Dentistry-_Sialogogues_and_Antisialogogues.pdf
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Dental Pharmacology Lecture Slides on Sialogogues and Antisialogogues by Sanjaya Mani Dixit Assistant Professor of Pharmacology at Kathmandu Medical College
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It’s a type of irreversible pulpitis
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Pulpotomy
Pulpotomy is the removal of the coronal portion of the pulp while preserving the radicular pulp. It is indicated for cariously exposed primary teeth when extraction is less advantageous than retention. There are various techniques for pulpotomy including devitalization with formocresol or other chemicals to fix the pulp, preservation techniques using less harmful chemicals to maintain pulp vitality, and regeneration techniques aiming to stimulate reparative dentin formation. The goal of pulpotomy is to disinfect the exposed pulp, maintain pulp vitality, and avoid periapical issues.
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1. The document provides guidance on class I cavity preparation for amalgam and composite restorations. It describes the different types of class I preparations including conservative and extensive preparations.
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The document summarizes the microscopic features of gingiva. It describes the different layers of the oral epithelium including the stratum basale, stratum spinosum, stratum granulosum, and stratum corneum. It also discusses the sulcular epithelium and junctional epithelium. The connective tissue of the gingiva contains collagen, reticulin and elastic fibers as well as fibroblasts, macrophages and mast cells. Blood supply to the gingiva is provided by suprapapillary arterioles and arteries from the crest of the interdental septa. Lymphatic drainage occurs through vessels that accompany the blood vessels.
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This document discusses chlorhexidine, a second generation chemical plaque control agent. It provides an overview of its history, forms, mechanism of action, and clinical uses. Chlorhexidine is highly effective at inhibiting plaque due to its prolonged release and bacteriostatic/bactericidal effects. It has a wide range of clinical applications and is generally safe, though long term use can cause staining and changes to oral flora.
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Hemostasis is the process of stopping bleeding. The key phases are primary hemostasis involving platelet plug formation and secondary hemostasis involving the coagulation cascade and fibrin clot formation. Several factors can influence surgical bleeding relating to the procedure, patient, and anatomical site. A variety of hemostatic agents exist to help control bleeding, including mechanical methods, energy-based methods, pharmacological agents, topical agents that are passive or active, and sealants. The ideal hemostatic agent stops bleeding quickly, is easy to use, durable, and safe.
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This document discusses various tests used to assess caries activity and susceptibility. It defines caries activity as referring to the speed of progression of caries lesions, while caries susceptibility refers to the inherent tendency to develop caries. Several tests are described that examine levels of cariogenic bacteria like lactobacilli or Streptococcus mutans in saliva, or that measure the ability of saliva to neutralize acids and buffer pH changes. These include bacterial culturing tests, color change assays, and tests analyzing the dissolution of enamel. Each test is outlined with the purpose, equipment, procedure, results, advantages and limitations.
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This presentation discusses the causes, symptoms, classification and treatment of peptic ulcers. It begins with an introduction defining ulcers and their locations in the stomach and duodenum. The main causes of ulcers are identified as alcohol, NSAIDs, smoking, stress and Zollinger-Ellison syndrome. Common symptoms include epigastric pain relieved by food or antacids. The presentation then classifies treatments for ulcers including anti-secretory agents like H2 receptor antagonists and proton pump inhibitors, anticholinergic drugs, prostaglandin analogues, antacids, and anti-H. pylori treatments. Sucralfate is also discussed as an ulcer protective agent.
Salivary glands disorders
Stress, depression, and diabetes can impact salivary gland function and cause hyposalivation or xerostomia. Experiments found stress and depression were significantly related to reduced unstimulated salivary flow and feelings of dry mouth. Diabetes can decrease stimulated saliva and change saliva composition. Sjogren's syndrome is an autoimmune disorder where the immune system attacks salivary glands, commonly causing dry eyes and mouth in women over 40, especially those with other autoimmune diseases. A dry mouth can increase dental issues so treatment aims to increase saliva or relieve symptoms.
ANTI-GLAUCOMA DRUGS.pptx
Glaucoma is caused by damage to the optic nerve from raised intraocular pressure. The main treatments are medications that lower IOP by reducing aqueous humor production or increasing outflow. The major drug classes include prostaglandin analogues, beta blockers, alpha agonists, carbonic anhydrase inhibitors, and parasympathomimetics. Newer drugs target the Rho kinase pathway or are nitric oxide donors. The goal of treatment is to lower IOP to a target level while minimizing side effects like hyperemia, allergy, and systemic effects.
Action of anticholinergics on Genito-urinary System
It describes the action of Anticholinergics on the genitourinary system. Detailed description of each anticholinergic drug is given .
they can be given in urinary incontinence.
