The document lists the names of 5 people and then discusses various classes of drugs used to treat oral diseases. It describes analgesics like NSAIDs and opioids that are used to control pain. It also discusses antibiotics that are used to treat bacterial infections, including penicillin, amoxicillin, metronidazole, cephalosporins, and clindamycin. The document also covers antifungals used to treat conditions like oral thrush, as well as antivirals to treat viruses like herpes. Finally, it discusses corticosteroids and other immunomodulating drugs that are used to suppress inflammation and modulate the immune system.

3.  FATIMA KHAN
 REBEIAAZIZ
 ELSA MUSTAFA
 FATIMA BHATTI
 MADIHAASLAM

4.  Analgesics to control pain
 Antibiotics
 antiviral
 Antifungal
 corticosteroids

5.  Drug that relieve pain without loss of
consciousness
 Types
 Non steroidal anti-inflammatory drug
 Opioids

7. Analgesics effect against mild to moderate pain
 Anti inflammatory
 Anti pyretic
 Anti platelet activity

8. Classification
A. Non selective COX inhibitors (traditional NSAIDs)
 Salicylates: Aspirin
 Prop ionic acid derivatives: Ibuprofen, Naproxen,
Ketoprofen, Flurbiprofen.
 Aryl-acetic acid derivatives: Diclofenac, Aceclofenac.
 In dole derivative: Indomethacin.
B. Preferential COX-2 inhibitors
 Nimesulide, Meloxicam, Nabumeton.
C. Selective COX-2 inhibitors
 Celecoxib, Etoricoxib, Parecoxib.
D. Analgesic-antipyretics with poor antiinflammatory
action
Para aminophenol derivatives: Paracetamol

9. Mechanism of action of NSAIDs
1. Anti inflammatory effect
 due to the inhibition of the enzymes that produce
prostaglandin H synthase (cyclooxygenase, or COX),
which converts arachidonic acid to prostaglandins, and
to TXA2 and prostacyclin.
2. Analgesic effect
 A. The analgesic effect of NSAIDs is thought to be
related to: the peripheral inhibition of prostaglandin
production
3. Antipyretic effect
 The antipyretic effect of NSAIDs is believed to be
related to inhibition of production of prostaglandins
induced by interleukins

11. Contraindications of nsaids
 Gastric ulcers
 Bleeding dyscrasias or concerns
 Significant renal disease
 asa (or other NSAID) hypersensitivity

12. 1 Aspirin:
 Mechanism of action
 The anti pyretic and anti inflammatory effect
salicylates are primarily due to the blockage of
prostaglandin synthesis
2 Ibuprofen
 Is a derivatives of phenyl prop ionic acid in doses
of 2.4g daily equivalent of 4 g aspirin in anti
inflammatory effect. Oral ibuprofen is often
prescribed in lower doses (<2.4g/d) at which it
has analgesics but not anti inflammatory efficacy.

13.  Acetaminophen Indications Pain and
inflammation associated with musculoskeletal
disorders, e.g. rheumatoid arthritis, osteoarthritis,
and ankylosing spondylitis. Postoperative
analgesia. Effects on oral and dental Patients on
long-term NSAIDs such as acemetacin may be
afforded some degree of protection against
periodontal breakdown. This arises from the
drug’s inhibitory action on prostaglandin
synthesis.

14. Mechanism of action
 Paracetamol inhibits prostaglandin
biosynthesis under some circumstances (e.g.
fever), but not others.
Adverse effects
 The most important toxic effect is hepatic
necrosis leading to liver failure after overdose

15.  Usually used for analgesia for moderate to severe
pain in dentistry
 Other opioids effects:
 Sedation
 Respiratory depression
 Nausea and vomiting
DRUGS
 codeine
 oxycodon
 morphine

16.  use to relieve severe pain max analgesia
occurs in 1o-20 mins with I/v routes controlled
released tablets given for chronic pain route
 determines time interval or frequency of
administrative

17.  Also called anti bacterial are a type of
antimicrobial drug used in the treatment and
prevention of bacterial infections
 They may either kill or inhibit the growth of
bacteria

18.  Bactericidal
 Penicillin's
 Metronidazole
 Cephalosporin's
 Bacteriostatic
 Clindamycin
 Erythromycin
 Tetracycline's

20. 1 Penicillin
 Oral penicillin are penicillinV and amoxicillin
 PenV is narrow-spectrum against gram-
positive Strep and others
 Drug of choice for orofacial infections
 e.g. dental abscesses, infections around
 wisdom teeth and infections after
 surgery
 Dose = 300-600 mg

