Transcript antibiotics and analgesics

Introduction
• Abu Ali ibn Sina, a Persian polymath, was the
first to propose the presence of bacteria in
1020,
• Louis Pasteur demonstrated that fermentation
is due to microorganisms,
• Koch (1843–1910) can be considered the
father of modern microbiology. His work with
tuberculosis proved the germ theory and for
this he received the Nobel Prize.
• The ancient Chinese, Greeks, and Egyptians
are all known to have used moulds and plants
to treat infection.
• In modern times, the first discovery was by
Ernest Duchesme, describing the antibacterial
properties of Penicillium spp. in 1897
• Fleming’s work in 1928.
• Substance that destroys or inhibits the growth
of other microorganisms and is used in the
treatment of external or internal infections.
While some antibiotics are produced by
microorganisms, most are now manufactured
synthetically.
1. Antimicrobial or anti-infective-drugs used to
prevent or treat infections caused by pathogenic
(disease-producing) microorganisms. Include
antibacterial, antiviral, and antifungal drugs.
2. Antibacterial or antibiotic-usually refer only to
drugs used in bacterial infections.
3. Antiviral- drugs used to treat viral infections.
4. Antifungal- drugs used to treat fungal infections.
5. Antiparasitic- drugs used to treat parasite infections
or infestations.
classification
• Broad Spectrum- antibacterial drugs that are
effective against several groups of
microorganisms
• Amoxicillin,
• Narrow Spectrum- antibacterial drugs which
are effective against only a few groups of
microorganisms
• Ex: Pen VK, Pen G, Erythromycin
• Bactericidal- action of an antibacterial drug in
that it kills microorganisms.
• Bacteriostatic- action of an antibacterial drug
in that it inhibits growth of the
microorganism.
Principles of antibiotics
• INFECTIONS ARE ULTIMATELY CURED BY
HOST,NOT BY ANTIBIOTICS.
• Its helps,
 when host has been overwhelmed by
bacteria.
When body defenses depressed,
Causes –physiologic
disease related
defective immune system
drug suppression related
• An antibiotic is not an antipyretic. Raised
temperature alone is not an indication for
administration of antibiotics
• Before any antibiotic therapy, attempt to
isolate the pathogen.
• Initial empirical therapy
Different types of antibiotics
Pain medication
• ANALGESICS
• A drug that selectively relieves pain by acting in CNS
or on peripheral pain mechanism, without
significantly altering consciousness.
CLASSIFICATION
• Divided into 2 groups:
1. Opioid Analgesics -Narcotics/Morphine like
analgesics
2. Non Opioid Analgesics -NSAIDs/Non
narcotic/aspirin like analgesics
OPIOID ANALGESICS
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Natural Opium alkaloids
Morphine & Codeine.
Semi synthetic opiates
- Diacetylmorphine
- oxymorphone
- Pholcodeine
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Synthetic opioids
Pethidine
Fentanyl
Methadone
Dextropropoxyphene
Ethoheptazine
Tramadol
NON OPIOID ANALGESICS
& NSAIDs
Analgesic and Anti inflammatory
A.
NON-SELECTIVE COX INHIBITORS
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Salicylates – Aspirin, Salicylamide, Benorylate, Diflunisal.
Pyrazolone derivatives – Phenyl butazone, Oxyphenyl-butazone.
Propionic acid derivatives – Ibuprofen, Naproxen, Ketoprofen,
Fenoprofen, Flurbiprofen, Oxaprozin.
Indole derivatives – Indomethacin, Sulindac.
Anthranilic acid derivative – Mephanimic acid, Flufenamic acid.
Aryl acetic acid derivative – Diclofenac, Tolmetin..
Oxicam derivative – Piroxicam, Tenoxicam.
Pyrrolo pyrrole derivatives – Ketorolac, Feprazone.
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B. Prefential COX-2 inhibitors
- Nimesulide
- Meloxicam
- Nabumetone
C. Selective COX-2 inhibitors
- Valdecoxib
- Celecoxib
- Rofecoxib
D. Analgesics with poor Anti inflammatory
action1. Paraminophenol derivative
- Paracetamol (Acetaminophen)
2. Pyrazolone derivative
- Metamizol, Propiphenazone
3. Benzoxazocine derivative
- Nefopam
INDICATIONS OF NSAIDS IN
DENTISTRY
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Irreversible pulpitis
Apical periodontitis
Acute alveolar abscess
Infected cyst
Sinusitis
TMJ Arthritis
MPDS
After tooth extraction
Dry socket
Recurrent apthous ulcers
Lichen planus
Agranulocytosis
Cyclic neutropenia
GENERAL CONTRAINDICATIONS
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Ulcer
Asthma
Patient with nasal polyp
Diabetes
Gout
Influenza (Reye’s syndrome)
Hypo coagulation state
Chronic allergic disorders
Chronic liver disease
Renal failure
Salicylate allergy
Breast feeding mothers
Pregnancy
FDA Drug Categories
DO NOT PRESCRIBE!
Methotrexate
ACE inhibitors
Carbamazepine (Tegretol)
Valproic acid (Depakote)
Isotretinoin (Accutane)
Warfarin
NSAIDs (Ibuprofen, Indomethacin)
Antibiotics throughout pregnancy
Generally considered safe:
Penicillin / Ampicillin / Amoxicillin
Nitrofurantoin
Cephalosporins
Clindamycin / Azithromycin / Erythromycin
Metronidazole orally and topically is safe