Quick update! According to the AHA May 2021 update, Clindamycin is now NO LONGER recommended for antibiotic prophylaxis for patients allergic to penicillin due to concerns over Clostridium difficile infection. Azithromycin is now the go-to alternative and this will be updated on the board exam to reflect that. The full article can be found here: www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000969?fbclid=IwAR0coU1wmmfUcHEb-J5j3q8kbVUFJEFt1B5gHbnEzoK6o3BqDi7Anqt0454
there have been a few updates in 2021 for antibiotic prophylaxis ( such as clindamycin is no longr in the recommended drugs , no prophylaxis for joint replacement pt). would you be able to confirm if these changes apply to the exams as well?
Thank you Dr. Ryan you are an effective teacher. All the way from Philippines 🇵🇭 I want to express my gratitude in all of your videos! Thank you Mental Dental 🦷
Thanks a lot for all your effort to make the exam journey easier on all of us. The content is all high yield and organized in a way that makes it so much easier to retain. It is all accurate in facts and updates are posted as needed.Appreciate it. Gratitude.
Thank you ...many thanks ...u have no idea how much i hated pharma subject and didnt know how to get prepared for the board! Ur a life saver thank youuuuuu
I would like to express my appreciation for making such valuable videos they are really helpful. one typo for our colleagues is @22:22 on the slide show it should be written (Pseudomembranous colitis) not Pseudomonas colitis, :)
thank you sooo much you are very generous and these videos are a real treasure......hope you share us always the most recent researches in the world of dental pharma
Hi, Ryan! Just a quick question: I found in some sources that clindamycin is a macrolide antibiotic. Most of the sources say it is lincosamide. Which one is it? I am giving you one or two titles Principles and practice of pediatric infectious diseases 2018. - clindamycin is a macrolide antibiotic. Biofilm in infection prevention and control 2014 - the spectrum of activity of clindamycin is generally similar to that of macrolides. Thank you. When you study for exams these not very important details become very important
Hi Ryan! I know your videos are from last year, but I read that now according to the lastest ADA statements, no prophylactic antibiotic regime is required for joint replacement unless indicated by the orthopedic surgeon. So I am confused now, for 2019 board Q's it is now better to choose that is NOT required this ATB prophy? (even if the First Aid says so)
Hi there! Thanks for the great clarifying question and you are exactly right. For boards, I would always choose that NO prophylactic antibiotics are required for joint replacement unless specifically indicated by the orthopedic surgeon!
Hello Dr Ryan thank you so much for your videos.. I read that now according to the latest ADA statements, that Clindamycin is now not a first choice for PCN allergy for prophylaxis... it should be azithromycin? correct??
Hi, you mentioned that there is a need for abx prophylaxis for a pt with prosthetic joint replacement, however I leanrt that we do not give prophylaxis anymore. Can you please confirm what to answer for the board. Thank you
I love all your videos they are very helpful am from sudan and We graduate with a degrees of oral and maxillofacial surgery too my question is if I were to take the NBDE do I have to study 2 more years in the US and is that for all staes there? If U can make a video for international dental students on this topic this would really be helpful. And thank u in advance
I am glad to hear my videos are helpful for you! Please refer to the ASDA website for information on international students: www.asdanet.org/index/dental-student-resources/tips-for-international-dental-students
Hey Dr Ryan, I have a question about not mixing bactericidal / bacteriostatic drugs together, but doxycycline and metronidazole often get prescribed together and was wondering if you knew about those interactions.
very thanks dr really wounderful explaination nearly saw all your playlist im preparing on MJDF exam if u dont mind make a series about some topics on that exam thx.
Yes you are right, and I personally agree with that! But I’m teaching to the board exam and the Ceflex recommendation as per an orthopedic surgeon is what seems to be tested currently.
Mental Dental alright .. but dental decks and dentin are the main sources for board exam so how to know that the exam makers don’t depend on what’s written in these sources or not ? ☹️
I am confused ! Some parts of information in this video about indications of antibiotic prophylaxis are not compatible with the Oral medicine video about the prophylaxis such as: prosthetic join and Mitral valve prolapse with regurgitation which does not need prophylaxis in the Oral medicine video but they need prophylaxis here !!!! Would you please tell me what should I do about these???
Mac and link are psychopaths in the making!!! Lmao This video is so great and super informative! This guy is great bcuz it really is phenominal! Its appreciated by many, I'm sure!
Antibiotic prophylaxis for prosthetic joints is not longer recommended. Do you think they are up-to-date with this on the exam? or should we choose Keflex anyway if all options are available
They should be up to date with this and not recommend antibiotics for joint prophylaxis. However, if that is not an option, then you would select Keflex.
Hi Rayan thanks for the video again could you please mention here what will be the AB of choice for children with Pen allergy through IV? like the choice most important in board exam for examiners. Thanks
Whenever you see Penicillin allergy on a boards question, think Clindamycin! The Clindamycin could be delivered orally or IV and it would be at the dose I stated in the video--20 mg/kg.
Oral infections caused by organisms that produce penicillinase should be treated with A. Ampicillin B. Dicloxacillin C. Erythromycin D. Any of the above E. Only A and C Please answer sir
Penicillinase is synonymous with Beta-lactamase which is an enzyme that certain potent bacteria can produce to cleave the Beta-lactam ring of some penicillins and cephalosporins, rendering them useless. Dicloxacillin is one of the "Beta-lactamase resistant" penicillins, so I would select B in this case. Erythromycin is not a penicillin so it would probably be fine to use as well, but it has an entirely different mechanism of action and is more typically used for skin infections and respiratory tract infections, not oral infections. Where did this question come from?
Hi Ryan! First of all thank you very much for your videos. I'm preparing myself to take the INBDE this year and your material is helping me a lot. Now I wanted to ask you something I saw while studying from the Dental Decks: Is it okay to put as a Side Effect the long QT Interval Syndrome for erythromycin antibiotic? I really appreciate your answer and time in advance!
I am glad to hear that! That is a correct statement, although I think it would be rare for that concept to show up on either the old or new board exam.
I don't have the full answer to your question, but what I know is that some of the bacteriostatic drugs -such as sulfonamides- were used long before the discovery of penicillin. Another indication for the use of other bacteriostatic drugs would be in cases of patients who are allergic to the bactericidal drugs
Good question--no they are not necessary! Recent MI may be indication for deferring elective dental treatment until the patient is more stable, but it is not an indication for antibiotic prophylaxis. Only the things I mentioned in that slide require it according to the AHA.
so if a question asked if patient had a med HX of MI and a knee replacement 6 months ago, would they need premedication if they wanted to be seen today for a procedure?
So this is a tricky question, because like I said in the video, it really depends on the orthopedic surgeon whether they require it or not. Prosthetic joint prophylaxis has had an ongoing debate back and forth, and currently most dentists would say it is not necessary, while a handful of medical providers still prescribe antibiotics for these patients. All that being said, I honestly don't think you will get a question that asks this. A question that asks whether or not a patient needs prophylaxis will be from the slide I mentioned about those four cardiac conditions.
Well, if that is the case, then I would say no, do not prescribe antibiotics for that patient. But a better answer would be to check with their physician.
Thank you so much for these awesome videos!! Currently studying for INBDE. I just had one comment though on the antibiotic prophylaxis medications. I think the med list has been updated and clindamycin is no longer recommended 2nd line and azithromycin 500mg or some other alternatives are instead? Not sure if the exams this year and next year reflect that change.
It depends! A low percentage of the population is cross-allergenic, which means if they are allergic to penicillin they may also be allergic to cephalosporins, because the two drugs are chemically related. Historically, this was taught to be around 10% but now people think it is actually much lower than that.
You can get them one of two ways! You can either sign up on my Patreon page for at least $10/month www.patreon.com/mentaldental or send $30 to me directly via PayPal www.paypal.me/mentaldental for the NBDE Part II slides (or $15 for the INBDE slides)
It is the prescription and administration of antibiotics prior to dental procedures to prevent prosthetic joint infection, which is generally not recommended anymore.
Hello doctor I am studying to inbde with your 10 week plan. I only go for the second week. I would like to ask you why not this biochemistry and microbiology? Is it necessary then to review these two subjects separately?
Those topics are hardly covered on the new exam, so I do not recommend spending much time reviewing those topics in depth, outside of the context of clinical dentistry (microbiology in periodontics, etc.)
@@heenakakadiya5698 Enter mental dental on the web, choose pass your exam, sign up, and select the 10-week plan. It's only $ 10 a month, they give you a study schedule, and you can print out the video slides and make notes on them.
thanks Dr. Ryan! Can you clarify for me - I though penicillin was not a broad spectrum antibiotic but in the video you mention that it is. I thought augmentin is broad spectrum but penicillin is not. Thanks!
Quick update! According to the AHA May 2021 update, Clindamycin is now NO LONGER recommended for antibiotic prophylaxis for patients allergic to penicillin due to concerns over Clostridium difficile infection. Azithromycin is now the go-to alternative and this will be updated on the board exam to reflect that. The full article can be found here: www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000969?fbclid=IwAR0coU1wmmfUcHEb-J5j3q8kbVUFJEFt1B5gHbnEzoK6o3BqDi7Anqt0454
there have been a few updates in 2021 for antibiotic prophylaxis ( such as clindamycin is no longr in the recommended drugs , no prophylaxis for joint replacement pt). would you be able to confirm if these changes apply to the exams as well?
Are the other indications of prophylaxis correct per the new update?
😂
Thank you Dr. Ryan you are an effective teacher. All the way from Philippines 🇵🇭 I want to express my gratitude in all of your videos! Thank you Mental Dental 🦷
You are the best teacher on this earth,thanks so much for all your efforts for making us understand the topics we always wanted to 🙏😊
Thanks a lot for all your effort to make the exam journey easier on all of us. The content is all high yield and organized in a way that makes it so much easier to retain. It is all accurate in facts and updates are posted as needed.Appreciate it. Gratitude.
You’re very welcome! So glad the content is helpful for you 😁
My classmates and I are taking part two in 2 weeks we anxiously await your videos to watch them as they’re posted!
Solange Perez hope u passed the exam !
Best video explaning antibiotics ever
Thank you very much! 🙏🏼
Your videos are the best! I can finally understand any subject you explain! Thank you!
So happy to hear that! You’re welcome! ☺️
Thank you ...many thanks ...u have no idea how much i hated pharma subject and didnt know how to get prepared for the board! Ur a life saver thank youuuuuu
Thank you dr.Ryan 🌸🌸
All your videos are so helpful and informative
The way mice was thrown.. hilarious 😂. Thank you for the memory trick. I will remember this for life. 🙏
It was so amazing, I really appreciate dr. Ryan for your kindness to make these videos 🙏🙏🙏
My pleasure! 😊
I'm only trainee dental nurse but yr knowledge is outstanding. Thanks
Thank you for your efforts.. Sooooooooooooo helpful 😍 please make more. Sharing it with my friends
I would like to express my appreciation for making such valuable videos they are really helpful. one typo for our colleagues is @22:22 on the slide show it should be written (Pseudomembranous colitis) not Pseudomonas colitis, :)
thank you sooo much you are very generous and these videos are a real treasure......hope you share us always the most recent researches in the world of dental pharma
Thank you so much, Dr Ryan! 🌸
great video Dr. Ryan Thank you so so much for your time and knowledge. God Bless you and your family
You're a hero sir.
Awesome style of explanation!
Thank you for the summary Dr. Ryan, pharmacology doesn't seem as daunting anymore
I have an oral exam in 3 days and this is going to save me...
Thank you a ton for such amazing content. You explain the information in such a soothing yet detailed matter!
Thank you for your wonderful videos Dr. Ryan.
You’re very welcome! 😁
Keep uploading for us basics and advanced we are benefited a lot..revising and learning many things from you. Keep uploading my dear friend
Thank you so much. It's so informative and well explained.
This is my second time to go back to your videos to review
Thanks again :)
Thank you for everything!!
I just loved it..thank you so much !
Thanks alot. You're the best.
Very well organised video! Thanks so much. :D
Excellent n great way of teaching n very knowledgeable thanks.
omg omg omg this is a treasure Channel omg you are the best i'm so sorry my english is so bad
thank you for your great videos! SO helpful.
thank you so much
Excellent, thank you
I really love ur vid!!!! Thanks for making vids. Really helpful for my study
I hope u can make more video. Love from me for you, ur fan 💞💞
Thank you! Always working on new videos, so stay tuned for more coming soon.
Hello , you can also memorize penicillin G cannot be given where Gastric acid found ( g doesn't go with g ) 😎
You can remember that V letter looks like tongue for penicillin V,,,, or,,,,, penicillin V is for Verbal
thank you
Hi, Ryan! Just a quick question: I found in some sources that clindamycin is a macrolide antibiotic. Most of the sources say it is lincosamide. Which one is it?
I am giving you one or two titles Principles and practice of pediatric infectious diseases 2018. - clindamycin is a macrolide antibiotic.
Biofilm in infection prevention and control 2014 - the spectrum of activity of clindamycin is generally similar to that of macrolides.
Thank you. When you study for exams these not very important details become very important
Hi Ryan! I know your videos are from last year, but I read that now according to the lastest ADA statements, no prophylactic antibiotic regime is required for joint replacement unless indicated by the orthopedic surgeon. So I am confused now, for 2019 board Q's it is now better to choose that is NOT required this ATB prophy? (even if the First Aid says so)
Hi there! Thanks for the great clarifying question and you are exactly right. For boards, I would always choose that NO prophylactic antibiotics are required for joint replacement unless specifically indicated by the orthopedic surgeon!
Thank you Ryan! Great topic ;^)
Hello Dr Ryan thank you so much for your videos.. I read that now according to the latest ADA statements, that Clindamycin is now not a first choice for PCN allergy for prophylaxis... it should be azithromycin? correct??
Yes that is correct! I have a newer video on Antibiotic Prophylaxis that addresses this change.
Hi, you mentioned that there is a need for abx prophylaxis for a pt with prosthetic joint replacement, however I leanrt that we do not give prophylaxis anymore. Can you please confirm what to answer for the board. Thank you
thank you very much !
Dr. Ryan, what about the Renal patient undergoing hemodialysys, is it necessary atb prophyilaxis?
I love all your videos they are very helpful am from sudan and We graduate with a degrees of oral and maxillofacial surgery too my question is if I were to take the NBDE do I have to study 2 more years in the US and is that for all staes there? If U can make a video for international dental students on this topic this would really be helpful.
And thank u in advance
I am glad to hear my videos are helpful for you! Please refer to the ASDA website for information on international students: www.asdanet.org/index/dental-student-resources/tips-for-international-dental-students
Hey Dr Ryan, I have a question about not mixing bactericidal / bacteriostatic drugs together, but doxycycline and metronidazole often get prescribed together and was wondering if you knew about those interactions.
very thanks dr really wounderful explaination nearly saw all your playlist im preparing on MJDF exam if u dont mind make a series about some topics on that exam thx.
According to new guidelines prosthetic joint surgery doesn’t need antibiotics prophylactics before dental procedure??
good video thank you
love it
Dr Ryan .. new recommendation said that no need for antibiotics prophylactic for joint replacement regardless the period
It is from ADA ..
Yes you are right, and I personally agree with that! But I’m teaching to the board exam and the Ceflex recommendation as per an orthopedic surgeon is what seems to be tested currently.
Mental Dental alright
.. but dental decks and dentin are the main sources for board exam so how to know that the exam makers don’t depend on what’s written in these sources or not ? ☹️
Dear dr Rayan,
Could you plz clarify the prophylaxis part where says joint replacement needs keflex but the books says not anymore
Thank you
شكرا😍
I am confused ! Some parts of information in this video about indications of antibiotic prophylaxis are not compatible with the Oral medicine video about the prophylaxis such as: prosthetic join and Mitral valve prolapse with regurgitation which does not need prophylaxis in the Oral medicine video but they need prophylaxis here !!!! Would you please tell me what should I do about these???
The Oral Medicine is the newer video, and was updated to include the changes in recommendations over the years! 😊
Thanks! :))@@mentaldental
Nice it helped me
Dr. Rayan do you think the INBDE series is enough to pass ORE part 1 exam?
21:58 Do you mean to say "Pseudomembranous Colitis" instead of "Pseudomonas Colitis"?
Yes, thank you for pointing that out!
Mac and link are psychopaths in the making!!! Lmao
This video is so great and super informative! This guy is great bcuz it really is phenominal! Its appreciated by many, I'm sure!
Antibiotic prophylaxis for prosthetic joints is not longer recommended. Do you think they are up-to-date with this on the exam? or should we choose Keflex anyway if all options are available
They should be up to date with this and not recommend antibiotics for joint prophylaxis. However, if that is not an option, then you would select Keflex.
Hi Rayan thanks for the video again could you please mention here what will be the AB of choice for children with Pen allergy through IV? like the choice most important in board exam for examiners.
Thanks
Whenever you see Penicillin allergy on a boards question, think Clindamycin! The Clindamycin could be delivered orally or IV and it would be at the dose I stated in the video--20 mg/kg.
Oral infections caused by organisms that produce penicillinase should be treated with
A. Ampicillin
B. Dicloxacillin
C. Erythromycin
D. Any of the above
E. Only A and C
Please answer sir
Penicillinase is synonymous with Beta-lactamase which is an enzyme that certain potent bacteria can produce to cleave the Beta-lactam ring of some penicillins and cephalosporins, rendering them useless. Dicloxacillin is one of the "Beta-lactamase resistant" penicillins, so I would select B in this case. Erythromycin is not a penicillin so it would probably be fine to use as well, but it has an entirely different mechanism of action and is more typically used for skin infections and respiratory tract infections, not oral infections. Where did this question come from?
I am preparing for AFK
So got from a group
Thanks a lot sir
Love you classes
Anyone know where to check out the latest update regarding prophylactic antibiotics?
Thank you so much !! It's very helpful and simple!!!
Thanks alote for sharing the info))
You’re welcome 😊
12:48 I see you are a man of culture as well. A fellow brother
You're the best!
When will we have a video on anti fungal and anti viral?
Hi Ryan! First of all thank you very much for your videos. I'm preparing myself to take the INBDE this year and your material is helping me a lot. Now I wanted to ask you something I saw while studying from the Dental Decks: Is it okay to put as a Side Effect the long QT Interval Syndrome for erythromycin antibiotic? I really appreciate your answer and time in advance!
I am glad to hear that! That is a correct statement, although I think it would be rare for that concept to show up on either the old or new board exam.
@@mentaldental Thank you very much for your answer. I really appreciate yout effort!!
Just found your channel your narrative and notes are awesome looking forward to watching the rest of your channel
Can somebody please answer me this question? If we have bactericidal antibiotics, why do we need bacteriostatic antibiotics?
I don't have the full answer to your question, but what I know is that some of the bacteriostatic drugs -such as sulfonamides- were used long before the discovery of penicillin. Another indication for the use of other bacteriostatic drugs would be in cases of patients who are allergic to the bactericidal drugs
@@Bishr2038 Thanks!! so far that is the best answer i got
for clindamycin.. did you mean pseudomembranous colitis ?
so antibiotics are not necessary if a patient has a recent MI? like less than 6 months ago?
Good question--no they are not necessary! Recent MI may be indication for deferring elective dental treatment until the patient is more stable, but it is not an indication for antibiotic prophylaxis. Only the things I mentioned in that slide require it according to the AHA.
so if a question asked if patient had a med HX of MI and a knee replacement 6 months ago, would they need premedication if they wanted to be seen today for a procedure?
So this is a tricky question, because like I said in the video, it really depends on the orthopedic surgeon whether they require it or not. Prosthetic joint prophylaxis has had an ongoing debate back and forth, and currently most dentists would say it is not necessary, while a handful of medical providers still prescribe antibiotics for these patients. All that being said, I honestly don't think you will get a question that asks this. A question that asks whether or not a patient needs prophylaxis will be from the slide I mentioned about those four cardiac conditions.
I had that question on my exam with that exact scenario in the cases lol
Well, if that is the case, then I would say no, do not prescribe antibiotics for that patient. But a better answer would be to check with their physician.
Thank you so much for these awesome videos!! Currently studying for INBDE. I just had one comment though on the antibiotic prophylaxis medications. I think the med list has been updated and clindamycin is no longer recommended 2nd line and azithromycin 500mg or some other alternatives are instead? Not sure if the exams this year and next year reflect that change.
Yes, the exam reflects those new changes! I discuss in the updated Oral Medicine video on antibiotic prophylaxis 😊
current literature shows that Penicillin G is given intramuscularly, not intravenously
Thanks for the great video Dr. Ryan! Was just wondering if aminoglycosides are another class of abx we should know for the boards? Many thanks!
Not quite as high yield, but might be nice to know if you have the room for it!
And my mom said videogames weren't a productive use of my time. I'll be picturing an epic battle over mice come test day.
Haha, love it!
Question plz, patients allergic to PNC, can we give them Cephalosporins? Thank you!!
It depends! A low percentage of the population is cross-allergenic, which means if they are allergic to penicillin they may also be allergic to cephalosporins, because the two drugs are chemically related. Historically, this was taught to be around 10% but now people think it is actually much lower than that.
Mental Dental got it! Thanks!!
Gays , where can I find a specific questions for each topic in pharm to practice ( for nbde 2 exam ) ?
Hi Dr. RYAN You don,t mention Metronidazole in your tutorial
mottis( first letter of all bacteriocidals including Trimethoprim ,Oxazolidinones )
Nice vedio
What would you give IV or IM if they had a Pen allergy?
Where can i found the slides, so i can write the notes on there?
You can get them one of two ways! You can either sign up on my Patreon page for at least $10/month www.patreon.com/mentaldental or send $30 to me directly via PayPal www.paypal.me/mentaldental for the NBDE Part II slides (or $15 for the INBDE slides)
thank u dr but I THINK this is an old information as now we don't give AB in mitral valve prolapse even WITH regurgitation
Yes, I agree that MVP with or without regurgitation does not require prophylaxis: www.ncbi.nlm.nih.gov/pmc/articles/PMC5662431/
you are awesome DR
What is proshetic joint prophylaxis ??
It is the prescription and administration of antibiotics prior to dental procedures to prevent prosthetic joint infection, which is generally not recommended anymore.
@@mentaldental thq sir
Hasn't prophylactic antibiotics stopped? For heart ?
Mac likes to throw mice!!! Awsome
He does! 😉
Mac likes to throw mice lol
Lovely
Please upload more topics
Hello doctor I am studying to inbde with your 10 week plan. I only go for the second week. I would like to ask you why not this biochemistry and microbiology? Is it necessary then to review these two subjects separately?
Those topics are hardly covered on the new exam, so I do not recommend spending much time reviewing those topics in depth, outside of the context of clinical dentistry (microbiology in periodontics, etc.)
@@mentaldental thanks for answering my question
haloo hii Maria.. what is 10 week plan ?? can you share it please?
@@heenakakadiya5698 It’s a mental dental plan.
@@heenakakadiya5698 Enter mental dental on the web, choose pass your exam, sign up, and select the 10-week plan. It's only $ 10 a month, they give you a study schedule, and you can print out the video slides and make notes on them.
thanks Dr. Ryan! Can you clarify for me - I though penicillin was not a broad spectrum antibiotic but in the video you mention that it is. I thought augmentin is broad spectrum but penicillin is not. Thanks!
What are your favorite video games, doc?
Anything Nintendo!
20:00 interesting
💚💚💚
why there arent other groups like amınoglıkoside
just curıos would be awasome ıf they were
You play smash bros dr? 💯👊🏼
Sure do! 💪🏼
Mac likes to throw my sins