ANTIBIOTICS
This section contains a partial listing of popular and useful antibiotics. It is not intended
to be a substitute for accepted references and texts. The lists do not in any way imply
endorsement of a particular antibiotic. Side effects, adverse reactions are those encountered
most often. Each patient must be provided information and be monitored by their clinician.
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Glossary of Abbreviations
Penicillin VK a semi-sythetic penicillin
Popular Brand Names
Pen-Vee K, Beepen-K, NovoPen-VK, V-Cillin K, Veetids, Nadopen-V.
Dose/route:
Oral:
- adult streptococcal infections
- and vincent's angina PO
250-500 mg q6-8h x 10 days,
Drug action:
- Inhibits enzymes responsible for cell wall synthesis of
susceptible organisms. This creates an osmotically unstable cell wall that
swells and bursts from osmotic pressure.
- This drug is bactericidal in normal
doses.
- This drug is excreted through the renal system.
How supplied:
- Tabs 125, 250, 500 mg;
- caps 250 mg;
- film-coated tabs 250, 500 mg;
- powder for oral suspention 125, 250 mg / 5 ml.
Spectrum covered:
- A narrow-spectrum antibiotic because at usual doses it
mainly affects gram-positive aerobic and facultative microorganisms, some
anaerobes, and spirochetes.
- Effective against anaerobes associated with
dental and periodontal diseases of acute or chronic types: Diphtheroids,
fusobacteria, peptostreptococci, spirochestes, Actinomyces, Veillonella, and
some Bacteroides.
- Effectve for gram-positive cocci (S. aureus, S. viridans,
S. faecalis, S. bovis, S. pneumoniae), gram negative cocci (N. gonorrhoeae, N.
memingitidis), gram-positive bacilli (B. anthracis, C. species), gram-negative
bacilli (S. Moniliformis), spirochetes (T. pallidum), Actinomyces,
peptococcus, peptostreptococcus species.
- Penicillin G is slightly more
effective against these organisms than is penicillin V which may be important
in severe infections.
Indications:
- Penicillin V is one of the most frequently prescribed
antibiotics for infections of dental origin.
- Penicillin V has direct
indications for microorganisms involved with infections:
- pneumoncoccal/staphylococcal infections;
- Streptococcal infections;
- prevention of recurence of rheumatic fever/chorea;
- Vincent's angina.
Drug interactions:
Penicillins can decrease the effectiveness of oral
contraceptives. Tetracyclines, erythromycins, lincomycins all decrease the
antimicrobial effectiveness of penicillin. Aspirin, probenecid, and
butazolidin may potentiate penicillin's effects. And finally, penicillin may
potentiate coumadin and tandearil effects.
Contraindications:
Hypersensitivity to penicillins; neonates. In patients
with renal impairment dosages should be decreased since excretion of drug is
by the renal system. Precaution with pregnancy category B, lactation, and
hypersensitivity to cephalosporins.
Side effects:
The penicillins are among the least toxic drugs known. They
rarely elicit adverse reactions in humans unless present in excessive
concentration. They can disrupt the normal gastrointestinal flora and cause
nausea, vomiting, diarrhea, abdominal pain, colitis, and anorexia. To
minimize diarrhea it is recommended that penicillin be taken with two to three
tablespoons of yogart, or a lactobacillum tablet. Fatal anaphylaxis is
estimated to occur in one in 10,000 users. At high doses penicillin can have
a toxic effect that can cause seizures, platelet dysfunction, hemolytic
anemias of an immunologic type, encephalitis, and nephritis.
Pseudomembraneous colitis is an occasional adverse reaction.
References:
Gage,T., Pickett, F.: Mosby's dental drug reference. Mosby publishing,
1996.
Neidle, E., Yageila, J.: Pharmacology and therapeutics for dentistry. Mosby
3rd edition. 1989.
Newman, M., Kornman, K.: Antibiotic/antimicrobial use in dental pratice.
Quintessence Publishing Co., Inc. 1990.