Dentistry simplified

          FLUOROQUINOLONES This are quinolones antimicrobials having one or more fluorine substitutions.  Fluorination of the quinolone structure at position 6 and introduction of a piperazine substitution at position 7 resulting in a derivative called fluoroquinolones.  Classification- First Generation fluroquinolones- Norfloxacin                       ofloxacin Ciprofloxacin                     pefloxacin Second Generation fluroquinolones- Lomefloxacin                     sparofloxacin Levofloxacin                       Gatifloxacin                                           ...

                        Quinolones These are synthetic antimicrobials having a quinolone structure and are active against gram negative bacteria.  Nalidixic acid is the first member.                      Nalidixic acid 1.It is  active against gram- negative bacteria especially E. Coli, proteus, klebsiella. Adverse effects of Nalidixic acid  1.  Individuals with G-6PD deficiency may develop haemolysis.  2.  Phototoxicty is rare.  3.  Consist mainly of g. i upset and rashes.  4.  Most important toxicity is neurological- headche, drowsiness, vertigo, visual disturbance, seizures.  Uses of nalidixic acid- 1.  used as urinary antiseptic.  2.  Used in diarrhoea caused by shigella, E. Coli and proteus. 

         COTRIMOXAZOLE COTRIMOXAZOLE is the fixed dose combination of trimethoprim and sulfamethoxazole.  Sequential block in bacterial folate metabolism PABA-para aminobenzoic acid, DHFA-Dihydrofolic acid, THFA-Tetrahydrofolic acid.   brand names include are  Septra, Bactrim, Apo-Sulfatrim, or Novo-Trimel.  Cotrimoxazole  comes in tablet and liquid form. Adverse effects of cotrimoxazole a) Nausea, vomiting, stomatitis, headache and rashes - Are common manifestations.  b) Neonatal haemolysis and methhaemoglobinemia occurs.  c) Hypersensitivity- Hypersensitivity reaction like rashes, headache and stomatitis  occurs.  d) Blood dyscrasis occurs rarely.  e) Folate deficiency (megaloblastic anaemia)  Occurs only in patients with marginal folate levels.  f) Should not be given during pregnancy. Trimethoprim being an antifolate there is a teratogenic ...

                   SULFONAMIDES First antimicrobial agents effective against pyogenic bacterial infections were sulfonamides.  Chemistry They are considered as derivative of sulfanilamide(p-aminobenzene sulfonamides).  Examples of sulfonamides include: sulfamethoxazole/trimethoprim (Bactrim, Bactrim DS, Septra, Septra DS) sulfasalazine (Azulfidine, Sulfazine) sulfisoxazole (Truxazole) What formulations are sulfonamides are available? tablets, injections, and oral solutions. Classication 1.Short Acting (4-8hr) - Sulfadizine 2.Intermediate acting (8-12hr) - Sulfamethoxazole 3.Long Acting(~7days)  Sulfadoxine 4.Special purpose sulfonamides- Sulfacetamide sod., Mafenide, silver sulfadiazine, sulfasalazine.  Adverse effects of Sulfonamides a)   Nausea, vomiting and epigastric pain are common.  b) Neutropenia are rare....