SlideShare a Scribd company logo
1 of 60
Download to read offline
-BY MAHAK RALLI
ROL NO. 41
THIRD YEAR BDS
 The most common clinical situations in
dentistry amenable to drug therapy in children
are pain and infection.
 Drug control is vital to all phases of dentistry
and a thorough knowledge of the art and
science of analgesic therapy is essential for
proper patient care.
 In management of dental pain in paedriatic
patient has lagged markedly behind than that
in the adult patient resulting from
misconceptions regarding the existence of
pain sensation and its tolerance in children.
 They have higher tolerance to pain
 Pain perception is low because of
immunologic immaturity
 Little or no memory of a painful experience
 They are more sensitive to side effects of
analgesics
 There is special risk for addiction to narcotics
 Most of the dental pain is associated with
inflammation.
 Hence, it responds well to drugs with anti-
infammatory components
 A good understanding of pain reaction and
pain perception is required for proper pain
management.
 Pain is objective and measurable, initiated by
physical and chemical stimuli.
 Pain perception may be similar in all patients.
 In contrast to pain perception, pain reaction
depends upon learned experience, ethnic
background, emotional status and presence
of fear and anxiety.
 Analgesics can be broadly classified into-
I. Centrally acting (narcotic) analgesics
eg. Morphine, codeine, pethidine.
II. Peripherally acting (non-narcotic) analgesics
eg. Diclofenac, paracetamol.
III. Topical analgesics
eg. Ethyl aminobenzoate
 These are the most effective against acute
pain, but have a greater incidence of adverse
effects
 They are administered parenterally and are
devoid of anti-inflammatory and anti-pyretic
effects.
 Serious drug dependence and abuse liability
has limited their use in paedriatic dentistry,
eg, morphine, codeine, pethedine,
methadone, dextro propoxyphene.
 Less effective against sever pain, lower
incidence of adverse effects
 Administered orally and used for chronic
lower grade of pain
 Some possess anti-inflammatory and anti-
pyretic effect
 Frequently combined with other drugs
 Low drug-dependance and abuse liability has
increased the scope in paedriatic dentistry
 Eg- ibuprofen, diclofenac, paracetamol,
nimesulide
 These are used to reduced soft tissue pain
associated with local anesthetic
administration and in management of gum
pain during teething and other soft tissue
irritation.
 Available in as gels, liquids, ointments, patch
and pressurized spray form.
 Smallest effective amount is used for children
to avoid anesthetizing the pharyngeal tissues.
 Eg. : ethyl aminobenzoate (benzocaine- an
ester local anesthetic)
Dosage Children <12 yrs : 4-10mg/kg/dose every 6-8 hours
(max daily dose – 40mg/kg/day)
Children >12yrs and adults : 200-400mg every 6 hrs
(max daily dose – 1.2g/day)
Advantages Anti-inflammatory, good for moderate to sever pain
and can be used as anti-pyretic.
Side effects Gastric irritant, may impair clotting
Supplied as • suspension, oral drops: 40 mg/ml
• suspension, oral : 100mg/5ml
• Tab, chewable : 50mg, 100mg contains
phenlyanaline
• Tab : 200mg, 400mg, 600mg
Commonly used analgesics and anitbiotics in pediatric  dentistry (2015 07-09 ralli's conflicted copy)
 Dosage : single dose every 4-6 hours
max. dosage- 1.2g
AGE (year) DOSE (mg)
Under 1 60
1-6 60-120
6-12 150-300
Precautions The drug should not be administered for more than 10
days, as it is available without prescription
Side effects 1. causes renal injury
2. Overdose leads to hepatic necrosis and death if
more than 3g is taken by children under 2 years of
age
Availability • drops-60mg/0.6ml and 120mg/2.5ml
• elixir-120mg/5ml and 150mg/2.5ml
• tablets-325mg and 500mg
• chewable tablets-120mg
• suppositories- 120mg, 300mg, 600mg, 900mg
Crocin 500mg tab, calpol 250mg suspension,
pyrigesic 500mg tab, syrup 120mg/5ml
Commonly used analgesics and anitbiotics in pediatric  dentistry (2015 07-09 ralli's conflicted copy)
Dosage Children : 5-10mg/kg/dose, every 8-12 hours
Adult : oral- 220mg every 8-12 hours, up to
660mg/day.
Advantages Anti-inflammatory and good for severe pain
Side effects Gastric irritant and may delay onset of bleeding.
Supplied as Suspension- 125mg/ml
Tablets- 250mg, 375mg, 500mg.
