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 • • Natural Opium alkaloids Morphine & Codeine. Semi synthetic opiates - Diacetylmorphine - oxymorphone - Pholcodeine • - - Synthetic opioids Pethidine Fentanyl Methadone Dextropropoxyphene Ethoheptazine Tramadol NON OPIOID ANALGESICS & NSAIDs Analgesic and Anti inflammatory A. NON-SELECTIVE COX INHIBITORS 1. 2. 3. 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. 4. 5. 6. 7. 8. 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 • • • • • • • • • • • • • 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 • • • • • • • • • • • • • 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