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1. anti septics & disnifectants


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1. anti septics & disnifectants

  1. 1. 1 Anti-septics, disinfectants, dentiferices, mouth washes, demulcents, emollients, protectives & hemostatics ‫ال‬ ‫بسم‬‫الرحمن‬‫الرحيم‬
  2. 2. 2 Anti-septics & disinfectants • Antiseptics: Destroy m.o. & used on living things • Disinfectants: Destroy m.o. & used on non-living things A. Alcohols: ethyl-alcohol, isopropyl-alcohol (50-70 %) • Precipitate proteins & enzymes, kill many m.o. • Used for preparing clean skin for injection and wiping tables • Also used as vehicle for other antiseptics: iodine, etc • Inactivated by biological material: pus, blood, etc • Does not kill spores B. Aldehydes: Formaldehyde (2-8%), glutaraldehyde (2%) • Denature proteins & effective against bacteria, fungi & viruses • Not inactivated by biological materials • Used for disinfection of dental instruments • Glutaraldehyde is more effective; less volatile & irritant, & lacks unpleasant smell of formaldehyde
  3. 3. 3 Anti-septics & disinfectants (Cont.) C. Bis-biguanides: Clorhexidine • Affect cell membrane & cause lysis. Kill most m.o. • 0.2 & 1 % with gluconate for oral rinses & in toothpastes • 1-4 % solution in water & 0.5 % sol in isopropyl alcohol for cleaning skin, mucosa & hands before surgery • 5 % solution for disinfection of instruments D. Halogens: Denature proteins & enzymes; kill most m.o. • Chlorine: (Na hypochlorite & organic chloramines) • 2 % sol for irrigation of root canal, cleaning instruments • Inactivated by organic matter • Iodine: (KI solution & tincture) • Not inactivated by organic matter • Stains skin & may causes allergy • Pavidone: 1% solution for mouth wash. 10% cream for skin
  4. 4. 4 • Iodoform: (Liberates iodine when applied to tissues) • 10% iodoform with benzoin, etc (Whitehead’s varnish) • Dressing of dry socket & after removing molars & cysts E. Oxidizing agents: (Hydrogen peroxide & Na perborate) • Release O2 & kill mo; may cause local irritation • Used as mouth wash in ulcerative gingivitis F. Phenols, cresols & related compounds: • Phenol & cresol: Disinfectants for floors & wash rooms • Irritate skin, not used now as antiseptic • Parachlorophenol: Less irritant • 1% as anti-septic & 35% for root canal treatment • Hexachlorophene: Less irritant, used as powder & cream on skin. Very effective against G (+) m.o. Anti-septics & disinfectants (Cont.)
  5. 5. 5 Anti-septics & disinfectants (Cont.) G. Cationic surface active agents: • Cetrimide & cetrimide + chlorhexidine (Savlon) • Used as general purpose antiseptics • Oxidizing agents: Potassium permanganate • Liberates oxygen and oxidises bacterial protoplasm • Used as anti-septic and disinfectant in different concentrations • Dental uses of antiseptics & disinfectants (summary): • Cold sterilization of instruments (when heat not possible) • Disinfection of surgeon’s & assistant’s hands • Preparation of skin & mucosa before surgery • Irrigation of root canal & inhibition of dental plaque • Treatment of mouth ulcers • Protection of dentists & assistants from viral (HBV, HCV & HIV), bacterial & fungal infections
  6. 6. 6 Dentiferices • Substances used with tooth-brush to clean teeth • Available as: gels, pastes, powders • Usual contents: a. Abrasives: Ca & Mg carbonate, phosphates or silicates b. Binders: Gum, cellulose, seaweed or mineral colloid c. Foaming agents: Na lauryl sulfate/sarcosinate or soap d. Flavoring & sweetening agents • Additional substances: a. Fluoride to prevent caries b. Strontium Chloride for sensitive teeth c. Anti-septics to prevent periodontal disease d. Coloring agents to make tooth paste look attractive, particularly for children
  7. 7. 7 Mouth washes • Aqueous solutions used in the mouth as: • Refreshing, deodorant, antiseptic or for control of dental plaque • Also used for the treatment of mouth ulcers • Antiseptics commonly used in mouth washes are: chlorhexidine, povidone-iodine, cetylpiridinium chloride • Also contain sweetening, coloring & surface active agents • Contents of a simple mouth wash: NaCl, sodium bicarbonate, peppermint & chloroform water
  8. 8. 8 Demulcents • Sticky viscid preparations • Applied on membranes & skin • Make a covering & protect from irritants a. Acacia (gum arabic): Used for inflammation of mouth b. Glycerine: Used for inflammation of mouth & throat c. Benzoin (Compound tincture benzoin) 1-2 drops poured on boiling water, its fumes inhaled & good for laryngitis & croup d. Methylcellulose, OH-methylcellulose, polyvinyl-alcohol Usually applied on eye & control irritation from dust & contact lenses
  9. 9. 9 Emollients • Emollients are bland, fatty or oily substances • Applied locally to skin & mucous membranes • Form a protective layer, make skin soft & moist • Prepared as cream or ointment • Also used as vehicle for active ingredients, to prolong their action • Draw backs: • Moisture under protective layer favors growth of m.o. • Liquid emollients may be aspirated, cause pneumonia • Examples: • Cocoa butter, theobroma oil, coconut oil, olive oil
  10. 10. 10 Protectives • Inert & insoluble substances • Cover & protect epithelial surfaces, ulcers & wounds • May also have astringent & adsorbent properties • Usually prepared as paste for covering, lining or coating a. Chemical: Aluminium hydroxyl gel, collodion, absorbable gelatin, dimethicone, Zn oxide, Zinc carbonate, Ca carbonate b. Mechanical: Film dressing: Acrylic adhesive coated on a plastic film Hold well to normal skin, but not on wet wound surface
  11. 11. 11 Hemostatics (topical) • Local measures for control of bleeding: Pressure packing, sutures, refrigerants & drugs • Drugs: (local hemostatics or styptics) • Absorbable gelatin sponge (gelfoam): Water-insoluble, sterile sponge. Moistened with saline or thrombin sol. Left in place after closure of surgical incision. Digested by tissue enzymes & absorbed in 4-6 weeks • Absorbable gelatin powder: Applied locally on ulcer, wound or cut, covered with dressing. • Thrombin: Sterile powdered protein, prepared from prothrombin • Used for control of bleeding from cuts or injuries • Not to be injected, can cause blood coagulation • Oxidized cellulose: Sterile cotton gauze oxidized chemically. Absorbed with in a week • Adrenaline (1:1000 sol): Constrict blood vessels & control bleeding
  12. 12. 12 Hemostatics (systemic) • Measures for control of bleeding in bleeding disorders: • Human plasma: In Hemophilics & other coagulation factor deficiencies • Platelet concentrate: In thrombocytopenia, disseminate intravascular coagulation, thrombocytopenic purpura • Anti-hemophillic factor (coagulation factor VIII): In classical hemophillia (hemophillia A) • Factor IX complex (Pooled human plasma protein fraction containing factors II, VII, IX & X): In hemophillia B & other coagulation factor deficiencies: factors II, VII & X • Vitamin K: anti-dote for warfarin • Protamine: anti-dote for heparin