Commonly used analgesics and anitbiotics in pediatric  dentistry (2015 07-09 ralli's conflicted copy)
Dosage Children : 10-15mg/kg/dose every 4-6hrs, up to a total
of 80-100mg.
Adult : oral, rectal – 325mg to 650mg every 4-6 hours up
to 4g/day.
Advantages Analgesic, antipyretic and anti-inflammatory properties
Side effects Allergic reaction in patients with pre-existing asthma,
atopy and nasal polyp
Development of Reye Syndrome
Gastric ulcers
Last choice of drug in children
Supplied as Chewable tablets – 81mg
Caplets, tablets- 325mg, 500mg
Suppository, rectal- 300mg, 600mg
Disprin chewable tablets300
mg, ecosprin 75mg, 150mg,
325mg
 Combinations of two analgesics having
different mechanisms (central or peripheral)
might be expected to produce addictive
effects and may not be true for the analgesics
acting by the same mechanisms.
 The common combinations of analgesics
used in our practice are:
1. ibuprofen and paracetamol
2. diclofenac sodium and paracetamol
3. nimesulide and paracetamol
4. mefenamic acid and paracetamol
Dosage Children </= 44kg-oral :
Codiene- 0.5to 1mg/kg/dose every 4-6hrs
Acetaminophen- 10 to 15mg/kg/dose every 4-6hrds up
to 2.6g/day
Children >/= 44kg-oral :
Codeine-30 to 60mg/dose every 4-6 hours
Acetaminophen-325mg to 650mg/dose every 4-6
hours, up to 4g daily.
Advantage 1. Codeine acts at central site of pain
2. Acetaminophen acts at the peripheral site for
enhanced analgesia
Side effects Codeine can cause nausea, vomiting, sedation,
constipation and dependency
Acetaminophen may cause liver damage in overdose
Supplied as Suspension : acetaminophen 120mg and codeine
phosphate 12mg/5ml
Tablets : acetaminophen 300mg and codeine phosphate
60mg
 Most pain resulting from paedriatic dental
procedures may be treated with mild
analgesics, such as aspirin and
acetaminophen. In case they are ineffective,
codeine may be administered in combination
to provide adequate relief.
 Stronger analgesics must be provided only if
all the other efforts at pain control have
proven in effective.
Commonly used analgesics and anitbiotics in pediatric  dentistry (2015 07-09 ralli's conflicted copy)
• DEVELOPMENT OF ORAL MICROFLORA
 Oral cavity is usually sterile at birth
 Number of microorganisms increase following 6-
8hrs after birth
 At 12 months of age, most children have the
following microorganisms in their oral cavity.
1. Streptococcus (S. salivarius, S. mutans)
2. Staphlyococcus
3. Actinomyces
4. Veillonella
5. Lactobacilli
6. Nocardia
7. Fusobacterium
 Antibiotics provide time for normal host
defenses to gain control and eliminate the
infectious process.
 Antibiotics for children are similar to those in
adults (as adjusted by body weight).
 The exceptions are infants, who require a
lower antibiotic dosing.
 Antibiotics act through specific mechanisms
dictated by the site of action-
1. Cell membrane
2. Cell wall loss of integrity rupture
bactericidal
3. Nucleic acid content interferes with
ribosomal function replication, protein
synthesis and information transfer is
disrupted
4. Intermediary metabolism metabolic
pathways interrupted suppression of
growth
Beta lactams Penicillins effective against – gram +ve oragnisms. Eg :
streptococci, clostridia, H. influenzae, Staph. Aureus
(when used with clavalunic acid)
Cephalosporins effective against gram +ve (first gen.) and
gram –ve (second and third gen.) and organisms that
show high resistance to beta lactamase (fourth gen.)
Sulphonamides Effective against gram +ve and gram-ve bacteria. Eg :
strep. Pyogens, H. influenzae, vibrio cholerae, E.coli,
Nocardia
Cotrimoxazole Effective against Salmonella typhi, seratia, klebsiella,
enterobacter, shigella, H. influnzae, E.coli, etc
Nitroimidazoles Metronidazole- effective against protozoal organisms. Eg
: Entamoeba histolytica and giardia lamblia
-anaerobic bacteria like Veilonella,
Clostridia, Fusobacterium, treponema vaginalis, etc.
 Dentists seldom treat infants, but doses for
paediatric patient require an adjustment from
the usual adult dose, as determined by body
surface area and weight.
 The following two formulae are used for
calculating paediatric doses-
1. Clark’s rule
2. Young’s rule
 Clark’s rule
child’s weight in lb X adult dose = child dose
150
 Young’s rule
Age of child X adult dose = Child’s dose
age + 12
 Anders in 1992
 Administration of drug based on infants weight
