Pharmacology/Perio Flashcards
What is the initiating factor of periodontal disease?
- microbial plaque
Pathogenesis of perio
- plaque presents microbial challenge
- upregulate host immune response
- tissue destruction
Plaque-induced gingival disease
- systemic factors
- endocrine changes (puberty, pregnancy, diabetes)
- blood dyscrasias (leukemia)
Plaque-induced gingival diseases
- medications
- DIGE with CCBs, dilantin and cyclosporine
- oral contraceptives
Plaque-induced gingival diseases
- modified by malnutrition
- vitamin C deficiency (scurvy)
Aspirin anaglesic mechanism
- inhibit COX 1 and 2 (Prostaglandin synthesis)
Aspirin antipyretic mechanism
- inhibit PG synthesis in hypothalamus
Aspirin affecting bleeding time mechanism
- inhibit TXA2 synthesis which inhibits platelet aggregation
Therapeutic effects of steroids (analgesic)
- inhibit phospholipase A2 (AA synthesis)
What is the “rule of 2s” in regards to corticosteroids?
- 20 mg cortisone (daily) or its equivalent
- 2 consecutive weeks
- Within 2 years
- could experience adrenal suppression
Narcotic/opiod mechanism of action
- mu-opioid receptor agonist
Therapeutic & side effects of morphine
Miosis
Out of it
Respiratory Depression
Pneumonia
Hypotension
Infrequency
Nausea and vomiting
Euphoria and dysphoria
What is first order kinetics?
- constant fraction of drug is eliminated per unit of time
- most common
What is zero order kinetics?
- constant amount of drug is eliminated per unit of time
- less common
what is induction?
- Drug #1 induces liver cytochrome enzymes resulting in an increased metabolism and reduced effect of drug #2
What is inhibition?
- Drug #1 competes for metabolism or directly inhibits liver cytochrome enzymes resulting in decreased metabolism and increased toxicity of drug #2
What is the therapeutic index?
TD50/ED50
-The higher the number, the safer the drug
2 classifications of receptors in the ANS and their mode of action
- ionotropic = ion channel
- metabotropic = G-protein coupled receptor
2 types of receptors in the ANS and what binds to them
- Cholinergic = binds acetylcholine
- Adrenergic = binds Epi/NE
What are the 2 forms of Cholinergic receptors?
- Nicotinic = binds nicotine; ionotropic
- muscarinic = binds muscarine; metabotropic
What type of receptors are all preganglionic nerves reaching?
- Nicotinic = ionotropic
In the PNS, what type of receptor is the post-ganglionic receptor?
- muscarinic = metabotropic
What type of receptor are the post-ganglionic nerves reaching in the SNS?
- adrenergic = metabotropic
What does the M2 muscarinic receptor do?
- Causes bradycardia
