305 microbiology and pathology Flashcards
(114 cards)
1
Q
Microorganisms that have the capability of producing a disease are referred to as what?
A
Pathogenic microorganisms/Pathogens
2
Q
Microorganisms that do not have the capability of producing illnesses or diseases are referred to as what?
A
Non pathogens
3
Q
what are the 3 main groups of pathogenic microorganisms?
A
Bacteria: Microscopic single cell organisms that can survive as inactive spores when conditions do not let them grow or reproduce.
Viruses: Ultra microscopic organisms that live within cells of other organisms
Fungi: Types of microscopic plant organisms that grow across tissue cells as an extensive branching network of fungal tissue
4
Q
What is the fourth type of microorganism, but has no relevance to dentistry as the microorganism does not cause diseases within the oral cavity?
A
Protozoa
5
Q
What are prions?
A
Not living microorganisms but an infectious protein that is capable of causing disease
6
Q
What are the diseases caused by prions?
A
Kuru in humans, Mad cow disease and its human variant called Creutzfeldt-Kakob disease (CJD) and its new variant VCJD
7
Q
Why is the transmission of CJD and VCJD becoming a concern in dentistry?
A
Prions are not killed by decontamination or sterilisation which means an infected patient could pass on CJD to another patient when instruments are sterile
8
Q
Prions are specifically known to effect what?
A
Nerve tissue
9
Q
Why are endodontic instruments considered single use items?
A
They come in contact with the nerve tissue found within the pulp of the teeth, using single use items avoids the possibility of passing prions from one patient to another
10
Q
What are the 3 bacteria’s?
A
Cocci: Circular microorganisms. Those living in clusters are called Staphlococci. Those living in chains are called Streptococci
Bacilli: Rod shaped with pointed ends. Rounded ends are called Lactobacilli
Spirochaetes: Spiral shaped like a helix
11
Q
What can bacteria survive as and why?
A
Spores. When bacteria can not grow it can survive as spores. This is because spores have a hard outer coating that protects the bacteria within from chemicals, drought and change in temperature. This means they can survive cleaning chemicals used for disinfection so items have to be sterilised or used once
12
Q
What is anaerobic bacteria,why is it harmful and what is it also known as?
A
This type of bacteria is an organism that doesn’t require oxygen to grow. It is harmful because these are difficult to remove physically and require drug treatment methods. Also known as an anaerobe
13
Q
what is aerobic bacteria?
A
Organisms that require an oxygenated environment
14
Q
To fight against bacteria the most important drug groups are?
A
Antibiotics: Taken to kill bacteria causing illness but can kill useful bacteria in the body e.g digestive system-associated with stomach pains and diarrhoea. Different antibiotics are required when infections are anaerobic or aerobic.
Bactericidal agents: Chemicals used to clean externally that act to kill bacteria e.g on work surfaces.
Bacteriostatic agents: Chemicals used to clean externally, don’t kill externally but prevent them from reproducing
15
Q
What is the associated disease with the bacteria called Streptococcus mutans?
A
Dental caries
Initial ineffective bacteria found in a caries, when a cavity first forms. Also responsible for most of the production of the weak organic acids that cause enamel demineralisation
16
Q
What is the associated disease with the bacteria called Lactobacillus?
A
Established dental caries
Later colonisation of an established caries lesion, as the deeper tooth tissues become infected
17
Q
what is the associated disease with the bacteria Actinomyes, Prophyromonas gingivalis, Prevotella, Intermedia, Treponema, Denticola, fusobacterium, nucleatum, Campylobacter, Rectus? And what is it?
A
Periodontal disease
Periodontal disease is the bacterial infection of the supporting structures of the teeth e.g gingivae, periodontal ligament, cementum, alveolar bone
18
Q
What is the associated disease with the bacteria staphylococci?
A
Skin boils, gingival boils and impetigo
19
Q
What is the associated disease with the bacteria bacillus fusiformis and borrelid vincentii?
A
Gingivitis
Acute necrotising ulcerative gingivitis, a specific periodontal infection seen in young adults when their oral hygiene is particularly poor
20
Q
What is the structure of a virus?
A
Reproductive chemicals
protein capsule
base to attach to host
21
Q
What is a anti-viral agent?
A
Drugs to treat viral infections
22
Q
What drug is used to treat cold sore lesions on the lip caused by herpes simplex type 1 virus?