is seldom appropriate.
dose p = dose a X weight pd
weight ad
 Children vary considerably in size and weight
at the same age levels.
 The dose of many drugs is not always a
simple linear function of body weight.
Surface area is a more accurate method in
determining the dose since it can be easily
determined by knowing the height and weight
and referring to the nomograms which relate
these body parameters.
Commonly used analgesics and anitbiotics in pediatric  dentistry (2015 07-09 ralli's conflicted copy)
Commonly used analgesics and anitbiotics in pediatric  dentistry (2015 07-09 ralli's conflicted copy)
 Resistance to a particular drug could be
either due to improper dose or duration.
 The only practical method to delay or restrict
antibiotic resistance is to limit the antibiotic
use to proper indication, dosages and
duration.
 Instructions by the physician or
manufacturers should be followed.
 Administration of antibiotics to patients
without the evidence of infection to prevent
bacterial colonization, to reduce subsequent
post-operative complications.
 Example : Antibiotic prophylaxis is required
in a patient with rheumatic heart disease to
prevent infective endocarditis. It is also
required in case of immunosuppressed
patients with blood dyscrasias, cancer
chemotherapy and graft recipients.
 Prophylaxis for children with rheumatic or
other valvular disease; congenital heart
disease, idiopathic hypertrophic subaortic
stenosis, mitral valve prolapse syndrome with
mitral insufficiency and cardiac valvular
prosthesis.
 Two regimen given by WHO-
1. Regimen A
2. Regimen B
Regimen A Regimen B
1. Parenteral-oral combined :
A. Aqueous crystalline penicillin (30,
000 U/kg IM) mixed with procaine
penicillin G (600, 000 U IM) 30-
60mins prior to dental procedure.
B. Then penicillin V – 500mg orally
every 6 hours for eight doses.
C. In children<60 pounds, penicillin V
– 250mg orally every 6 hourly for 8
doses
2. Orally only :
A. Penicillin V – 2g orally 30-60mins
prior to dental procedure, then
500mg every 6 hours for 8 doses.
B. In children<60 pounds, penicilllin
V- 1g orally, 30-60mins prior to
dental procedures then 250mg
every 6 hours for 8 doses.
1. Aqueous crystalline penicillin G (30,
000 U/kg IM) mixed with procaine
penicillin G (60, 000 U IM) +
streptomycin (20mg/kg IM), 30-60
mins prior to dental procedures.
2. Followed by oral penicillin V-
500mg every 6 hours for 8 doses.
3. In children<60 pounds, oral
penicillin V- 250mg every 6 hours
for 8 doses.
4. For patients allergic to penicillin-
A. Parenteral vancomycin +
erythromycin (vancomycin –
20mg/kg IV over 30-60mins + oral
erythromycin 10mg/kg every
6hours for 8 doses)
B. Oral erythromycin- 20mg/kg orally
1.5-2hours prior to the dental
procedure and 10mg/kg every
Antibiotics Generic Names Brand Names
Penicillins Oral penicillin G
Penicillin V
Pentids, Pizerpen,
Ledercillin VK,
Veracillin, V-cillin-K
Cephalosporins Cephalexin
Cephradine
Keflex, Anspor, Velosef
Erythromycin Erythromycin base
Erythromycin succinate
Erythromycin stearate
Erythromycin estolate
E-mycin, erythrocin,
Pedia mycin, eryhtrocin
ilosone
Lincosamides Lincomycin
Clindamycin
Lincocin
Cleocin
 Amoxicillin
 Amoxicillin + Clavulanate potassium
 Amoxicillin + cloxacillin
 Ampicillin
 Cephalexin
 Cotrimoxazole
 Erythromycin
 Metronidazole
Actions Interferes with cell replication of susceptible organisms,
the cell wall rendered osmotically unstable, swells and
bursts from osmotic pressure
Dosage Per oral 20-40mg/kg/day in three doses
Availability Capsule-250mg, 500mg
Tablet-125mg, 250mg
Powder for suspension- 50mg/ml
Side effects Increased thirst, nausea, vomiting, diarrhoea, pruritis,
urticaria, angioneurotic oedema, bronchospasm,
anaphylaxis.
Commonly used analgesics and anitbiotics in pediatric  dentistry (2015 07-09 ralli's conflicted copy)
Commonly used analgesics and anitbiotics in pediatric  dentistry (2015 07-09 ralli's conflicted copy)
Action Interferes with cell wall replication of susceptible
organisms, the cell wall rendered osmotically
unstable, swells and bursts from osmotic pressure
Dosage and route Per oral 20-40mg/kg/day in three divided doses
Available forms Capsule 250mg, 500mg
Chewable tablets 125mg and 250mg
Powder for oral suspension 125mg, 250mg/ml.
Side effects Discoloured tongue, glossitis, increased thirst,
