La tétracycline, connue sous le nom commercial Sumycin, agit en bloquant la fixation de l’ARNt sur la sous-unité 30S ribosomale, interrompant l’élongation de la chaîne protéique bactérienne. Ce mécanisme confère une activité sur un spectre large, incluant bactéries Gram positives, Gram négatives, rickettsies et spirochètes. Sa biodisponibilité digestive varie selon la prise alimentaire et les interactions avec les ions divalents comme calcium et magnésium. Sa diffusion tissulaire est importante, notamment dans les voies respiratoires et génito-urinaires. L’élimination se fait par voie rénale et biliaire. Les effets indésirables incluent photosensibilisation, troubles digestifs et coloration dentaire en cas d’administration précoce. Les guides thérapeutiques mentionnent sumycin prix, en soulignant la nécessité de restreindre son utilisation afin de limiter les résistances acquises.

New referral form

Canterbury Oral & Maxillofacial Surgery Kurt F. Martin, DDS, MD
Ronald L. Roholt, DDS, MD
Craig E. Miller, DDS
Referring Doctor_________________________________________Person that Scheduled________________________________________ Patient Name_____________________________________________________________________________________________________ Patient Address_________________________________________________City__________________________ZIP__________________ Home Phone________________________________________Work Phone____________________________________________________ Alternate Phone__________________________________ O Male O Female Date of Birth_______________________________
Is this a former patient? O Yes O No
If yes, when?______________________________ last name (s) used______________________________________________________
What are we seeing this patient for? O Tooth extraction # (s)____________________________________________________________

O Implant # ___________________________ O Other____________________________________________________________________
Diagnosis:
O Non-Restorable Tooth O Acute apical periodontitis O Other _____________________________________________________________________________________________
What are the patient’s symptoms? O asymptomatic
O Other _______________________________________________________________________________________________________ Have you seen the patient for this condition? O Yes

Has there been any treatment performed or medication prescribed? ______________________________________________________

________________________________________________________________________________________________________________
Is this an emergency (STAT) or urgency (see within the week)? O Yes
If yes, please circle if it is STAT or urgent.
Other Information:
(If yes, we would ask the referring doctor to prescribe and instruct the patient to take 1 hour before surgery) History of Chemotherapy or Immunosuppressants? Yes History of Bisphosphanates? (Fosamax, Actonel, Didronel, Skelid, Boniva, Aredia, Zometa, Reclast, Other __________) If yes, has the patient been on it over 3 years?
Has the patient had a pano done within the last year? O Yes
If yes, please send a diagnostic copy to our office showing all anatomy clearly.
Referring Doctor’s Signature: ______________________________________________________________________________________
PLEASE FAX THIS FORM TO THE ABOVE NUMBER OR IF X-RAYS ARE AVAILABLE PLEASE E-MAIL OR MAIL PRIOR TO
THE PATIENTS APPOINTMENT.
For Office Use Only
Date Appointed ___________ Consult Date __________________ Consult Time ______________ Dr. Martin / Dr. Roholt / Dr. Miller

Source: http://canterburyoms.com/yahoo_site_admin/assets/docs/New_Referral_Form.235134802.pdf