Antimicrobial - pharmacology

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pharmacology
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MCU

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Antimicrobial - pharmacology

  1. 1. <ul><li>Drugs </li></ul><ul><li>hemostatics/ antihemorragic </li></ul><ul><li>Antibiotic </li></ul><ul><li>Antihistmine </li></ul><ul><li>Analgesic, Antipyretic </li></ul><ul><li>Antiinflammatory </li></ul><ul><li>V. Anesthetics </li></ul><ul><li>VI . Minor tranquilizer, sedative-hypnotic </li></ul><ul><li>sedative antihistamine </li></ul><ul><li>Bleeding </li></ul><ul><li>infection </li></ul><ul><li>Allergy </li></ul><ul><li>Pain, Fever Inflammation </li></ul><ul><li>Pain </li></ul><ul><li>Anxiety/fear </li></ul>
  2. 2. Drugs that suppress the growth of kill bacteria and other microorganism
  3. 3. <ul><li>Categories </li></ul><ul><li>□ Antibiotic </li></ul><ul><li>□ Sulfonamide </li></ul>
  4. 4. Characteristics of an ideal antibiotic <ul><li>□ Be selective and effective without injury to the </li></ul><ul><li>host </li></ul><ul><li>□ Destroy microorganism (bacteriocidal) </li></ul><ul><li>□ Do not become ineffective because of bacterial </li></ul><ul><li>resistance </li></ul><ul><li>Types of Bacterial Resistance </li></ul><ul><li>* Natural </li></ul><ul><li>e.g. Penicillinase resistant Staphylococcus Aureus </li></ul><ul><li>* Acquired </li></ul><ul><li>* Cross </li></ul><ul><li>e.g. Penicillin and Cephalosporin </li></ul>
  5. 5. <ul><li>□ not be inactivated by plasma protein, </li></ul><ul><li>enzymes or body fluid </li></ul><ul><li>□ have minimal adverse effects </li></ul>
  6. 6. <ul><li>Indications </li></ul><ul><li>(√) 1. an infection is genuinely present </li></ul><ul><li>(√) 2. the infection is likely to respond to the </li></ul><ul><li>antibiotic </li></ul><ul><li>(√) 3. the infection is sever enough to warrant treatment </li></ul><ul><li>(√) 4. antibiotic is the best form of treatment </li></ul>
  7. 7. Points to Remember <ul><li>(√) antibiotic should not be used unless the </li></ul><ul><li>need for them is certain </li></ul><ul><li>(√) an adequate history must be taken prior </li></ul><ul><li>to treatment </li></ul><ul><li>(√) less than therapeutic dose must never be prescribed </li></ul><ul><li>(√) administration of 1 ½ hours before and 3 hours after </li></ul><ul><li>meals is advisable </li></ul>
  8. 8. <ul><li>(√) there should be prompt response that is beneficial </li></ul><ul><li>usually 24-48 hrs </li></ul><ul><li>(√) therapy should continue 2-3 days pass the </li></ul><ul><li>asymptomatic point </li></ul><ul><li>(√) if antibiotic fails do not hesitate to utilized other </li></ul><ul><li>antibiotic therapy or dosage </li></ul><ul><li>(√) attention must be paid at all times to possible </li></ul><ul><li>development of adverse effect </li></ul>
  9. 9. Classification of Antibiotic <ul><li>I. Type of Action </li></ul><ul><li>bactriocidal bacteriostatic </li></ul><ul><li>II. Mechanism of action </li></ul><ul><li>* inhibition of cell wall </li></ul><ul><li>* affect cell membrane permeability </li></ul><ul><li>* interferes with protein synthesis </li></ul><ul><li>* competitive antagonism </li></ul>
  10. 10. <ul><li>III. Spectrum ( Range of activity) </li></ul><ul><li>narrow broad </li></ul><ul><li>IV. Similarity in chemical structure </li></ul><ul><li>penicillin – cephalosporin </li></ul><ul><li>erythromycin- lincomycin </li></ul>
  11. 11. General Adverse Effects <ul><li>□ superinfection (fungal infection) </li></ul><ul><li>□ allergies </li></ul><ul><li>□ drug interactions </li></ul><ul><li>□ GIT irritations </li></ul>
  12. 12. Antimicrobials in Dentistry
  13. 13. Penicillin Type of Action Mechanism of Action Spectrum Category bacteriocidal Cell wall Narrow- Gm(+) aerobic and facultative Gm (-) N. Gonorrhea N. Meningitides <ul><li>Prototype </li></ul><ul><li>Oral </li></ul><ul><li>Penecillinase </li></ul><ul><li>resistant </li></ul><ul><li>IV extended spectrum </li></ul>
  14. 14. Categories <ul><li>Prototype penicillin </li></ul><ul><li>Pen G </li></ul><ul><li>Best for treating sensitive microorganism </li></ul><ul><li>II. Oral penicillin </li></ul><ul><li>Pen V (Phenoxymethyl penicillin) </li></ul><ul><li>Often used for dental infection </li></ul><ul><li>Available as potassium (K) and free acid </li></ul><ul><li>Dosage: 250mg- 500mg every 6 hours </li></ul>
  15. 15. Categories <ul><li>I. Prototype penicillin </li></ul><ul><li>Pen G </li></ul><ul><li>Best for treating sensitive microorganism </li></ul><ul><li>1 mg sodium Pen G= 1665 units </li></ul><ul><li> 1 mg of potassium Pen G = 1595 units </li></ul>