nausea, vomiting, diarrhoea, hyperkalemia, puritis,
urticaria, bronchiospam, anaphylaxis
Contra indications Hypersensitivity to penicillin
Augmentin duo, clavam 375mg (250mg+125mg),
625mg (500+125mg) tablet
Augmentin duo syrup 228mg/5ml
Action Interferes with cell wall replication of susceptible
organisms, the cell wall rendered osmotically
unstable, swells and bursts from pressure
Dosage and route 50-100mg/kg of combination, divided in 3 divided
doses
Available forms Tab 250mg and 500mg
Capsule 250 and 500mg
Powder for oral suspension 125mg, 150mg/15ml
Side effects Increased thirst, Nausea, Vomitting, Hyperkalemia,
Pruritis, Urticaria, Bronchospasm, Anaphylaxis
Contra indications Hypersensitivity to penicillin
Action Interferes with cell wall replication of susceptible
organisms, the cell wall rendered osmotically
unstable, swells and bursts from osmotic pressure
Dosage Per oral 50-100mg/kg/day in four divided doses (6
hourly)
Available forms Cap 200mg and 500mg
Powder for oral suspension 125mg/5ml
Side effects Discoloured tongue, glossitis, rash, urticaria,
glomerulonephritis, puritis, angioneurotic oedema,
bronchospams, anaphylaxis, nausea, vomiting,
Diarrhoea.
Contra indications Hypersensitivity to penicillin
Capsule Roscillin, Biocillin,
Ampilin
Syrup Amipilin 125mg/5ml
Actions Inhibits bacterial wall synthesis , rendering the cell wall
osmotically unstable
Dosage and route Per oral 50-100mg/kg/day in 4 divided doses
Available forms Capsule 250mg, 500mg
Tablet 250mg, 500mg
Oral suspension 125mg, 250mg/5ml and 100mg/ml
Side effects Candidiasis, glossitis, NVD, anorexia,
pseudomembranous colitis, nephrotoxicity, urticaria,
rash, anapylaxis
Contra indications Hypersensitivity, pregnancy, infants <1 months.
Commonly used analgesics and anitbiotics in pediatric  dentistry (2015 07-09 ralli's conflicted copy)
Commonly used analgesics and anitbiotics in pediatric  dentistry (2015 07-09 ralli's conflicted copy)
Commonly used analgesics and anitbiotics in pediatric  dentistry (2015 07-09 ralli's conflicted copy)
Actions Sulfamethazole interferes with bacterial biosynthesis
of proteins by competitive antagonism of PABA;
trimethoprim blocks synthesis of tetrahydrofolic acid,
this combination blocks consecutive synthesis of
essential nucleic acids, proteins.
Dosage and route Per oral 8mg/kg (TMP) + 40mg (SMZ) [double
strength]
160mg TMP/800mg SMZ
Suspension 40mg+200mg/5ml
Side effects Candidiasis, Stevens-Johnson Syndrome, anaphylaxis,
SLE, NVD, hepatitis, leukoopenia, agranulocytosis,
renal failure
Contra indications Hypersensitivity to trimethoprim, sulfamethoxazole,
megaloblasic anemia, infants of 2 months, pregnancy
and lactation
Commonly used analgesics and anitbiotics in pediatric  dentistry (2015 07-09 ralli's conflicted copy)
Commonly used analgesics and anitbiotics in pediatric  dentistry (2015 07-09 ralli's conflicted copy)
Action Binds to ribosomal units of susceptible bacteria and
supress protein synthesis
Dosage and route Per oral 30-5-mg/kg/day in 4 divided doses
Available forms Tab 250mg, 500mg
Suspension 250mg/5dl
Side effects Candidiasis, rash, urticaria, pruritis, hypersensitivity,
NVD, hepatotoxicity, abdominal pain,
pseudomembranous tnnitus
Contra indications Hypersensitivity to pre existing hepatic disease
Commonly used analgesics and anitbiotics in pediatric  dentistry (2015 07-09 ralli's conflicted copy)
Actions In anaerobic microorganisms, metronidazole is
converted to active form by reduction of its
nitrogroup. This gets bound to DNA and prevents
nucelic acid formation
Dosage and route Per oral 5mg/kg/TID
Available forms Tab 200mg, 400mg
Suspension 200mg/5ml
Side effects Dry mouth, furry tongue, bitter taste, metallic taste,
leukopenia, bone-marrow aplasia, rash, urticaria,
NVD, abdominal pain, nehprotoxicity
Contra indications Hypersensitivity to drug, renal disease, pregnancy
and lactations, hepatic disease, alcoholic patients
(disulfuram like reactions)
Commonly used analgesics and anitbiotics in pediatric  dentistry (2015 07-09 ralli's conflicted copy)
 Paediatric drug therapy and immunization by
RK Suneja.
 Textbook of paediatric dentistry by Braham
and Morris.
 Text book of paediatric dentistry by Shobha
Tandon.
Commonly used analgesics and anitbiotics in pediatric  dentistry (2015 07-09 ralli's conflicted copy)