21. Adverse effect of penicillin
 Allergy
 Diarrhea
 Nausea and vomiting
 Candidacies
 Penicillin's responsible for 75% of
anaphylaxis deaths
 Penicillin: Contraindication
 (none except hypersensitivity to penicillin)

22.  Amoxicillin is broad-spectrum and better
absorbed orally
 Dose = 250-500 mg q8h
Indications
 Used to treat bacterial infection such as a dental
 abscess. Used prophylactically
 in the prevention of infective endocarditis
Contraindications
 Hypersensitivity.
Side effects
 Glossitis and tongue discoloration.
 Candidacies.
 Gastrointestinal upset

23. 3. Metronidazole
FOR OBLIGATE ANAEROBES effective
against against becteriodsspecies esp. in
periodontal infection
Drugs
flagyl and gramex
Avoid in pregnancy

24.  Cephalosporin's are bactericidal agents (which
means that they kill bacteria)
 More resistance to penicillase
 Gram +ve coccus
 Gram –ve rods
 Cephazolin
 Claforan

25.  Side effects
 GI upset
 Can also cause overgrowth of fungus normally
present in the body.
 the cephalosporin's are structurally similar to
the penicillin's,
 some patients allergic to penicillin's may be
allergic to a cephalosporin
 antibiotic.

26. 5. Clindamycin
 An alternative for penicillin-allergic or
penicillin-resistant patients
 *Active against gram-positive and gram-
negative anaerobes and
 facultative/aerobic bacteria
 *Dose = 150-300 mg

27. 6. Macrolides
 Group includes
erythromycin, clarithromycin and azithromycin
 Erythromycin was the former drug of choice for
penicillin allergic
 penicillin-resistant patients
 Numerous GI adverse effects
 Active against gram-positive aerobic/facultative
staph and strep and
 gram-negative anaerobes
Contraindication
 Patients with hepatic dysfunction

28.  Broad-spectrum, bacteriostatic
 Useful in treatment of periodontal disease
 Widespread resistance
 Host of adverse effects including: tooth
staining, photosensitivity,
 blood dyscrasias, GI effects
Contraindications:
 Renally impaired patients
 Lactating or pregnant women's

29.  GI tract complications
 Cross reactions with other medications
 Colonization of resistant or fungal strains

30. Antibiotic prophylaxis
 Indicated for patients with:
 Prosthetic heart valves
 History of infective endocarditis
 Implant placement
 Extractions
 Periodontal procedures

31.  An antifungal medication, also known as
an antimycotic medication, is
a pharmaceutical fungicide or fungi static used to
treat fungal infections
 Groups
Polyenes
 Amphotercin b and nystatin
azole
 Ketoconazole
 Miconazole
 fluconazole

32. Indication of antifungal drugs
 Stop spread of infection
 Treat oral thrush
 Denture stomatitis
 Used in combination with antibiotic in case of
abscess

33. Mechanism of action
Binding to ergo sterol of fungal membrane
Indications
 Used to treat candidal infections
Contraindication
 Hypersensitive drug
Side effect
 -Gastrointestinal disturbances.
 -Renal damage.
 -Hypokalaemia.
 -Myopathy and neuropathy
 -Respiratory depression

34. Mechanism of action
 Binding to ergo sterol of fungal membrane
Indications
 Used in the treatment of candidal infections
Contraindications
 Hypersensitivity.
Side effects
 Hypersensitivity.
 Gastrointestinal upset

35. Mechanism of action
 Inhibition of ergo sterol synthesis
Indications
 Used to treat oral fungal infections
Contraindications
 Previous hypersensitivity
 Best avoided during pregnancy and when
breastfeeding.
Precautions
 Use with caution in patients with renal and hepatic
disease.
Side effects
 Hypersensitivity reactions.
 Gastrointestinal problems

36. Mechanism
 Inhibit synthesis of ergo sterol
Used for the treatment of
a. systemic infections
b. mucocutaneous Candida infections
c. cryptococcal meningitis
 Avoid use in patients with kidney problems

37.  An agent that kills a virus or that suppress its
ability to replicate and hence inhibits its
capability to multiply and reproduce.
 Many antiviral drugs are Purine or Pyrimidine
analogs.
 Many antiviral drugs are Pro drugs. They must
be phosphorylated by viral or cellular enzymes in
order to become active.
 Anti-viral agents inhibits active replication so the
viral growth resumes after drug removal.

