Pharmacology - T3 C. Local Anti-Infectives

Front 1

what are 2 broad classes of anti-infectives?
p126

Back 1

antiseptics - on tissue, inhibits w/o killing, bacteriostatic/fungistatic
Disinfectants - on inanimate objects, kills, bactriocidal,fungicidal,virucidal,sporicidal

Front 2

t/f disinfecting is sterilization b/c of limitation of our commercial products all can be safely autoclaved. who regulates disinfection?
p126

Back 2

disinfection is ont sterilization

EPA (environmental protection agency)

Front 3

minor oral infections are treated how?

p126

Back 3

with antiseptics, often used for 2nd-ary infections of superficial oral ulcerations, topical

Front 4

antiseptics used preventatively?
p126

Back 4

ADA guidelines test to establish efficacy (if better than placebo) - used to prevent plaque and gingivitis

Front 5

what are mechanisms of action for anti-infectives?

p127

Back 5

denaturing proteins, bind covalently with sulfhydryls and disulfide bonds in key enzymes
osmotic disruption (pore formation)
interferes with specific metabolic processes - altring enzymatic processes
all bacteriocidal

Front 6

effectiveness of anti-infectives depends on preparation, avoid what? what else is important with preparation/use?
p127

Back 6

avoid ritualism
measure accurately
shelf life - read instructions
contacting time (w/ organisms) read

Front 7

why scrub instruments before anti-infectives used?
p128

Back 7

many agents have reduced efficacy to organic materials, bind tightly and don't go after the microbes they should. so scrub debris away first

Front 8

3 facts about sodium hypochlorite, first, what is sodium hypochlorite?
(mech, mj clinical application, mj disadvantage)
p128

Back 8

bleach 1. releases chlorine denaturing key enzymes
2. effective surface disinfctant, needs 10 min contact time
3 corrosive to metals (incl. instruments) and plastics, irritates skin

Front 9

iodine
mech, mj. clinical application, mj disadvantage
p129

Back 9

1. release of iodine denatures
2. complexes o polymers (or glycols) to form IODOPHORS) which are surface disinfectants. less discoloring, odor, pain (open wounds)
3. corrosive o some metals, discolors some, inactive w/ hard water

Front 10

glutaraldehyde
mech, mj. clinical application, mj disadvantage
p129

Back 10

1. cross-links to denature enzymes
2. used as immersion disinfectant (instruments) 10 hrs, overnight
3. irritation to lungs, mucous membranes, never spray, ventilation, short shelf life

Front 11

triclosan
mech, mj. clinical application, mj disadvantage
p129

Back 11

1. nonionic molecule, dissolves into lipid memB., and disrupts transport mech's
2. antiplaque/antigingivitis, less than chx
3. doesn't bind oral structures so complexed to a copolymer for effectiveness

Front 12

essential oils (thymol, clorothymol, menthol, hexylresorcinol) listerine
mech, mj. clinical application, mj disadvantage
p130

Back 12

1. phenolic compounds related to triclosan, denaturing proteins
2. ADA approvedfor mouthrinse (supragingival plaque/gingivitis)
3. discoloration, objectionable taste, high alcolol, allergic, poor h2o solubility

Front 13

Sanquinarine (in Viadent)
mech, mj. clinical application, mj disadvantage
p130

Back 13

denatures enzymes by binding sulfhydryl
2. antiplaque, not ADA ok, too substantive (binds tissue)
3. tastes bad, poor clinical efficacy

Front 14

quaternary ammoniums (cetylpyridinium)
mech, mj. clinical application, mj disadvantage

p130

Back 14

1. cationic detergent (like triclosan), memB's & memB enzymes
2. in mouthrinses as antiplaue, moderately effective good substantivity
3. poor activty w/ gm -. inactivated by organic stuff, low pH, soaap, metal ions, taste bad

Front 15

hydrogen peroxide
mech, mj. clinical application, mj disadvantage
p131

Back 15

oxidizing agent. 1. hydroxyl radical, attacks bacteria components
2. used as antiseptic (3%) perio, O2 toxic to anaerobes. effervescent O release
3. lot of peroxidase enzymes, carcinogenic at high doses. little proof

Front 16

Chlorhexidine (bis-biquanides)
mech, mj. clinical application, mj disadvantage
p131

Back 16

1. binds bacterial memB = leakage
2. .12% chlorhexidine mouthrinse (peridex) "gold standard antiplaque", good for immunocompromised
3. stains, incrased calculus formation, changes taste perception

Front 17

Chlorhexidine (periochip)
mech, mj. clinical application, mj disadvantage
p131

Back 17

chlorhexidine gelatin matrix, resorbable, 6-9 day. placed after SRP, in pocket that's been resistant to previous PT, destroys disruptive bacteria, localized, improved PD and CAL
3. less likely = resistance/allergy