Antibiotics-Local

Question 1

What are 5 desirable characteristics of local chemotherapeutics?

Answer 1

• Substantivity
• Low toxicity
• High potency
• Good permeability
• Intrinsic efficacy

Question 2

Which topical antimicrobial ruptures cell membranes, has good substantivity, is a cationic bisbiguanide and is considered the gold standard?

Answer 2

Chlorhexidine

*Reduce plaque by 50-55%, gingivitis 45%

Question 3

What are 3 side effects of chlorhexidine?

Answer 3

1-Staining
2-Calculus formation
3-Taste alteration

Question 4

What topical antimicrobial contains alcohol, reduces plaque and gingivitis 34%, disrupts cell wall and bacterial enzymes (lesterine is an example)?

Answer 4

Essential oils

Question 5

Used as a pre surgical scrub, which antimicrobial is water soluble, effective agains bacteria, viruses and fungi?

Answer 5

Povidine Iodine

*Avoid in patients with iodine of shellfish allergy, thyroid dysfunction, or pregnant/lactating women

Question 6

Which antimicrobial reduces plaque and gingivitis 14% and 24% respectively, ruptures cell walls and is a domiphen bromide as in Scope?

Answer 6

Quarternary ammonium compounds

*Cepacol as well

Question 7

Which antimicrobial is a herbal alkaloid extract, reduces plaque and gingivitis 17-50% and is most effective with other agents?

Answer 7

Sanguinarine

Question 8

Used as an endodontic irrigant, which antimicrobial is corrosive to metal and is also known as bleach?

Answer 8

Sodium hypochlorite

Question 9

Which local antimicrobial promotes remineralization of decalcified enamel and inhibits cariogenic microbial process in plaque?

Answer 9

Stannous Fluoride

Question 10

Which antimicrobial has 20% gingivitis and 25% plaque reduction and is a bisphenol with broad spectrum?

Answer 10

Triclosan

Question 11

At what depth do mouth rinses and supra gingival irrigation have a hard time reaching in a periodontal pocket?

Answer 11

5 mm

Question 12

What are some contraindications for local antibiotics alone?

Answer 12

• Preventative care
• Aggressive periodontal disease
• Multiple unresponsive sites
• Sites that require surgical treatment (vertical bone loss, greater than 6 mm pocket)
• Pregnant or lactating women
• Patients with allergies to medication

Question 13

What are 5 controlled drug delivery systems for local antimicrobials?

Answer 13

1-Tetracycline fibers 
2-Metronidazole gel
3-Minocycline (gel, ointment, powder)
4-Chlorhexidine chip
5-Doxycycline

Question 14

What controlled local drug delivery contains chlorhexidine gluconate, releases for 7-10 days and is found to suppress pocket flora for up to 11 weeks?

Answer 14

Periochip (chlorhexidine chip)

Question 15

What local controlled drug is applied while withdrawing the tip of a plastic cartridge in the pocket, is a minocycline hydrochloride and does not require removal later?

Answer 15

Arestin