More Related Content

What's hot

1.Antibiotics and analgesics in pediatric dentistry
1.Antibiotics and analgesics in pediatric dentistry1.Antibiotics and analgesics in pediatric dentistry
1.Antibiotics and analgesics in pediatric dentistryAminah M
 
Epidemiology of dental caries
Epidemiology of dental cariesEpidemiology of dental caries
Epidemiology of dental cariesDrAmrita Rastogi
 
Direct and indirect pulp capping
Direct and indirect pulp capping Direct and indirect pulp capping
Direct and indirect pulp capping Weam Faroun
 
space-maintainers-pedo
space-maintainers-pedospace-maintainers-pedo
space-maintainers-pedoParth Thakkar
 
Band and loop space maintainer
Band and loop space maintainerBand and loop space maintainer
Band and loop space maintainerDr.kritika singh
 
Pedodontic treatment triangle
Pedodontic treatment trianglePedodontic treatment triangle
Pedodontic treatment triangleKhushboo Vatsal
 
Preventive resin restoration ppt
Preventive resin restoration pptPreventive resin restoration ppt
Preventive resin restoration pptAnu S
 
Porcelain jacket crown (PJC)
Porcelain jacket crown (PJC)Porcelain jacket crown (PJC)
Porcelain jacket crown (PJC)CPGIDSH
 
Pit and Fissure sealants
Pit and Fissure sealantsPit and Fissure sealants
Pit and Fissure sealantsprincesoni3954
 
space-regaining-pedo
space-regaining-pedospace-regaining-pedo
space-regaining-pedoParth Thakkar
 