Drugs in muculoskelatal
1. The document discusses various drugs used in musculoskeletal system including prostaglandins, NSAIDs, and paracetamol.
2. Prostaglandins are lipid compounds derived from arachidonic acid that have hormone-like effects. NSAIDs like aspirin, ibuprofen, and diclofenac work by inhibiting prostaglandin synthesis.
3. The document describes the mechanisms of action, uses, doses, side effects and toxicity of common NSAIDs and paracetamol. NSAIDs are used for their anti-inflammatory, analgesic and antipyretic effects while paracetamol is primarily used for its analgesic and antipyretic properties.
GI pharmacology
Small frequent meals
instead of 3 large meals
Avoid: Fatty, fried, spicy foods
Caffeine, alcohol, carbonated
drinks
Diarrhea and constipation
This document discusses drugs used to treat diarrhea and constipation. It describes various causes of diarrhea and different types of laxatives. Oral rehydration solutions and antimotility drugs like loperamide, clonidine and octreotide are used to treat diarrhea. Bulk-forming, stool softening, and stimulant laxatives are described for treating constipation. Drugs used for inflammatory bowel disease like 5-aminosalicylates, corticosteroids, antibiotics, and biologics are also summarized.
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- 1. Sialogogues and Antisialogogues Sanjaya Mani Dixit Assistant Prof of Pharmacology
- 2. Salivary stimulants A sialogogue is a drug or substance that increases the flow rate of saliva.
- 3. Saliva • Saliva has a bactericidal effect, so when low levels of it are secreted – the risk of caries increases. – Not only this, but fungal infections such as oral candidiasis also can be a consequence of low salivary flow rates. – The buffer effect of saliva is also important, neutralizing acids that cause tooth enamel demineralization.
- 4. Causes of dry mouth • Iatrogenic – Drugs – Irradiation • Dehydration • Psychogenic • Disease – Salivary gland disease – Salivary aplasia (agenesis) – Sjogren’s syndrome – Sarcoidosis – Cystic fibrosis – Primary biliary cirrhosis – Infections • HIV • Hepatitis C • Human T lymphotropic virus 1 (HTLV-1)
- 5. Cevimeline Cevimeline has a long-lasting sialogogic action and may have fewer side effects than pilocarpine. Cevimeline also enhances lacrimal secretions in Sjögren’s syndrome. Mechanism of Action • Muscarinic receptor agonist , exhibits high binding affinity for muscarinic M3 receptors on lacrimal & salivary gland epithelium: increases salivation Elimination • Half-Life: ~5 hr • Excretion: Urine 97%; feces 0.5%
- 6. Cevimeline Uses • Xerostomia: Indicated for xerostomia in patients with Sjogren's syndrome • 30 mg PO TID A/Es • Sweating • Nausea • Rhinitis Contraindications • Uncontrolled asthma, conditions in which miosis is undesirable (eg, narrow- angle glaucoma, acute iritis) • Hypersensitivity
- 7. Pilocarpine Pilocarpine 5-10 mg dose is given three times daily in the treatment of xerostomia. Mechanism of Action Cholinergic parasympathomimetic, binds with muscarinic M3 receptors on lacrimal & salivary gland epithelium hence increases salivation Half-Life: 0.76-1.35 hr
- 8. Pilocarpine Uses: • Radiation-induced Xerostomia • Xerostomia Associated with Sjogren's Syndrome (An autoimmune disorder that occurs primarily in women decreasing salivary and lacrimal secretions)
- 9. Pilocarpine A/Es • Sweating (most common) • Headache • Flushing • Chills Bethanecol is oral alternative drug with less diaphoresis. Contraindications • Uncontrolled asthma, anterior eye inflammation, any time miosis in undesirable (eg, narrow-angle glaucoma, acute iritis) • Hypersensitivity
- 10. Sialogogues Uses • In the treatment of xerostomia (the subjective feeling of having a dry mouth) • Radiotherapy induced xerostomia – Pilocarpine reduces difficulty in speaking and swallowing • to stimulate any functioning salivary gland tissue to produce more saliva. • Sjogren’s syndrome- Cevimeline
- 11. Drugs causing Xerostomia • Anticholinergic drugs • Phenothiazines • Clonidine
- 12. Drugs for treatment of xerostomia • Parasympathomimetic drugs • Pilocarpine • Bethanecol • Cevimeline • Chewing gum
- 13. Antisialogogues • A substance that reduces the salivary secretion • Atropine and anti-cholinergic drugs are known to decrease salivary secretion • Propantheline bromide, atropine substitute is commonly used for the purpose.
- 14. Antisialogogues Uses Sialocele • A sialocele is a localized, subcutaneous cavity containing saliva. • They are a relatively common complication following surgery to the salivary glands commonly parotidectomy In this case the sialocele is the result of saliva draining out of remaining parotid tissue.
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