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...