Drugs to prevent caries, plaque, and gingivitis Flashcards Preview

AU 15 - Pharmacology Exam 3 > Drugs to prevent caries, plaque, and gingivitis > Flashcards

Flashcards in Drugs to prevent caries, plaque, and gingivitis Deck (34):
1

Tooth enamel is made up of mostly what?

More or less hydroxyapatite

2

What is dissolved in saliva and sometimes adds back to enamel?

Ca+2
PO4-3

3

What is the interaction of PO4 and acid?

PO4 is a base, and the pH will affect the distribution of it's ionic forms

4

Acid induced demineralization

The lower the pH, the less PO4-3 will be available
Thus, the acidic environment will lead to more removal of (Ca+2)3(PO4-3)2 from enamel

5

What is the "critical pH"?

5.5
Above, teeth will remineralize
Below, teeth will lose minerals

6

What drugs can prevent caries

Fluoride

7

If all of the hydroxide in a tooth was replaced with fluoride, you would have a tooth with what?

Smaller crystals
Better H bonding within the crystal
Decreased solubility

8

What does a 'fluoridated tooth' have?

A little Fluorohydroxyapitite
A lot of Hydroxyaptite

9

What does fluoride inhibit?

Enolase

10

Substitution of some of the hydroyls in the HA lattice of tooth enamel with fluoride increases what? By what mechanism?

Increases the resistance of the enamel to demineralization under mildly acidic conditions
Satisfactory explanation for this effect have not yet been provided

11

Dental plaque

A biofilm or mass of bacteria that grows on surfaces within the mouth
Commonly associated with oral diseases such as caries and perio disease
Formation is a normal process that cannot be prevented

12

Facultative anaerobe

Organism that make ATP by aerobic respiration if oxygen is present, but is capable of swiching to fermentation under or anaerobic respiration if oxygen is absent

13

What can be found in healthy gums

Gram+ microbes
Facultative anaerobes

14

What can be found in unhealthy gums

Gran- microbes
Obligate anaerobes

15

Absorption in the mouth

Vascular and thin epithelium allows drugs to be well absorbed
This is great for drugs like nitroglycerin, but not so great if you want drugs to act in the mouth and no where else
Drugs tend to be highly ionized for this reason

16

Oral cavity distribution

The ability of oral agents to bind reversibly to oral reservoirs is an important quality for sustained release oral drugs

17

Salivary flow is a major determinant of what?

The duration that a drug remains in contact with the surface of the tooth

18

Substantivity

The time a drug is in contact with a particular substrate in the oral cavity
Reflects reversible binding to oral reservoirs and rate of clearance by salivary flow

19

What are properties of good antiplaque and anti-gingivitis agents?

Safe
Efficacious
Speficic
No induced drug resistance
Good/acceptable taste
Low cost

20

What are some anti-plaque and anti-gingivitis agents?

Bis-biguanised
Non-ionic bisphenols
Phenolic compounds
Quaternary ammonium compounds
Morpholino compounds

21

What are examples of Bis-biguanides?

Chlorohexidine
Alexidine

22

How does Chlorohexidine work?

Ruptures bacterial cell membranes, leading to leakage of contents and death
Binds salivary mucins, reducing pellicle formation, which in turn inhibits bacterial colonization
Binds bacteria, inhibiting absorption onto the teeth

23

What might be a indication for chlorohexidine?

Gingivitis
Periodontitis
Dental traumas
Oral cysts
Post wisdom tooth extractions

24

Low doses of chlorohexidine are what?

Bacteriostatic

25

High doses of chlorohexidine are what?

Bacteriocidal

26

Chlorohexidine acts on what type of bacteria

Both gram+ and gram-

27

What is an example of non-ionic bisphenol?

Triclosan

28

High concentrations of triclosan act as what?

Biocide with multiple cytoplasmic and membrane targets

29

Lower concentrations of triclosan are what?

Bacterostatic; targeting bacteria primarily by inhibiting fatty acid synthesis

30

Triclosan theraputics in toothpaste and mouth rinses

Moderal plaque-inhibitory action and antimicrobial substantivity of around 5 hours

31

Phenolic compunds

Phenol, thymol, chlorothymol, hexylresorcinal
In many mouth rinses
Probably has more of an effect on gingivitis than on plaque formation (anti-inflammatory?)

32

Quaternary ammonium compound example

Cetylpyridinium chloride (CPC)

33

Cetylpyridinium chloride (CPC)

Catatonic quaternary ammonium compound used in some types of mouth rinses, toothpastes, lozenges, throat sprays, breath sprays and nasal sprays
Antiseptic that kills bacteria and other microorganisms
Shown to be effective in preventing dental plaque and reducing gingivitis
May cause brown staining, but they're easily removed during prophys

34

Morpholinos

Cationic surfactant
Keeps bacteria from attaching to tooth surface