A
The drug Aciclovir used as a topical cream
23
Q
What is acquired immunity?
A
Immunity that develops after exposure to a dead virus or its protein capsule which is injected in to the individual or given orally. The presence of this causes the bodys immune system to fight against it making anti-bodies, so if the person is exposed to the viral disease the body can fight it
24
Q
How are viruses killed?
A
Sterilisation/use of viricidal chemicals
25
What does a viricidal chemicals do?
Viricidal/viracide is a chemical agent that destroys viruses
26
What is the associated disease with the virus name Hepatitis A,B,C?
Various inflammatory liver disease some are fatal.
Hepatitis B vaccinations are an occupational health requirement
27
What is the associated disease with the virus Human Papillomavirus (HPV)?
Oral cancers
Certain types of this virus have been inked to oral cancer, especially those occurring in the oropharyngeal regien- the part of the throat at the back of the mouth
28
What is the associated disease with the virus Herpes varicella?
Chicken pox
Chicken pox which effects the area supplied by the trigeminal nerve (cranial nerve v) as well as the torso.
Trigeminal nerve is responsible for sensations in the face and motor functions such as biting and chewing
29
What is the associated disease with the virus Human Immunodeficiency virus (HIV)?
Aids
A blood borne infection which was initially found in certain patient groups; drug users/homosexuals but can now be found in the wider population
30
What is the associated disease with the virus herpes zoster?
Shingles
A painful blistering skin rash which can involve the area supplied by the trigeminal nerve (cranial nerve v) as well as the torso
31
What is the associated disease with the virus Herpes simplex type 1?
Cold sores
Blister lesions occurring on the lips, highly infectious in their initial stages if touched
32
What is the associated disease with the virus Epstein-Barr virus
Glandular fever
A debilitating viral infection which results in painfully swollen lymph glands including those found in the neck. Lymph glands are also known as lymph nodes
33
What is the associated disease with the virus Paramyxovirus?
Mumps
A viral infection of the parotid salivary glands (either one or both) but doesn't effect any other salivary glads.
34
What is the associated disease with the virus Coxsackievirus?
Hand, foot and mouth disease
A common infection seen in young children which presents as painful blistering in the oral cavity, on the palms of their hands and soles of their feet
35
What are the characteristics of fungi/how do they grow?
Plant like organism. Grow as an extensive network of branches lying across the body tissues called hyphae and reproduce by budding out from the ends of the hyphae or by the producing of spores from fruiting bodies like microscopic mushrooms
36
Which fungal infection is important in dentistry?
Candida albicans
37
What is the fugal infection caused by Candida albicans responsible for?
lesions and diseases in the mouth called:
Acute oral candidosis (oral thrush)
Chronic oral candidosis
Angular cheilitis
38
Give an explanation of Acute oral candidosis (oral thrush)?
Removable white film with red sore patches on the soft tissues of the oral cavity-hard palate and cheeks. Associated with ill health in the elderly or those suffering from disease e.g aids.
In a healthy individual this would develop because of the disruption in the populations of the normal oral bacteria usually following a cause of antibiotics, known as denture sore mouth.
39
Give an explanation of Chronic oral candidosis/what is it also known as?
Also known as denture stomatitis. Occurs in healthy patients beneath both dentures and removable orthodontic appliances as a reddened but painless area lying exactly across the platal section of the appliance. It is associated with poor appliance hygiene and raised moisture levels beneath the appliance allowing the fungus to colonise the underlying oral tissues
40
Give an explanation of Angular chelitis?
Involves the angles of the mouth, appears inflamed/ cracked which is often crusted over. wide mouth opening will split the lesion and cause bleeding and more splitting. Associated with constant saliva leakage into the angles, allowing the fungal infection to occur-patients usually have deep tissue folds here or a 'crumpled face' appearance due to loss of their occlusal face height. This may be due to edentulousness, worn dentures or tooth surface loss with age
41
How are fungal infections treated?
Treated with ani-fungal agents:
Tablets
oral gels
oral solutions/pastille
42
What are some examples of antifungal agents?
Topical nystatin pastilles or solution
Amphotericin lozenges tablets
Miconazole gel
Sustemic fluconazole tablets
43
What are the effects of disease on the body?
Infection/Inflammation
Ulceration
Oral white/Red Patches
Formation of a cyst
Formation of a tumore- Bengin or malignant
Congenital or development defect
44
What is an infection?
