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DENTAL HYGIENIST
M.DJAMALUDIN,DR.,SPFK.,M.KES
DEPARTMENT OF PHARMACOLOGY
UNJANI MEDICAL FACULTY
Antimicrobial agents
Antibacterial agents
Antibiotic agents
Bactericidal
Bacteriostatic
Infection
Minimal lnhibitory Concentation (MIC)
Spectrum
Superinfection
Suprainfection
Synergism
Antagonism
ANTIINFECTIVE AGENTS
Caries
Cariers produced by Streptococcus mutans, is the
first imporant dental infection of the newly erupting
teeth of the young patient.
Periodontal disease
In adult patient, the dental health care teams
biggest dental problem is peri0dontal disease
SYSTEMIC INFECTIONS
Systemic
PERIODONTAL MICROBES
Aggregatebacter actinomycetes comitans
Porphyromonas ginggivalis
Prevotella intermedia
Elkenella corrodens
Fusobacterium spp.
Campylobacter rectus (Wolinella recta)
AIDS-related complex
HIV
Alcoholis
Blood discrasias
Cancer
Cirrhosis of the liver
CLASSIFICATION OF ANTIINFECTIVE
AGENTS BACTERICIDAL OR
BACTERIOSTATIC
BACTERICIDAL
Aminoglycosides
Bacitracin
Cephalosporins
Metronidazole
Macrolides
Penicillin
Polymyxin
BACTERIOSTATIC
Chloramphenicol
Clindamycin
Macrolides
Spectinomycin
Sulphonamide
Tetracyclines
Trimethoprim
ALTERNATIVE
Metronidazole
Tetracycline
Tetracycline
Amoxicillin + Metroidazole
Augmentin + Clavulanate
Clindamycin
Amoxicillin+Metron
ORAL INFECTION
PROPHYLACTIC INDICATIONS
Before a dental procedure (recomended) by the
Allergic Reaction
Drug Interaction
- Oral contraceptive
- Oral anticoagulant
- Other antiinfective
SUPERINFECTION(SUPRAINFECTION)
All antiinfective agents can produce an overgrowth of an
organism that is different from the original infecting
organism and resistant to the agent beiing used. The wider
spectrum and the longer administrating the agent the
greater chance of superinfection occuring.
ALLERGIC REACTIONS
All antiinfective agents have the potential to produce a
DRUG INTERACTIONS
Oral contracepties
Antibiotics decrease oral contraceptive efficacy by
increasing their clearance from the body.
Oral anticoagulants
Oral anticoagulants are vitamin K inhibitor, so
interfering with vit K could increase the anticoagulant
effect. Antiinfective agents reduce the bacterial flora that
produce vit K.
Gastrointestinal Complaints
The most serious gastrointestinal complain of any of
the antibiotics i.e erythromycin which linked with
clindamycin.
Pregnancy
The antimicrobial agents that can give during pregnancy
to treat infections are limited.
ERYTROMYCIN
Erythromycin, have not associated with teratogenicity and
are often used. The use of clindamycin probably also
acceptable, but before any antibiotics are used in the
pregnant dental patient, the patients obstetrician should
be contacted.
Cost
Cost is an important factor in choosing an antibiotic for
PENICILLIN
Divided in four major group:
1. Penicilin G and V
2. Penicillinase-resistant penicillin (Ampicillin)
3. Third group (Amoxicillin)
4. Extended-spectrum penicillins(Carbenicillin)
In dentistry, the first and the third groups are
commonly used.
PHARMACOKINETICS
ROA : p.o. and p.e.
are that the blood levels rise slower, the blod levels are
less predictable because of variable absorption or lack of
patient compliance (biggest problem), and some
penicillin are degraded by gastric acid.
PENICILLINS
Source and Chemistry
Pharmacokinetics
Mechanism of Action
Spectrum
Resistance
Adverse Reaction
Toxicity
MACROLIDES
Erythromycin
Azithromycin
Clarithromycin
ERYTHROMYCIN
ROA : Po and pe (i.v and i.m)
Adverertse Reaction:
Stomatitis, nausea, vomitus,diarrhea and abdominal
cramp then other i.e cholestatic jaundice.
Drug Interaction:
Theophyllin, digoxin, triazolam, warfarin,
carbamazepine and cephalosporine
USES
As alternative therapy for patient with Penicillin
CLARYTHROMYCIN
Increases the level of drugs metabolized in liver such as
TETRACYCLINE
Bacteriostatic
Pharmacokinetic
Spectrum
Adverse Rection:
Hematologic effect
Super infection
Photo sensitivity
Allergy
Drug interaction
USES :
CLINDAMYCIN
Bacteriostatic, Effective against Gram positive and
METRONIDAZOLE
Antiparasit.
For anaerobic bacteria.
Pharmacokinetics: p.o.
Bactericidal.
DENTAL
Because of its anaerobic efficacy,metronidazole is useful
CEPHALOSPORINE
Structurally related to penicillin.
Adverse Effect :
USES
Their dental use includes prophylaxis for patients with
Referensi
Elene Bablenis Heveles, BS Pharm, PharmD,.et al
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