Dentistry simplified

          USES OF CHLORAMPHENICOL 1) H. Influenza Meningitis- Chloramphenicol is highly efficacious and it has excellent penetrability into CSF.  2) Intraocular Infections- Chloramphenicol given systemically attains high  concentration in ocular fluids. It is the preffered drug for endophthalmitis caused by sensitive organism.  3) Topically- In conjunctivitis, external ear infection chloramphenicol 0.5-5.0%is highly effective.  4) Enteric Fever- Till recently chloramphenicol was the drug of choice for typhoid fever. Chloramphenicol does not prevent or cure carrier state.  5) Anaerobic Infections- It is effective in anaerobic infections caused by Bact. fragilis and other wound infections and brain abscesses.  6) As second choice drug-drug- a)  To Erythromycin - for whooping cough.  b) To tetracycline- for brucellosis and rickettsial infections especially in children and pre...

               ADVERSE EFFECTS OF                                  CHLORAMPHENICOL Mnemonics to Remember adverse effects of chloramphenicol- Herschelle GIBbS   South African cricketer). H-  Hypersensitivity reactions, G- Gray baby syndrome, I-  Irritative effects, B-  Bone Marrow depression, S- superinfections.  1.Hypersensitivity Reactions Fever, Atrophic glossitis, Angioedema and rashes are infrequent.  2.Gray baby syndrome It  occurs at high doses(~100mg/kg)  in neonates especially premature. The baby stops feeding, vomited, become hypotonic and respiration becomes irregular. If gray cyanosis developed in many,  it is followed by cardiovascular collapse and death. It should be avoided in neonates and even if given doses should be ~25mg/kg/day. 3. Irritative effects Nausea, vomit...

     USES OF TETRACYCLINE 1) Orodental infections Tetracycline are of limited usefulness in treating acute dental infections.  They are useful in certain forms of periodontal diseases.  They are useful in periodontal inflammation by scavenging free radicals.  It has a adjuvant role in the management of chronic periodontitis and in juvenile periodontitis.  To control gingival inflammation tetracycline (1g/ day)  Or doxycycline (0.1-0.2g/day) therapy to be used.  Tetracycline are highly active against actinobacillus species which is responsible for destruction of gums and bone loss in juvenile periodontitis.  2) General Medicinal uses They can be used for initial treatment of mixed infections. Tetracycline are the first choice drugs: 1. Brucellosis- Tetracycline are highly efficacious. Therapy used is doxycycline 200mg/day+rifampin 600mg/day for 6 weeks. Gentamicin may be combined with doxycyclin...

ADVERSE EFFECTS OF TETRACYCLINE Dose related toxicity Irritative effects Superinfection Hypersensitivity Mnemonics to Remember adverse effects of tetracycline (DISH) -Dose related toxicity, Irritative effects, superinfections and Hypersensitivity.  1) Dose related toxicity:  a) kidney damage-  It is prominent only in the patient with pre- existing kidney disease. All tetracycline except  Doxycline accumulate and enhance renal failure. b)  Teeth and bones- Tetracycline having chelating property.  Calcium- tetracycline chelates get deposited in developing teeth and bones.When  given from mid pregnancy to 5 months of extrauterine life, the deciduous teeth are affected (brown discolouration, ill formed teeth, more susceptible to caries. Tetracycline given between 3 months and 6 years of age affect the crown of permanent anterior dentition.  Given during late pregnancy or childhood, tetracycline can cause tempora...

              BROAD SPECTRUM ANTIBIOTICS Tetracyclines and chloramphenicol                       Tetracyclines These are class of antibiotics having a nucleus of four cyclic rings. Chemical structure:     The  tetracyclines still available in India for clinical use are- Tetracycline                           Democlocycline Oxytetracycline                     Doxycycline                                                 Minocycline              Chloramphenicol In 1947 chloramphenicol was obtained from streptomyces Venezuelae.  Chemical structure   The chlo...

             USES OF CEPHALOSPORIN  a)As alternative to PnG:    In allergic patients one of the first generation cephalosporin may be used.  b) Respiratory, urinary and soft tissue infections:  Cephalosporin used for these infections are- cefuroxime, cefotaxime, ceftriaxone.  c) Penicillinase producing  staphylococcal infections.  d)  septicaemia:  Septicaemia caused by gram negative organism an aminoglycosides may be combined with a cephalosporin. e) Meningitis:  For empirical therapy before bacterial diagnosis, i. v cefotaxime/ceftriaxone is generally combined with ampicilln or vanconycin. For pseudomonas meningitis-          ceftazidime+ gentamicin is most effective.  f)  Gonorrhea:  Ceftriaxone is the first choice of drug. Cefuroxime and cefotaxime have also been used for this purpose.  g)  surgical pr...

               ADVERSE EFFECTS OF                                               CEPHALOSPORIN   Cephalosporin are more toxic than penicillin.  a) Hypersensitivity reactions:  Hypersensitivity reactions caused by cephalosporin are similar to penicillin but incidence is lower.  Rashes are common.  Angioedema, asthma, anaphylaxis, urticaria also occurs.  Cross reactivity is seen in 10% of patients allergic to penicillin.  b) pain :  Pain after i. m injection and thrombophelebitis occurs on i. v injection.  c)  Bleeding:  Occurs due to hypoprothrombinaemia in cancer patients and in renal failure.  d) A disfuliram like interaction with alcohol has been reported with cefoperazone.  e)  Nephrotoxicity:   Ne...