An infection is an invasion of the body cells by the pathogens, resulting in a inflammatory response of cells that produces the five signs of inflammation
45
What are the five signs of inflammation?
Heat
Swelling
Pain
Redness
Loss of function
46
What are the dentally relevant infections?
Dental caries
Periodontal disease
Herpes simplex
47
What are the four inflammatory conditions affecting the oral cavity?
Stomatitis
Angular chelitis
Glossitis
Buring mouth syndrome
48
What is Stomatitis?
Inflammatory condition affecting the oral cavity.
- Occurs is elderly, denture wearers
- Mucosa appears red and inflamed and has an overlying candida infection present
- Responds well to improved oral/denture hygiene
- Can be due to malnutrition especially in the elderly
49
What is Angular cheilitis?
Inflammation of the corners of the mouth.
- Occurs in elderly patients who are denture wearers as on extension of stomatitis
- Appears as red and inflamed angles-cracking on opening
- Due to loss of facial height which allows saliva pooling in the area
- Wet conditions produced allows infection with common skin microorganisms e.g Staphlococcus
50
What is Glossitis?
Inflammation of the tongue which appears red and smoothed.
- Seen in iron deficiency anaemia
- Also occurs when extensive Candida infection in present in debilitated patients
- May indicate vitamin B deficiencies
51
What is burning mouth syndrome?
Usually occurs in elderly women and described as the oral cavity being on fire.
- Usually no physical abnormality is found on examination
- Considered psychogenic in many cases, due to depression, fear of cancer or of other serious disorders
52
What is an ulcer?
Ulcer is a shallow break in the skin or mucosa membrane leaving a raw and circular base that may bleed when touched. They have many cases and vary in appearance
53
What are the five ulcer conditions affecting the oral cavity?
Recurrent ulceration
- Minor alphthous ulcers
- Major aphthos ulcers
- Herpetiform apthous ulcers
Ulceration due to systemic disease
- Crohns disease
- Ulcerative colitis
- Coeliac disease
- Inflammatory bowel disease
Ulceration due to viral infections
- Herpes simplex virus
- Cpxsackievirus
Ulceration due to skin disorders
-lichen planus
Malignant ulceration
-Squamous call carcinoma
54
What is recurrent ulceration and the 3 ulcers that reflect it?
They are called this because the ulcers occur again and again usually with no cause but can be due to nutritional deficiencies
- Minor apthous ulcers: small shallow painful ulcers which take weeks/months to heal and leave no scar
- Major apthous ulcers: large painful ulcers, take weeks/ moths to heal and cause scarring
- Herpetiform apthous ulcers: Very small multiple ulcers which occur sometimes up to 100 at a time
55
What are the ulcers due to systemic disease?
Diseases affecting the digestive system often exhibit oral ulceration. some examples include:
- Crohns disease
- Ulcerative colitis
- Coeliac disease
- Inflammatory bowel disease
56
What are the ulcers due to viral infection?
There are two viral diseases associated with this:
- Herpes simplex virus: Causes ulceration of most of the oral soft tissues and recurs throughout life as herpes libials-cold sores
- Coxsackievirus: Hand, foot and mouth disease in childhood with small ulcers present in all these areas, specifically on the soft palate and back of the mouth in the oral cavity.
57
What are the ulcers due to skin disorders and the relevant condition?
-Lichen planus: An inflammatory skin condition that often causes oral ulceration in suffers.
Oral lesions are recognised as being premalignant which means they can undergo call mutation and develop into malignant (cancerous lesions)
Ulcers appear orally with white striae (stripes) around them
58
What is the malignant ulceration and which one is relevant in the mouth?
-Squamous cell carcinoma: Develops as an ulceration in the floor of the mouth or on the sides of the tongue. Painless, no obvious causes and doesnt heal within 2-3 weeks of appearance. Apthous-like ulcer with a 'punched out' floor and rolled edges- Advanced malignancy usually diagnosed in smokers, uses of tobacco products and heavy alcohol users
59
What are the white and red patches and the 3 conditions that reflect this?
Oral white patches can occur as transient or presistent lesions.
