Corticosteroids used in oralsurgery /certified fixed orthodontic courses by Indian dental academy
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats. Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics, Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call 0091-9248678078
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Corticosteroids used in oralsurgery /certified fixed orthodontic courses by Indian dental academy
- 1. CORTICOSTEROIDS IN ORAL AND MAXILLOFACIAL SURGERY www.indiandentalacademy.com
- 2. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
- 3. Introduction Aim & Objectives Adrenal physiology Pharmacological actions Applications in oral surgery Risks, contraindications & complications Management of dental patients with adrenal insufficiency Conclusion References www.indiandentalacademy.com
- 5. Steroids the Sleaziest of Drugs Steroids are fast catching up with antibiotics as the most abused class of drugs in doctor's black bag. High doses of corticosteroids and other immunosuppressive agents cause AIDS Mohammed Ali Al-Bayati Ph.D www.indiandentalacademy.com
- 6. Discuss the pharmacological effects of glucocorticoids Side effects and contraindications of steroid use Distinguish the short term from long term therapy Describe possible indications & regimens for their use in oral surgery www.indiandentalacademy.com
- 10. Biosynthesis Transport in the blood Metabolism Mechanism of action www.indiandentalacademy.com
- 13. Transcortin or Corticosteroid binding Globulin Bound form – 94% Free form – 6 % www.indiandentalacademy.com
- 14. Glucuronic acid or sulfate conjugation 25% - bile & faeces 75% - urine www.indiandentalacademy.com
- 17. Injectable: Betamethasone, Dexamethasone, Prednisolone, Methylprednisolone, Hydrocortisone, Triamcinolone Oral: Betamethasone ,Fludricortisone ,Prednisolone,Prednisone, Methylprednisolone Topical: Betamethasone ,Clobetasol ,Flucinolone ,Mometasone Inhalation: Beclomethasone ,Budesonide ,Flunisolode www.indiandentalacademy.com
- 19. Carbohydrate, Protein & Fat Metabolism: Gluconeogenesis Glycogen deposition in liver (activation of hepatic glycogen synthase) Negative nitrogen balance & hyperglycaemia Redistribution of Fat www.indiandentalacademy.com
- 20. Aldosterone is more important Act on D.T. & C.D. of kidney ◦ Na+ reabsorption ◦ Urinary excretion of K+ and H+ Calcium excretion by the kidney www.indiandentalacademy.com
- 21. Restrict capillary permeability Maintain tone of arterioles Corticosteroid induced hypertension ?? www.indiandentalacademy.com
- 22. Mild euphoria Maintain level of sensory perception & normal level of excitability of neurones HIGH DOSES LOWER SIEZURE THRESHOLD - CAUTIOUS USE IN EPILEPTICS www.indiandentalacademy.com
- 26. Replacement therapy Inflammatory states Leukemia Shock Severe allergic reactions Dermatology Immunosuppresion www.indiandentalacademy.com
- 28. Topical use: non-infections, ulcerative diseases in oral cavity. Inhibit the inflammatory reaction, redness and edema Systemic use: third molar extraction, pre-prosthetic surgery, reconstructive oral surgery, orthognatic surgery www.indiandentalacademy.com
- 29. CONDITION Aphthous ulcer dentin hypersensitivity desquamative gingivitis oral lichen planus post extraction pulp capping pulpotomy severe allergy TMJ arthritis symptoms oral pemphigus Oral Submucous Fibrosis ADMINISTRATION Topical Topical Topical,systemic Topical,systemic Systemic Topical Topical Systemic Systemic Topical,systemic Local www.indiandentalacademy.com
- 33. Minor surgical stress Moderate surgical stress Major surgical stress www.indiandentalacademy.com
- 37. Use of Corticosteroids in Oral Surgery; J Oral Maxillofac Surg 50:270-277, 1992; Lisa Gersema, Karen Baker Efficacy and safety of steroid use for postoperative pain relief; The journal of bone & joint surgery · JBJS.Org; Volume 88-A · number 6 · June 2006 Supplemental corticosteroids for dental patients with adrenal insufficiency :Reconsideration of the problem;Craig S. Miller, James W. Little,; Donald A. Falace, JADA, Vol. 132, November 2001; 1570 Corticosteroids and Oral Surgery: Jason Bodnar, Anesth Prog 48:130-132 2001 Perioperative Glucocorticoid Coverage - A Reassessment 42 Years After Emergence of a Problem; Michael Salem, Robert E. Tainsh, Annals Of Surgery;April 1994;Vol. 219, No. 4,416-425 Textbook of Modern Pharmacology with Clinical Applications by Charles R Craig Textbook of Review of Medical Physiology by William Ganong www.indiandentalacademy.com
- 39. www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com