  16. 16. Categories <ul><li>II. Oral penicillin </li></ul><ul><li>Pen V (Phenoxymethyl penicillin) </li></ul><ul><li>Often used for dental infection (Pen vk) </li></ul><ul><li>Available as potassium (k) and free acid </li></ul><ul><li>Dosage: 250mg- 500mg every 6 hours </li></ul>
  17. 17. <ul><li>III. Penicillin Resistant Penicillin </li></ul><ul><li>* cloxacillin, methicillin, oxacillin </li></ul>
  18. 18. <ul><li>IV Extended Spectrum Penicillin </li></ul><ul><li>Ampicillin-like </li></ul><ul><ul><li> ampicillin (Ampicin) 250mg-500mg every 6 hours </li></ul></ul><ul><li> amoxicillin ( Amoxil) 250mg-500mg every 8 hours </li></ul><ul><li>b. Carbenicillin-like </li></ul><ul><li>c. Amdinopenicillin </li></ul><ul><li>* Clavulanic acid </li></ul>
  19. 19. <ul><li>Oral and parenteral </li></ul><ul><li>Degraded by gastric juice </li></ul><ul><li>Crosses placental barrier </li></ul><ul><li>Excretion: kidney </li></ul><ul><li>Uses: dental infection </li></ul><ul><li> : prevent bacterial endocarditis </li></ul>
  20. 20. Erythromycin (Macrolide) Type of Action Mechanism of Action Spectrum Kinds bacteriostatic/ Bacteriocidal Protein synthesis narrow Base Stearate Ethylsuccinate estolate
  21. 21. <ul><li>Best substitute for patient allergic to penicillin </li></ul><ul><li>Adverse effect : cholestatic jaundice </li></ul><ul><li>precaution: liver disease </li></ul><ul><li>Dosage: 250 mg - 500mg every 4-6 hours </li></ul>
  22. 22. Tetracycline Type or Action Mechanism of Action Spectrum Kinds bacteriostatic Protein synthesis Broad Tetracycline Oxytetracycine Doxycyline Minocycline Methacycline demeclocyline
  23. 23. <ul><li>Usually given by mouth </li></ul><ul><li>Stored in the dentin and enamel of unerupted teeth </li></ul><ul><li>Concentrated in the gingival crevicular fluid </li></ul><ul><li>Do not give with food with high calcium content, aluminum oral iron supplements of antacids </li></ul>
  24. 24. <ul><li>Adverse effects: </li></ul><ul><li>GIT effects </li></ul><ul><li>Hepatotoxicity </li></ul><ul><li>Renal toxicity </li></ul><ul><li>Effect in teeth and bone </li></ul><ul><li>Photosensitivity </li></ul><ul><li>superinfection </li></ul>
  25. 25. Dosage <ul><li>Tetracycline/ Oxytetracycline </li></ul><ul><li>250mg-500mg every 4-6 hours </li></ul><ul><li>Doxycyline </li></ul><ul><li>50 mg every 12 hrs or 100mg every 24 hours </li></ul><ul><li>Minocycline </li></ul><ul><li>100mg every 12 hours </li></ul><ul><li>Methacycline/ Demeclocycline </li></ul><ul><li>150mg every 6 hours 300mh every 12 hours </li></ul>
  26. 26. Cephalosporin <ul><li>Type of action, mechanism of action spectrum- similar to penicillin </li></ul><ul><li>Contraindication: kidney disease </li></ul><ul><li>Agents recommended for dentistry: Cephalexin, cephradine </li></ul><ul><li>Dosage: 250mg -500mg every 4-6 hours </li></ul>
  27. 27. Clindamycin / Lincomycin <ul><li>Bacteriostatic/ bacteriocidal </li></ul><ul><li>Narrow spectrum </li></ul><ul><li>Protein synthesis </li></ul><ul><li>Recommended for Osteomyelitis </li></ul><ul><li>Adverse effect: Pseudomembranous colitis </li></ul><ul><li>Dosage: Clindamycin (Dalacin C) 150-300mg every 4-6 hour </li></ul><ul><li> Lincomycin (Lincosin) 250-500mg every 4-6 hours </li></ul>
  28. 28. Other antimicrobials <ul><li>Metronidazole (Flagyl) </li></ul><ul><li>Aminoglycoside: for Gm – infection </li></ul><ul><li>Chloramphenicol ( Chloromycetin) Drug of choice for typhoid fever </li></ul><ul><li>Sulfonamides: </li></ul><ul><li>□ mechanism of action : competitive antagonism </li></ul><ul><li>□ recommended for lower urinary tract infection </li></ul><ul><li> □ adverse effect: Urinary tract crystals </li></ul><ul><li>* Flouroquinolones: Ciprofloxacin (Ciprobay) </li></ul>
  29. 29. Antifungal agents <ul><li>Types Fungal infection </li></ul><ul><li>Involve the skin </li></ul><ul><li>Involve the oral mucosa (Candida species) </li></ul><ul><li>Produce systemic disease </li></ul>
  30. 30. Oral Candidiasis ( Thrush Mouth) <ul><li>Drug of choice: Nystatin (Mycostatin) </li></ul><ul><li>□ Mechanism of action: binds to fungal cell </li></ul><ul><li>membrane </li></ul><ul><li>□ Fungistatic/fungicidal </li></ul><ul><li>□ Dosage: 400,000-600, 000 units (4-6ml) 4 x a </li></ul><ul><li>day </li></ul>
  31. 31. <ul><li>Other agetns: </li></ul><ul><li>clotrimazole: Canesten </li></ul><ul><li>ketoconazole: Nizoral </li></ul><ul><li>Ampotheracin ( Fungizone) </li></ul>
  32. 32. Antiviral <ul><li>Acyclovir(Zovirax) </li></ul><ul><li>Inteferon ( Intron A) </li></ul><ul><li>Idoxuridine( Herplex) </li></ul>

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