-Oral candidosis: Commonally occurring infection with the fungas cadndida albicans, producing a transient white patch that can be wiped off the oral mucosa and leave a raw area underneath. Occurs after using antibiotics, which disturbs microorganisms in the body and allows the overgrowth of fungus-Denture sore mouth. can occur in immune compromised patietns/inhaler users
- Leukoplakia: White patch with no cause, can not be removed from mucosa by wiping. Appears as white striae on the buccal muccosa or the tounge. Potentially premalignant condition. Associated with smoking/heavy alcohol intake.
- Erythroplakia: Red patch on the oral mucosa, in isolation or adjacent to an area of leukoplakia
60
What is a tumour and the 4 dentally relevant tumours?
Tumour is a swelling within the body tissue due to abnormal overgrowth of body cells. when the swelling causes no harm it is called bengin but when the swelling invades and damages the surrounding structures it is called malignant.
-Squamous cell carncinoma of the oral epithelium
-Osteosarcoma of the maxilla or mandible
Salivary gland tumours -Lymphoma; lymph glands in neck
61
What is a cyst and name the 3 dentally relevant cysts?
Abnormal sac of fluid within body tissues
- Dentigerous cyst: Develops around on impacted, unerupted tooth.
- Periapical cyst: Develops around the tooth apex
- Trauma of minor salivary glands, producing a cyst called a mucocele. occurs on the lower lip
62
What is the congenital/development defect and name 33?
An inherited condition or genetic mutation that produces produces a condition present from birth.
- Cleft lip or palate
- Congenital absence of some teeth (hhpodontia)
- Defect of tooth formation e.g amelogenesis imperfecta
63
What is the bodys natural line of defence against a pathogen attack?
Physical and chemical barriers: Intact skin and mucous membrane act as physical barriers against the pathogens preventing them from invading deeper tissues of the body
Surface secretions on to the skin or mucous membranes help to dilute and neutralise the pathogens and their poisons (toxins) such as saliva, gastric juice, sweat and tears.
Inflammatory defence within the body tissues if skin/muccous membrane is breached
64
Who are more likely to be unable to defend themselves from a pathogen attach?
Elderly: Cells and tissues wear out with age and not be replaced easily
Young children/babies: immune system will not be fully functioning-prone to develop disease. Not developed acquired immunity yet
Debilitated: Patients who are immunocompromised as they have illnesses affecting their immune system to fight pathogens-Kidney failure, aids, cancers and leukaemia
65
How does infection occur and what are the 5 ways it can enter the body?
Infection occurs when pathogenic microorganisms breach the skin or mucouc membrane and gain entry to the deeper body issues.
- Direct contact: Saliva, blood and vomit
- Airborne droplets: Of bodily fluids from infected host by sneezing, coughing or spitting
- Aerosol spray: Created during the use of dental hand pieces, water sprays spraying blood and saliva in the atmosphere.
- Direct entry: Damaged skin, oral epithelium from cuts/ eye
- Inoculation injury: Piercing skin/ oral epithelium
66
What is the bodys response to a pathogenic attack in their inflammatory response?
If the bodys tissues are breached an inflammatory response occurs.
-White blood cellls transported to fight pathogens, increase, in blood volume causes tissue to be red/swollen, swollen tissues will press against nerve cells, causing pain resulting in loss of function. Toxic production by pathogens may cause rise in temperature called pyrexia. Both leukocytes and pathogens are killed during the infection and their debris collect and form puss in the body tissues. If the puss remains in the area it is called an abscess, but if i spreads to the surrounding tissue it is called cellulitis. This is described as acute infection but when it occurs over a long period of time with pain and other symptoms its called chronic infection. If the microorganism if difficult for the inflammatory response to control it is called virulent.
67
What are the five signs of inflammation?
Heat
Swelling
Redness
Pain
Loss of function
68
What happens to the body when exposed to physical and chemical irritants such as cuts, fire burns or chemical burns?
When a inflammatory response occurs in the absence of microorganisms no infection will occur or puss form and the body tissues will repair any damage caused by the irritant
69
What happens after the inflammatory response?
Tissue repair-The body will start repairing it self. Leukocytes will travel to the area and remove dead/damaged tissue and lay down a layer of temporary repair cells called 'granulation tissue'. Consists of tissue cells and capillaries forming a fibrous for specialised cells to grow and develop on to so if the damage occurred in the skin, skin cells will be formed/if in bone bone cells will be formed.
70
What are the four types of immunity?
