ch 9 pharm

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ch 9 pharm
2011-03-06 23:15:19

ch 9 pharm starting on slide 45
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  1. what does TJR stand for?
    total joint replacement
  2. who needs TJR prophylaxis?
    someone that is immunocomprimised or commorbities
  3. importance of MAINTAINING ORAL HYGIENE and receiving regular dental care to avoid formation of transient bacteremias is to avoid ______ _______
    Bacterial Endocarditis
  4. _____ makes the guidelines for prevention of IE
    AHA (american heart association)
  5. if someone has a prosthetic heart valve, do they need a prophylaxis?
  6. if someone has had previous endocarditis, do they need to premed before tx?
  7. prophylaxis needed for CHD?
    yes! (CHD=congenital heart disease)
  8. is a prophylaxis needed for unrepaired cyanotic CHD includign palliative shunts and conduits?
  9. is a prophylaxis needed for a completely repaired CHD with prosthetic material or device x 6 mo?
  10. is a prophylaxis necessary for repaired CHD and residual defects at site or adjacent to patch?
  11. do cardiac transplant recipients who develop cardiac valvulopathy need a prophylaxis?
  12. Prophylaxis needed for: Shunts?______! Stents? _____!
  13. ____ min to ___ hour _____ a dental procedure, a prophylaxis should be administered
    30 min to 1 hour
  14. when MUST an antibiotic be taken?
    within 2 hours. able to be taken AFTER the procedure!
  15. if your patient has had a coronary artery bypass graft or stents, should they premed with an antibiotic?
  16. if a patient is taking anticoagulants, but needs to premed for their appt, which route should NOT be used?
    IM injection
  17. if a pt is already taking an antibiotic (amox), what should they take to prevent IE? More amox?
    NO! they should take clindamycin or macrolide
  18. why would someone taking amoxicillin, why would a cephalosporin not be indicated?
    because the chemical structure is close to penicillins
  19. pts with systemic lupus erythematosus or a phen-fen user often manifest immune-medicated cardiac valvular damage and have an increased risk for developing ___
  20. antibacterial prophylaxis not routinely recommended, and consult with a physician if they have had a ________within 2 years or if they are a child. which group is this?
    • splenectomy
    • if they have had their spleen removed
  21. what should be done if someone with uncontrolled diabetes mellitus (DM) comes into the office before elective oral health care is considered?
    refer for medical evaluation
  22. how do you know if an end-stage renal disease or an organ transplant pt needs an antibacterial prophylaxis? how do you know the specific regimen to choose?
    determined in a consultation with the client's physician
  23. when should an antibiotic be considered for a pt with HIV to treat?
    when <500 PMN/mm3 is reported. elective dental tx should be delayed until blood values improve above this level (call physician)
  24. metronidazole + alcohol =
  25. t/f it was reported that more individuals died from developing IE than taking an antibiotic
    FALSE! they died from taking an antibiotic than developing IE
  26. why should pt's taking metronidazole not be taken alcohol because it causes _______ (antabuse) effect of ____, abdominal cramps, and _______
    • disulfiram
    • nausea
    • vomiting
  27. alcohol + CHX should be avoided when when someone is taking _________
  28. t/f if a female is taking an oral contraceptive, and needs antibiotics, who recommends that they use other forms of birth controls during this time?
    AMA (american medical association)
  29. t/f does rifampin for TB reduce the efficacy of oral contraceptives?
  30. oral antibacterial agents and _________ often cause GI disturbances such as acute onset of nausea, retching (make the sound and movement of vomiting), and vomiting
  31. antibacterial agents are a common cause of _______
  32. if someone is taking an antibacterial agent, and complains of bloody diarrhea with lower cramping, this can eventually lead to ____________ _________ if not changed immediately!
    pseudomembranous colitis
  33. which antibacterial agents are dangerous for possible pseudomembranous colitis???
    clindamycin = Cleocin (and lincomycin cause fatality!)
  34. t/f superinfection is possible with most antibacterial agents taken more than a few days
  35. _______ can cause black pigmentation of bone and bluish mucosa
    minocycline (for acne)
  36. several antibacterial agents can cause ____ to ____ staining of mucosa and teeth
    brown to black
  37. t/f there is no firm evidence that any agent is teratogenic when antibacterial drugs are used during pregnancy
  38. what is the most allergenistic antibiotic?
  39. if someone has an allergic rxn with penicillin that ends up to be anaphylactic shock, what should be administered to save them from dying?
    epipen (epinephrine) 1:1,000 injected IM
  40. t/f allergic rxns tend to occur for the first time in ____ or ____-aged adults
    • young
    • middle
    • (younger = greater)
  41. The patient who has had a TJR 1 year ago is returning for oral prophylaxis. All of the following drugs may be prescribed for antibiotic prophylaxis except one. Which one is the exception?
    A) Amoxicillin (penicillin)
    B) Cephradine (velocef-cephlasporin)
    C) Cephalexin
    D) Azithromycin (macrolide) which is not used in tjr
    D) Azithromycin (macrolide) which is not used in TRJ
    (this multiple choice question has been scrambled)
  42. Macrolides (erythromycin, azithromycin, and clarithromycin) are not included in rec. for _____ prophylaxis