit protein synthes by binding with 30 S-Inhibit protein synthes by binding with 30 S- sub-unit of ribosomesub-unit of ribosome
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved. Antibiotics: TetracyclinesAntibiotics: Tetracyclines • Bind to CaBind to Ca2+2+ and Mgand Mg2+2+ and Aland Al3+3+ ions toions to form insoluble complexesform insoluble complexes • Thus, dairy products, antacids, and ironThus, dairy products, antacids, and iron salts reduce absorption of tetracyclines. Sosalts reduce absorption of tetracyclines. So should not be given with themshould not be given with them
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved. Tetracyclines:Tetracyclines: Therapeutic UsesTherapeutic Uses • Wide spectrum:Wide spectrum: – gram-negative, gram-positive, protozoa,gram-negative, gram-positive, protozoa, Mycoplasma, Rickettsia, Chlamydia, syphilis,Mycoplasma, Rickettsia, Chlamydia, syphilis, • Demeclocycline is also used to treat pleuralDemeclocycline is also used to treat pleural and pericardial effusionsand pericardial effusions
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved. Tetracyclines:Tetracyclines: Side EffectsSide Effects Strong affinity for calciumStrong affinity for calcium • Discoloration of permanent teeth and toothDiscoloration of permanent teeth and tooth enamel in fetuses and childrenenamel in fetuses and children • May retard fetal skeletal development if takenMay retard fetal skeletal development if taken during pregnancy.during pregnancy. • Contra-indicationContra-indication Should not be used in children &Should not be used in children & pregnancypregnancy
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved. Tetracyclines:Tetracyclines: Side EffectsSide Effects Alteration in intestinal flora may result in:Alteration in intestinal flora may result in: • Superinfection (overgrowth of nonsusceptibleSuperinfection (overgrowth of nonsusceptible organisms such as Candida)organisms such as Candida) • DiarrheaDiarrhea • Pseudomembranous colitisPseudomembranous colitis
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved. Tetracyclines:Tetracyclines: Side Effects contSide Effects cont May also cause:May also cause: • Vaginal moniliasisVaginal moniliasis • Gastric upsetGastric upset • EnterocolitisEnterocolitis Skin rashSkin rash
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved. Antibiotics: QuinolonesAntibiotics: Quinolones ( Floroquinolones)( Floroquinolones) • Ciprofloxacin (Cipro)Ciprofloxacin (Cipro) • Enoxacin (Penetrex)Enoxacin (Penetrex) • lomefloxacin (Maxaquin)lomefloxacin (Maxaquin) • Norfloxacin (Noroxin)Norfloxacin (Noroxin) • Ofloxacin (Floxin)Ofloxacin (Floxin) • LevofloxacinLevofloxacin
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved. QuinolonesQuinolones • Excellent oral absorptionExcellent oral absorption • Absorption reduced by antacidsAbsorption reduced by antacids • First oral antibiotics effective againstFirst oral antibiotics effective against gram-negative bacteriagram-negative bacteria
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved. Quinolones:Quinolones: Mechanism of ActionMechanism of Action • Bactericidal by inhibiting DNA gyraseBactericidal by inhibiting DNA gyrase • Effective against gram-negative organismsEffective against gram-negative organisms and some gram-positive organismsand some gram-positive organisms • Alter DNA of bacteria, causing deathAlter DNA of bacteria, causing death • Do not affect human DNADo not affect human DNA
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved. Quinolones:Quinolones: Therapeutic UsesTherapeutic Uses • Lower respiratory tract infectionsLower respiratory tract infections • Bone and joint infectionsBone and joint infections • Infectious diarrheaInfectious diarrhea • Urinary tract infectionsUrinary tract infections • Skin infectionsSkin infections • Sexually transmitted diseasesSexually transmitted diseases
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved. Quinolones:Quinolones: Side EffectsSide Effects Body SystemBody System EffectsEffects CNSCNS headache, dizziness, fatigue,headache, dizziness, fatigue, depression, restlessnessdepression, restlessness GIGI nausea, vomiting, diarrhea,nausea, vomiting, diarrhea, constipation, thrushconstipation, thrush
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved. Chloramphenicol.Chloramphenicol. • Chloramphenicol] is active against a wideChloramphenicol] is active against a wide range ofrange of • gram-positive and gram-negative organisms.gram-positive and gram-negative organisms. However, because of its toxicity,However, because of its toxicity, • its use is restricted to life-threateningits use is restricted to life-threatening infections for which no alternativesinfections for which no alternatives • existexist
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved. • A. Mechanism of actionA. Mechanism of action • The drug binds to the bacterial 50 -SThe drug binds to the bacterial 50 -S ribosomal subunit and inhibits proteinribosomal subunit and inhibits protein synthesissynthesis
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved. • B. Antimicrobial spectrumB. Antimicrobial spectrum • Chloramphenicol, a broad-spectrumChloramphenicol, a broad-spectrum antibiotic, is active not only againstantibiotic, is active not only against • bacteria, but also against otherbacteria, but also against other microorganisms, such as Rickettsia.microorganisms, such as Rickettsia. • Pseudomonas aeruginosa is not aff ected,Pseudomonas aeruginosa is not aff ected, nor are the Chlamydiae.nor are the Chlamydiae. • Chloramphenicol has excellent activityChloramphenicol has excellent activity against anaerobes. The drug isagainst anaerobes. The drug is
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved. • Side effectsSide effects • Bone marrow depressionBone marrow depression • Gray baby syndromeGray baby syndrome
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved. • MiscellaneousMiscellaneous • VancomycinVancomycin • ClindamicinClindamicin
  • Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved.