Medische Tandheelkundige Interactie
Overzicht infectieziekten, antibiotica en antimycotica
Inhoudsopgave
Infectieziekten ................................................................................................................................................3
Covid-19 ..............................................................................................................................................................3
Candidiasis ..........................................................................................................................................................3
Hepatitis A ..........................................................................................................................................................4
Hepatitis B...........................................................................................................................................................4
Hepatitis C ...........................................................................................................................................................5
HIV ......................................................................................................................................................................5
Herpes .................................................................................................................................................................6
Herpes Simplex Virus .....................................................................................................................................6
Waterpokken .................................................................................................................................................7
Gordelroos .....................................................................................................................................................7
Epstein-Barr virus ...........................................................................................................................................8
Griep ...................................................................................................................................................................8
Mazelen ..............................................................................................................................................................9
Bof .......................................................................................................................................................................9
HPV ...................................................................................................................................................................10
Chlamydia .........................................................................................................................................................10
Syfilis .................................................................................................................................................................11
Gonorroe ...........................................................................................................................................................11
Legionella ..........................................................................................................................................................12
Tuberculose .......................................................................................................................................................12
Endocarditis ......................................................................................................................................................13
Antibiotica ....................................................................................................................................................14
Bèta-lactam antibiotica ....................................................................................................................................14
1. Penicilline .................................................................................................................................................14
1.1 Flucloxacilline (FXC) ...........................................................................................................................14
1.2 Amoxicilline (AXC) .............................................................................................................................14
1.3 Amoxicilline-clavulaanzuur (AXC-CZ) .................................................................................................15
2. Cefalosporinen .........................................................................................................................................15
3. Carbapenems ...........................................................................................................................................15
Tetracycline .......................................................................................................................................................16
1. Doxycycline (DXC) ....................................................................................................................................16
Macroliden ........................................................................................................................................................17
1. Clindamycine (CDM) ...........................................................................................................................17
Metronidazol.....................................................................................................................................................18
Chinolonen/ Quinolonen ...................................................................................................................................18
, LOTJE GOMMERS BA3 – MEDISCHE TANDHEELKUNDIGE INTERACTIE
Antimycotica.................................................................................................................................................19
Nystatine ...........................................................................................................................................................19
Miconazol..........................................................................................................................................................19
Inhibitors en inducers ...................................................................................................................................20
2
, LOTJE GOMMERS BA3 – MEDISCHE TANDHEELKUNDIGE INTERACTIE
Infectieziekten
Covid-19
Veroorzakende m.o.
SARS-CoV-2: enveloped, enkelstrengs positief RNA-virus met nucleocapside
Overgedragen via
Kleine druppeltjes inademen/ via handen in mond/neus/oog
Symptomen
Verkoudheidsklachten, hoesten, benauwd, koorts, verlies reuk/smaak, ernstige longontsteking,
algehele pijnklachten, oogpijn, spierpijn, duizelig, prikkelbare buik, afvallen/verlies eetlust, diarree,
overgeven, misselijk, oogontsteking, verschillende huidafwijkingen
Beloop van het klinische beeld
Incubatietijd: binnen 10 dagen na laatste contact met een besmet iemand (meestal 5-6 dgn.)
Milde symptomen tot heftige symptomen
Bijzonderheden
Mensen ouder dan 70/ volwassen ouder dan 18 met onderliggende ziekten
Overgegaan op mensen vanuit dieren in China (zoönotisch)
Behandeling
Paracetamol à pijn/koorts
Dexamethason/ andere corticosteroïden: afweersysteem onderdrukken à minder overlijdenskans
Remdesivir: antiviraal middel IV-toediening à klinisch herstel versnellen
Candidiasis
Veroorzakende m.o.
Schimmelinfectie: Candida
Overgedragen via
Ecologische verandering à vermeerdering
Symptomen
Spruw (wit beslag op de tong, wangzakken, palatum, keel), roodheid en pijn, katoenachtig gevoel in
mond, smaakverlies, pijn tijdens eten en slikken, scheuren en roodheid mondhoeken
Beloop van het klinische beeld
Komt weinig voor in gezonde mensen
In slokdarm à verminderd immuunsysteem
Bijzonderheden
1/3 v/d mensen met gevorderde HIV hebben candidiasis in mond/keel
Risicogroep: neonaten (<1 mnd.), dragen protheses, diabetes, kanker, HIV/AIDS, gebruik
AB/corticosteroïden, xerogene medicatie, roken
Behandeling
Preventie: goede MH, poetsen/spoelen na gebruik corticosteroïden
Antischimmelmedicatie: miconazol/ clotrimazol/ nystatine/ fluconazol(heviger/slokdarm) – 7-14 dgn.
medicijn appliceren
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