Case history diagnosis and treatment planning in pediatric dentistry
Case history diagnosis and treatment planning in pediatric dentistryCase history diagnosis and treatment planning in pediatric dentistry
Case history diagnosis and treatment planning in pediatric dentistrySwati manohar
 
Early childhood caries
Early childhood cariesEarly childhood caries
Early childhood cariesshayonisen2012
 
Glass ionomer cement
Glass ionomer cementGlass ionomer cement
Glass ionomer cementAnkit Patel
 

What's hot (20)

PLAQUE DISCLOSING AGENTS
PLAQUE DISCLOSING AGENTSPLAQUE DISCLOSING AGENTS
PLAQUE DISCLOSING AGENTS
 
serial extraction
 serial extraction  serial extraction
serial extraction
 
1.Antibiotics and analgesics in pediatric dentistry
1.Antibiotics and analgesics in pediatric dentistry1.Antibiotics and analgesics in pediatric dentistry
1.Antibiotics and analgesics in pediatric dentistry
 
Epidemiology of dental caries
Epidemiology of dental cariesEpidemiology of dental caries
Epidemiology of dental caries
 
Direct and indirect pulp capping
Direct and indirect pulp capping Direct and indirect pulp capping
Direct and indirect pulp capping
 
space-maintainers-pedo
space-maintainers-pedospace-maintainers-pedo
space-maintainers-pedo
 
Band and loop space maintainer
Band and loop space maintainerBand and loop space maintainer
Band and loop space maintainer
 
Pedodontic treatment triangle
Pedodontic treatment trianglePedodontic treatment triangle
Pedodontic treatment triangle
 
Child first dental visit
Child first dental visitChild first dental visit
Child first dental visit
 
Oral screen
Oral screenOral screen
Oral screen
 
Preventive resin restoration ppt
Preventive resin restoration pptPreventive resin restoration ppt
Preventive resin restoration ppt
 
Anticipatory guidance
Anticipatory guidanceAnticipatory guidance
Anticipatory guidance
 
Porcelain jacket crown (PJC)
Porcelain jacket crown (PJC)Porcelain jacket crown (PJC)
Porcelain jacket crown (PJC)
 
calcium hydroxide
calcium hydroxidecalcium hydroxide
calcium hydroxide
 
Pit and Fissure sealants
Pit and Fissure sealantsPit and Fissure sealants
Pit and Fissure sealants
 
space-regaining-pedo
space-regaining-pedospace-regaining-pedo
space-regaining-pedo
 
Inlay
InlayInlay
Inlay
 
Case history diagnosis and treatment planning in pediatric dentistry
Case history diagnosis and treatment planning in pediatric dentistryCase history diagnosis and treatment planning in pediatric dentistry
Case history diagnosis and treatment planning in pediatric dentistry
 
Early childhood caries
Early childhood cariesEarly childhood caries
Early childhood caries
 
Glass ionomer cement
Glass ionomer cementGlass ionomer cement
Glass ionomer cement
 

Viewers also liked

Antibiotics & analgesics dentistry
Antibiotics  & analgesics dentistryAntibiotics  & analgesics dentistry
Antibiotics & analgesics dentistryHema Latha
 
Medications in pediatrics
Medications in pediatricsMedications in pediatrics
Medications in pediatricsPratik Kumar
 
Drugs commonly used for children
Drugs commonly used for childrenDrugs commonly used for children
Drugs commonly used for childrenampaulin1
 
Commonly used drugs in children By Dr Sachin Rathod
Commonly used drugs in children By Dr Sachin RathodCommonly used drugs in children By Dr Sachin Rathod
Commonly used drugs in children By Dr Sachin RathodDr Sachin Rathod
 
Commonly used drugs in pediatric dentistry
Commonly used drugs in pediatric dentistry Commonly used drugs in pediatric dentistry
Commonly used drugs in pediatric dentistry All Good Things
 
Antibiotic in endodontic
Antibiotic in endodonticAntibiotic in endodontic
Antibiotic in endodonticms khatib
 

Viewers also liked (9)

