Chemotherapeutic Agents Flashcards
Name the phases of periodontal therapy?
Emergency Phase
Non surgical phase (Phase 1 Therapy)
Surgical phase(phase 2 Therapy)
Restorative phase
Maintenance phase
Name 4 mechanisms through which chemotherapeutic agents works?
- BY PREVENTING BACTERIAL ADHESIONS
2.BY AVOIDING BACTERIAL GROWTH AND CO AGGREGATION.
- BY ELIMINATING AN ALREADY ESTABLISHED BIOFILM
4.BY ALTERING THE PATHOGENICITY OF PLAQUE.
Define Antibiotic
An antibiotic is a naturally occurring , semi synthesis, or synthetic type of anti infective agents that destroyed or inhibits the growth of selective microorganisms, at low concentrations.
Define antiseptic
An antiseptic is a chemical antimicrobial agent applied topically or subgingivally
Ideal properties of antiplaque agents are?
Eliminate pathogenic bacteria only.
Prevent development of resistant bacteria.
Easy to use and inexpensive.
SPECIFICITY: AGENTS FOR CHEMICAL PLAQUE CONTROL SHOULD HAVE WIDE SPECTRUM OF ACTION, INCLUDING AGAINST VIRUS, BACTERIA AND YEASTS.
EFFICACY: ANTIMICROBIAL CAPACITY SHOULD BE EFFECTIVE AGAINST MICRO ORGANISM IMPLICATED IN GINGIVTIS AND PERIODONTITIS.
SUBSTANTIVITY: DURATION OF THE ANTIMICROBIAL ACTION AND AS A MEASUREMENT OF THE CONTACT TIME BETWEEN THE AGENT AND THE SUBSTRATE IN A DEFINED MEDIUM.
SAFETY: IN LONG TERM USE, SECONDARY EFFECTS SHOULD BE MINIMUM.
STABILITY: AGENTS MUST BE STABLE AT ROOM TEMPERATURE FOR AN EXTENDED PERIOD OF TIME.
First Generation Agents include?
1.ANTIBIOTICS AND ANTIMICROBIAL AGENTS. It includes penicillin, Tetracycline, Metronidazole, Vancomycin
2.Enzymes
3.Phenols and essential Oils
4.Metal Salts
5.Stannous flouride
———— generation agents Have limited substantivity capable of reducing 20-50% plaque
1st
2 Categories of enzymes in 1st generation antibiotics are ?
IT HAS TWO CATEGORIES:
1, WHICH DISRUPT BIOFILM INCLUDE DEXTRANASE, MUTANASE PROTEASE AND LIPASE
2, ENHANCE HOST DEFENCE MECHANISM INCLUDE GLUCOSE OXIDASE AND AMYLOGLUCOSIDASE
Essential Oils used as 1st generation antibiotics are ?
Listerine And Triclosan
Name some metal salts used as an antiplaque agent and comes under 1st generation antibiotics
INCLUDE ZINC CHLORIDE, ZINC LACTATE, ZINC SULPHATE, ZINC CITRATE. ZINC IS MOST COMMONLY USED HEAVY METAL ION AS AN ANTIPLAQUE AGENT AND HAVING ANTIBACTERIAL ACTIVITY
THESE AGENTS HAVE HIGH SUBSTANTIVITY WITH ANTIMICROBIAL ACTIVITY. THEY ARE 70-90% MORE EFFECTIVELY RETAINED BY ORAL TISSUES AND ARE SLOWY RELEASED.
2nd generation agents
2nd generation agents includes
BISBIGUANIDES
CHLORHEXIDINE
The most widely used and most efficacious agent among all chemical agent is
Chlorhexidine
Explain antimicrobial effect of chx
At low concentration, chx increase permeability of cell membrane, leading to bacteriostatic effect.
At high concentration , it includes precipitation of cytoplasmic proteins and cell death
Explain plaque inhibitory effect of of chx
Chx adheres to the tooth surface thus prevents bacterial adhesion
Chx interects with salivary gp and thus prevents pellicle formation
Explain substantivity of chx
Binds reversibly to oral tissues with a slow release that allows for sustained antimicrobial effects upto 12 hours
Most common side effect of chx
staining of teeth ,dorsum of tongue and restorations is the most common side effect.
Adverse effects of chx include
hypersensitivity reaction , neurosensory deafness, taste alterations, mucosal erosion, staining
Local antinfective agents includes
Mouthwash,Lozenges,Gels,Sprays,Irigators,Chewing Gum,Dentrifices
T/F Systemic administration of anti infective agents, may be necessary adjunct in controlling bacterial infection because mechanical therapy alone some time ineffective due to bacteria invade periodontal tissues.
T
Oral antinfective agents/Antibiotics should be
specific
Non toxic.
In expensive.
Minimum side effects.
Convenient dose.
Low spectrum.
Bactericidal.
Factors considerations during prescribing antibiotics
Pt need
Pt age
pt medical condition
pt past drug history