- Natural immunity: Present from birth by being randomly inherited
- Passive immunity: Present from birth and specifically inherited directly from the mother own pool of antibodies and antitoxins
- Acquired immunity: Creation of the antibodies/antitoxins by the leukocytes during pathogenic attack- new antibodies remain for life
- Vaccination to produce acquired immunity: Harmless dose of pathogen to stimulate leukocytes to develop the antibodies/antitoxins.
71
What is a mutation?
Microorganism that changes their chemical make-up and produces a new variant of a disease
72
Which diseases should dental staff be vaccinated against?
- Hepatitis B
- MMR: Measles, Mumps, Rubella
- Tuberculosis and whooping cough (Pertussis)
- Diphtheria and tetanus
- Chicken pox
- Meningitis
73
What procedures are in place to avoid infection?
- Staff vaccination
- PPE, during treatment/ cleaning
- Using single use items
- Correct decontamination and sterilisation of reusable items
- Correct cleaning of clinical areas
- Thorough hand washing
74
What is an allergy?
Normal Immune response over reacts to the presence of an antigen: allergic reaction occurs- results in swelling of tissues and production of copious fluids from body tissues. The substance that stimulated the over reaction is called an allergen
75
What are the effects/symptoms of an allergic reaction?
Hay fever like symptoms
Mild rash
Full anaphylactic shock
76
Who is more likely to be prone to an allergy?
Those who suffer from:
Asthma
Eczema
Hay fever
77
What is contact dermatitis?
Red, itchy rash. Found in dental staff due to increased use of hand cleaning products, surface cleaning sprays and wipes.
78
What is a dental caries?
Bacterial infection of the hard tissues of the tooth
79
What is periodontal disease?
Bacterial infection of the gingivae and periodontal supporting tissues
80
What is oral thrush?
Fungal infection of the oral soft tissues
81
What is a periapical abscess?
Bacterial infection of the tooth pulp causing abscess formation of the apex-can be chronic or acute
82
What is a periodontal abscess?
Bacterial infection within a periodontal pocket causing abscess formation
83
What is a apthous ulcer?
Ulceration of the oral soft tissues that is not related to infection
84
What is a herpetic ulceration?
Viral infection of the oral soft tissues causing ulceration
85
Waht is acute necrotisng uncerative gingivitis?
Acute bacterial infection of the gingivae causing ulceration
86
What is a dental cyst?
Cyst formation associated with a tooth, either erupted or unerupted
87
What is a alveolar bone cyst?
Cyst formation within the jaw bone
88
What is periocoronitis?
Acute bacterial infection of the soft tissues (operculdum) associated with a partially erupted tooth, especially the lower third molars
89
What is localised osteitis?
Bacterial infection of the bony walls of an extraction socket also called 'dry socket'
90
What is cellulitis?
Bacterial infection spreading from a tooth in to the surrounding deep soft tissue structures
91
What is a cleft palate?
Development defect of the palate (roof of the mouth) where the two bony halves fails to join together completely during embryonic development
92
What is oral cancer?
Malignant tumour usually affecting the oral soft tissues initially and then spreading to the underlying tissues if treated
93
Oral cancer includes those affecting what area?
```
Lip
Tongue
Floor of the mouth
Gingiva
(and other oral soft tissues)
```
94
What is squamous cell carcinoma (SCC)?
Form of skin cancer that develops in the squamous cells that make up the middle and outer layers of the skin
95
What is a carcinogen?
Substance capable of causing cancer in living tissue
96
what are the 5 known risk factors of oral cancer?
-Tabaco habits
-High alcohol consumption: Solvent for carcinogens allows easy entry into deeper layers of soft tissues. Binge drinking is more harmful
Both smoking and drinking: Higher risk of developing SCC
-Sunlight: Fair skin- sunlight associated with SCC on lower lip
Genetics: Predisposed to develop SCC
-Diet: link made with diets low in fresh fruit and vegetables- green and yellow veg
97
What is NCSCT?
National centre for smoking cessation and training
98
What are the 4 types of drugs use to fight disease?
- Antibiotics
- Antivirals
- Antifungals
- Analgesics
99
What are antibiotics used to fight against?
Specifically used to fight against infection by bacteria
100
What is a antimicrobial?
Agent that kills microorganisms or stops the growth (tablets)
101
What are the limitations of using antimicrobials?