              USES OF PENICILLIN G Penicillin G is the drug for infection caused by organism susceptible to it. But now it's use has been declined due to fear of anaphylaxis.  Streptococcal infections: for pharyngitis, otitis media, scarlet fever, rheumatic fever ordinary doses of PnG is given for 7-10 days. For subacute bacterial endocarditis(SABE)  high doses 10-20MU i.v daily along with gentamicin given for 2-6 weeks.  2. Meningococcal infections: Meningitis and other infections may be treated with intravenous injections of high doses.  3.syphilis:  Early and latent syphilis is treated either with daily injection of 1.2 MU of procaine penicillin for 10 days Or with 1-3 weekly doses of 2.4MU benzathine penicillin. Cardiovascular and neurosyphilis requires 5 MU i.m 6 hourly of sod.  PnG for 2 weeks followed by the above regimen. 4.Diphtheria:  procaine penicillin 1-2MU daily for 10 d...

   ADVERSE EFFECTS OF PENICILLIN Adverse effects:  Penicillin G is one of the most non toxic antibiotics.  a)  local irritancy and direct toxicity:  Bleeding occurs at higher doses due to interference with platelet function.  Pain at i.m injection site. Nausea - when given orally and Thrombophlebitis - when given i.v. Accidental i.v injection of procaine penicillin produces :  Microembolism, CNS stimulation, convulsions and hallucinations.  Toxicity related to brain are:  Mental confusion, convulsions and coma. Intrathecal injection produces arachnoiditis and degenerative changes in spinal cord.  b) Hypersensitivity:  Frequent manifestation are:  Itching, fever,  rash and urticaria. serum sickness, exfoliative dermatitis, Angioneurotic edema and wheezing are less common.  c) superinfection:  Superinfection are rare because of its narrow spectrum. Though bowel, respiratory a...

   BETA-LACTAM ANTIBIOTICS These are antibiotics having beta lactam ring.  Major groups are: 1. penicillin  2. Cephalosporin.                                                        PENICILLIN 1.Penicillin was the first antibiotics to be used in 1941. 2. It was obtained from the fungus penicillium notatum.  3.chemical structure of penicillin:  consist of Thiazolidine ring, beta lactam ring, (x)  bond which is broken by Penicillinase.   Chemical  structure of penicillin:  Classification:  1.Natural penicillin - ex- Penicillin-G(Benzyl penicillin)  2. Semisynthetic penicillin:  a)  Acid resistent alternative to penicillin G:  phenoxymethyl penicillin.  b)  penicillinase resistant penicillin : Methicillin, cloxacillin ...

                  ANTIMICROBIAL DRUGS   Antimicrobial drugs can be classified in many ways:    A)  chemical  structure 1. sulfonamides and related drugs:   sulfadiazine, sulfones_ Dapsone, paraaminosalicyclic acid.  2. Diaminopyrimidines:  Trimethoprim, pyrimethamine.  3. Quinolones:   Nalifixic acid, Norfloxacin, ciprofloxacin, Gatifloxacin.  4. Beta_lactam antibiotics:    penicillin, cephalosporins, Monobactams, carbapenems.  5. Tetracyclines:   oxytetracycline, Doxycycline.  6. Nitrobenzene derivative:   chloramphenicol.  7. Aminoglycosides:   streptomycin, Gentamicin, Amikacin, Neomycin.  8. Macrolide antibiotics:   Erythromycin, clarithromycin, Azithromycin.  9. Lincosamide antibiotics:   lincomycin, clindamycin.  10. Glycopeptide...

ROUTES OF DRUG ADMINISTRATION 1. local Routes       2. Systemic Routes local Routes:  used for localized lesions at accessible sites and for drugs whose systemic absorption from these sites is absent or minimal. Local routes are- a)  TOPICAL       b)  DEEPER TISSUE  C) ARTERIAL SUPPLY. a) TOPICAL:  refers to external application of the drug to the surfacefor localized action. Ex- drugs are delivered to the localized lesions on skin, nasal mucosa, eyes, ear canal in the form of lotion, ointment, cream, powder, rinse, drops, spray. b) DEEPER TISSUES:  certain deep areas can be approached by using a syringe and needle. Ex-Intra - articular injection ( hydrocortisone acetate) ,Intrathecal injection (lidocaine). Systemic Routes: Drugs in these routes are absorbed into the blood stream and distributed all over including the site of action through circulation. Systemic routes are- a) ORAL   b) BUCCAL...

                            Pharmacology Pharmacology is the science which deals with drugs.   Division of pharmacology:  Pharmacodynamics       Pharmacokinetics Pharmacodynamics -deals with what drugs does to the body. Ex- Adrenaline stimulates heart.          2.pharmacokinetics_deals with what the            body does to the drug.Ex_absorption              Distribution, binding, storage and             Excretion of drugs. DRUGS: A substance  used in the prevention, cure or alleviation of diseases or pain or as an aid in some diagnostics procedures.  Drugs are divided into: 1. Pharmacodynamic agents :Designed to have pharmacodynamic effects in the recipient.        2.chemotherapeutic agents:...

                     INTRODUCTION Dentistry simplified includes topics and subjects of all four years of dentistry in a simplified way  for better understanding to dental students.  Contents Pharmacology Dental Anatomy Dental Histology Periodontology Pedodontology Oral surgery Endodontics Biochemistry.