antimicrobial - pharmacology
DESCRIPTION
pharmacologyuploaded by : Morteza ParmisMCUTRANSCRIPT
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DrugsI. hemostatics/
antihemorragicII. AntibioticIII. AntihistmineIV. Analgesic,
Antipyretic AntiinflammatoryV. AnestheticsVI . Minor tranquilizer,
sedative-hypnotic sedative
antihistamine
Bleeding infection Allergy Pain, Fever
Inflammation
Pain Anxiety/fear
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Drugs that suppress the growth of kill bacteria and other microorganism
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Categories
□ Antibiotic □ Sulfonamide
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Characteristics of an ideal antibiotic □ Be selective and effective without injury to the host□ Destroy microorganism (bacteriocidal)□ Do not become ineffective because of bacterial resistance
Types of Bacterial Resistance
* Natural
e.g. Penicillinase resistant Staphylococcus Aureus
* Acquired
* Cross
e.g. Penicillin and Cephalosporin
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□ not be inactivated by plasma protein, enzymes or body fluid
□ have minimal adverse effects
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Indications
(√) 1. an infection is genuinely present(√) 2. the infection is likely to respond to
the antibiotic(√) 3. the infection is sever enough to
warrant treatment(√) 4. antibiotic is the best form of
treatment
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Points to Remember
(√) antibiotic should not be used unless the
need for them is certain
(√) an adequate history must be taken prior
to treatment
(√) less than therapeutic dose must never be prescribed
(√) administration of 1 ½ hours before and 3 hours after
meals is advisable
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(√) there should be prompt response that is beneficial
usually 24-48 hrs (√) therapy should continue 2-3 days pass the asymptomatic point(√) if antibiotic fails do not hesitate to utilized
other antibiotic therapy or dosage(√) attention must be paid at all times to possible development of adverse effect
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Classification of AntibioticI. Type of Action
bactriocidal bacteriostaticII. Mechanism of action
* inhibition of cell wall* affect cell membrane
permeability* interferes with protein
synthesis* competitive antagonism
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III. Spectrum ( Range of activity)narrow broad
IV. Similarity in chemical structure penicillin – cephalosporin erythromycin- lincomycin
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General Adverse Effects
□ superinfection (fungal infection)□ allergies□ drug interactions□ GIT irritations
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Antimicrobials in Dentistry
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Penicillin Type of Type of
Action Action Mechanism of Mechanism of
ActionAction
SpectrumSpectrum CategoryCategory
bacteriocidbacteriocidalal
Cell wallCell wall
Narrow-Narrow-
Gm(+)Gm(+)
aerobic andaerobic and
facultativefacultative
Gm (-) Gm (-)
N. GonorrheaN. Gonorrhea
N. MeningitidesN. Meningitides
I.I. PrototypePrototype
II.II. OralOral
III.III. PenecillinaPenecillinasese
resistantresistant
IV extended IV extended spectrumspectrum
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Categories
I. Prototype penicillin Pen G Best for treating sensitive
microorganismII. Oral penicillin Pen V (Phenoxymethyl penicillin) Often used for dental infection Available as potassium (K) and free
acid Dosage: 250mg- 500mg every 6 hours
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Categories
I. Prototype penicillin Pen G Best for treating sensitive
microorganism 1 mg sodium Pen G= 1665
units 1 mg of potassium Pen G =
1595 units
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Categories
II. Oral penicillin Pen V (Phenoxymethyl penicillin) Often used for dental infection (Pen
vk) Available as potassium (k) and free
acid Dosage: 250mg- 500mg every 6
hours
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III. Penicillin Resistant Penicillin * cloxacillin, methicillin,
oxacillin
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IV Extended Spectrum Penicillina. Ampicillin-like
ampicillin (Ampicin) 250mg-500mg every 6 hours
amoxicillin ( Amoxil) 250mg-500mg every 8 hours
b. Carbenicillin-likec. Amdinopenicillin
* Clavulanic acid
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Oral and parenteral Degraded by gastric juice Crosses placental barrier Excretion: kidney Uses: dental infection
: prevent bacterial endocarditis
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Erythromycin(Macrolide)Type of Type of ActionAction
MechanisMechanism of m of ActionAction
SpectrumSpectrum Kinds Kinds
bacteriostatic/bacteriostatic/
BacteriocidalBacteriocidalProtein Protein synthesissynthesis
narrownarrow BaseBase
StearateStearate
EthylsuccinEthylsuccinateate
estolateestolate
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Best substitute for patient allergic to penicillin
Adverse effect : cholestatic jaundice precaution: liver disease Dosage: 250 mg - 500mg every 4-6
hours
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Tetracycline
Type or Type or ActionAction
MechanisMechanism of m of ActionAction
SpectrumSpectrum KindsKinds
bacteriostbacteriostaticatic
Protein Protein synthesissynthesis
Broad Broad TetracyclineTetracycline
OxytetracycinOxytetracycinee
DoxycylineDoxycyline
MinocyclineMinocycline
MethacyclineMethacycline
demeclocylinedemeclocyline
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Usually given by mouth Stored in the dentin and enamel of
unerupted teeth Concentrated in the gingival
crevicular fluid Do not give with food with high
calcium content, aluminum oral iron supplements of antacids
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Adverse effects:GIT effectsHepatotoxicityRenal toxicityEffect in teeth and bonePhotosensitivitysuperinfection
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Dosage
Tetracycline/ Oxytetracycline
250mg-500mg every 4-6 hours
Doxycyline
50 mg every 12 hrs or 100mg every 24 hours
Minocycline
100mg every 12 hours
Methacycline/ Demeclocycline
150mg every 6 hours 300mh every 12 hours
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Cephalosporin
Type of action, mechanism of action spectrum- similar to penicillin
Contraindication: kidney disease Agents recommended for dentistry:
Cephalexin, cephradine Dosage: 250mg -500mg every 4-6
hours
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Clindamycin / Lincomycin
Bacteriostatic/ bacteriocidal Narrow spectrum Protein synthesis Recommended for Osteomyelitis Adverse effect: Pseudomembranous colitis Dosage: Clindamycin (Dalacin C) 150-300mg
every 4-6 hour
Lincomycin (Lincosin) 250-500mg every 4-6 hours
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Other antimicrobials
Metronidazole (Flagyl) Aminoglycoside: for Gm – infection Chloramphenicol ( Chloromycetin) Drug of choice
for typhoid fever Sulfonamides:
□ mechanism of action : competitive antagonism
□ recommended for lower urinary tract infection
□ adverse effect: Urinary tract crystals
* Flouroquinolones: Ciprofloxacin (Ciprobay)
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Antifungal agents
Types Fungal infectiona. Involve the skinb. Involve the oral mucosa
(Candida species)c. Produce systemic disease
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Oral Candidiasis ( Thrush Mouth)Drug of choice: Nystatin (Mycostatin) □ Mechanism of action: binds to
fungal cell membrane □ Fungistatic/fungicidal □ Dosage: 400,000-600, 000 units
(4-6ml) 4 x a day
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Other agetns: clotrimazole: Canesten ketoconazole: Nizoral Ampotheracin ( Fungizone)
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Antiviral
Acyclovir(Zovirax) Inteferon ( Intron A) Idoxuridine( Herplex)