38.  Antiviral drugs
 Used to treat infections caused by viruses other
than HIV
 Antiretroviral drugs
 Used to treat infections caused by HIV, the virus
that causes AIDS
 Herpes-Simplex Viruses
 HSV-1 (oral herpes)
 HSV-2 (genital herpes)
 Varicella Zoster Virus
 Chickenpox
 Shingles

39. 1.Acyclovir (Zovirax)
Indication
 Used in topical , IV, oral formulations
 Herpes simplex virus 1,2 (HSV)
 Varicella zoster virus
 And used in treatment of herpes simplex
Herpes Simplex
 Herpes viruses are associated with “cold
 sores”
Adverse reactions
 Oral administration: headache (13%) is one of the
 most common; other central nervous system
 (CNS) and GI effects
 Parenteral administration: local reactions at the
 injection site are the most common

40. Side effect of acyclovir
 -Stinging sensation at site of application,
altered taste,
 gastrointestinal
 upset, renal failure, bone marrow depression,
tremors and
 convulsions,
 lichenoid reactions, rash and urticaria

41. 2. Famciclovir
Indications
 Used in the treatment of herpes zoster and genital herpetic
infections
Contraindications
 Hypersensitivity, children.
Precautions
 Renal and liver disease, pregnancy and
 breastfeeding.
Side effect
 Maintenance of adequate fluid intake is required
 with high doses.
 Fever, gastrointestinal upset, dizziness,
 confusion, and hallucinations,
 headache and sinusitis, rash

42. 3.Valaciclovir (Valtrex)
 An antiviral drug. It is a pro-drug for acyclovir.
Indications
 Used to treat herpes simplex and varicella-zoster
infections..
Contraindications
 Hypersensitivity, children.
Precautions
 Renal disease, pregnancy and breastfeeding.
Side effects
 Glossitis, altered taste, gastrointestinal upset, renal failure,
bone
 marrow depression, tremors and convulsions, rash, and
urticaria

43.  Frequently used to suppress inflammation.
The use of corticosteroids for the treatment of
oral mucosal lesions is justifiable if topical
therapy has failed

44.  Immunomodulating drugs
 Systemic therapy with non specific immuno
modulating drug are increasingly being used
for severe ulcerative and erosive oral
conditions
 Immunomodulatory drugs modify the
response of the immune system by increasing
(immunostimulators) or decreasing
(immunosuppressive) the production of serum
antibodies

45. Immunostimulator
 prescribed to enhance the immune response
against infectious diseases, tumours, primary or
secondary immunodeficiency, and alterations in
antibody transfer, among others
e.g. Thymosin ,Interleukins ,Specific antibodies
Immunosuppressor
 used to reduce the immune response against
transplanted organs and to treat autoimmune
diseases such as pemphigus, lupus, or allergies
 E.g. Prednisone ,dexamethasone ,Azathioprine

47. 1.Prednisolone
 Is used as an anti inflammatory and
immunosuppressive medication. Prednisolone
predominantly has glucocorticoids activity and is
the corticosteroids most commonly taken orally
for long term disease suppression
 50% of pts on long term corticosteroids develops
osteoporosis and bone loss
 Pts on prednisolone 25mg/day for more than 3-6
months should b given prophylactic
bisphosphonate

48.  Steroid sparing drugs it is used to minimize the
long term effect of systemic steroids
 It is cytotoxic immunosuppressant with
potentially serious side effect
 Not prescribed unless adequate monitoring is
available
 Pts are at risk of developing bone marrow
suppression particularly if thy have a deficiency
of thiopurine methyletransprase (tpmt), a
cytoplasmic enzyme involves in the metabolism
of azathioprine

49.  Dapsone
 Cyclosporine
 Colchicines
 Thalidomide
 mycophenolate

50.  Recurrent aphthous stomatitis
 bechets diseases
 Ulcerative vesiculoerosive diseases
 Major aphthae or erosive lichen planus
 Pamphigus vulgaris
 Erythema multiform
 Lichen planus
 Cicatrical pemphigoid
 Bullous pemphigoid
 Lupus erythamatosis

51.  Suppression of adrenal function
 Hypertension
 Diabetes
 Peptic ulceration
 Cushing syndrome
 Susceptibility to infection ( candidacies,
bacterial and viral infections)