- Side effects: Nausea, vomiting and diarrhoea
- Allergic reactions: Sensitivity reactions to the colour dyes in capsules/ anaphylaxis to drugs e.g penicillin
- Interactions with other drugs: Prevents from working/ side effects e.g penicillin's and methotrexate
- Resistance: Overuse of antibiotics allows resistant strains of bacteria to evolve which are not killed by usual antibodies
102
Which antibiotics are recommended when a patient is suffering from acute or chronic dento-alveolar infections, or a periodontal abscess, when there is evidence of local spread of the infection (as a diffuse or swelling) or there is systemic involvement shown by an elevated temperature (pyrexia) or the patient looks and feels generally unwell?
Amoxcillin (or phenoxymethylpencilin) as a 500mg dose three times daily for up to 5 days- adults
Metronidazole: Alternative to Amoxicillian or used together. Dose of 400mg 3 times daily for up to 5 days. Adults warned not to drink alcohol
Clarithromycin or crythromycin: Alternative to penicillin dose of 200mg twice daily for up to 5 days. Erythromycin is less effective as organisms are resistant to it.
Clindamycin: Recommended for dento-alveolar infections, its over use will allow resistant strains of to develop
103
Which antibiotics are recommended when a patient is suffering from acute necrotising ulcerative gingivitis or pericoronitis in addition to operational measures to treat infections?
-Occupational measures:
With acute necrotising ulcerative gingivitis thorough scaling and appropriate oral hygiene instructions should be given especially chlorhexidine mouth wash.
With pericoronitis thorough cleaning in the area and irrigation with warm salt water or a specialist mouthwash- Peroxyl
- Metronidazole: Dose of 400mg 3 times daily for 5 days.
- Amoxicillin: patients who cant take^ (pregnant/alcohol dependant) 500mg 3 times daily for 5 days
104
What medications are recommended by some implant manufactures to prevent postoperative infections and pain and peri-implantitis?
Amoxicillin: 4 500mg capsules taken 1 hour before surgery
Clindamycin: patients allergic to penicillin, 600mg ( 4 150 mg capsule) taken 1 hour before surgery
105
What is antibiotic prophylaxis?
giving antibiotics to stop infection occurring
106
What is endocarditis?
Infection of the endocardium, which is the inner lining of your heart chambers and heart valves. occurs when bacteria, fungi or other germs from another part of your body such as your mouth, spread to your blood stream and attach to damaged areas in your heart
107
why is antibiotic prophylaxis no longer needed/recommended?
Patients with certain heart conditions/valve or joint replacements were previously considered at risk from developing dangerous infections within the heart or joint following dental treatment. Evidence based research 10 years ago determined the use of prophylactic antibiotics for these patients was not necessary
108
What are anti-virals used to fight against?
Specifically used to fight against infections caused by a virus. Only infection of dental relevance is cold sore herpes labialis produced on the lip after a primary infection with herpes symplex type 1 virus
109
What is given to treat Herpes labialis?
Aciclovir antiviral cream applied to the lesion 5 times daily for 5-10 days- may prevent the full development and blistering of the cold sore infection
110
What are the antifungals used to fight against?
Drugs specifically used to fight against fungal infections
111
What antifungals agents are prescribed when a patient has denture stomatitis, sores at the angles of the mouths?
Antifungal lozenges or pastilles to suck or gels
capsules
Fluconazole: Difficult fungal infections- 1 daily 500mg 7-14 days
Nystatin: Oral suspension or lozenges 4x daily after food for 7 days
Amphotericin: As 10mg lozenges to be dissolved in the mouth 4xdaily between 10-15 days
miconazole: Oral gel to be swilled around the mouth 4x daily
112
What are analgesics used for?
Drugs used to relieve pain, although some have other effect too. All analgesics should be avoided during pregnancy
113
What is antipyretic?
Drugs used to reduce prevent fever
114
What analgesics are used?
Paracetamol: An analgesic and has antipyretic properties. However it can cause liver damage if dose exceeded.
Ibuprofen: Safer that paracetamol but can cause stomach ulcers if exceeded, shouldn't be given to asthmatics
Aspirin: Has anti-inflammatory properties. Limitations include acts as an anticoagulant to shouldn't be given after extractions, causes stomach ulcers, cant be given to to those under 16- Rare complication of Reyes disease; fatal brain disease, avoid asthmatics