Antibiotics & analgesics dentistry
Antibiotics  & analgesics dentistryAntibiotics  & analgesics dentistry
Antibiotics & analgesics dentistry
 
Medications in pediatrics
Medications in pediatricsMedications in pediatrics
Medications in pediatrics
 
Drugs commonly used for children
Drugs commonly used for childrenDrugs commonly used for children
Drugs commonly used for children
 
Commonly used drugs in children By Dr Sachin Rathod
Commonly used drugs in children By Dr Sachin RathodCommonly used drugs in children By Dr Sachin Rathod
Commonly used drugs in children By Dr Sachin Rathod
 
Commonly used drugs in pediatric dentistry
Commonly used drugs in pediatric dentistry Commonly used drugs in pediatric dentistry
Commonly used drugs in pediatric dentistry
 
Pediatric drug dose calculation
Pediatric drug dose calculationPediatric drug dose calculation
Pediatric drug dose calculation
 
Pediatric Medication
Pediatric MedicationPediatric Medication
Pediatric Medication
 
Antibiotic in endodontic
Antibiotic in endodonticAntibiotic in endodontic
Antibiotic in endodontic
 
Antibiotics ppt
Antibiotics pptAntibiotics ppt
Antibiotics ppt
 

Similar to Commonly used analgesics and anitbiotics in pediatric dentistry (2015 07-09 ralli's conflicted copy)

Various drugs available in pediatric dentistry and calculation involved
Various drugs available in pediatric dentistry and calculation involvedVarious drugs available in pediatric dentistry and calculation involved
Various drugs available in pediatric dentistry and calculation involvedJeyashriTamilarasu
 
110445675-Drugs-Used-in-Pediatric-Dentistry.pptx
110445675-Drugs-Used-in-Pediatric-Dentistry.pptx110445675-Drugs-Used-in-Pediatric-Dentistry.pptx
110445675-Drugs-Used-in-Pediatric-Dentistry.pptxnonaaryan2
 
antibiotic and using in common infection
antibiotic and using in common infection antibiotic and using in common infection
antibiotic and using in common infection Y Alsfah
 
Antibioitcs guide choice for common infection (doc toon.page)
Antibioitcs guide choice for common infection (doc toon.page)Antibioitcs guide choice for common infection (doc toon.page)
Antibioitcs guide choice for common infection (doc toon.page)abdullahsharaf55
 
Antibioitcs choices for common infections (2013 edition)
Antibioitcs choices for common infections (2013 edition)Antibioitcs choices for common infections (2013 edition)
Antibioitcs choices for common infections (2013 edition)Ahmad Ali
 
Antituberculosis Drugs 1 Manisacan Et Al( Midterm 2)
Antituberculosis Drugs 1 Manisacan Et Al( Midterm 2)Antituberculosis Drugs 1 Manisacan Et Al( Midterm 2)
Antituberculosis Drugs 1 Manisacan Et Al( Midterm 2)guest151c
 
بحث البيدو المجموعه 6.pptx
بحث البيدو المجموعه 6.pptxبحث البيدو المجموعه 6.pptx
بحث البيدو المجموعه 6.pptxHamdiAlaqal
 
مشروع البحث للطبع.pptx
مشروع البحث   للطبع.pptxمشروع البحث   للطبع.pptx
مشروع البحث للطبع.pptxHamdiAlaqal
 
General Anesthesia in Pediatric Dentistry
General Anesthesia in Pediatric Dentistry General Anesthesia in Pediatric Dentistry
General Anesthesia in Pediatric Dentistry Jaya sri
 
Terapia en micosis superficiales
Terapia en micosis superficialesTerapia en micosis superficiales
Terapia en micosis superficialescsanoja2020
 
Anti emetics in gastroenteritis in children
Anti emetics in gastroenteritis in childrenAnti emetics in gastroenteritis in children
Anti emetics in gastroenteritis in childrenDR SHAILESH MEHTA
 
L-24 Drug therapy in pediatric & geriatric age groups.pptx
L-24 Drug therapy in pediatric & geriatric age groups.pptxL-24 Drug therapy in pediatric & geriatric age groups.pptx
L-24 Drug therapy in pediatric & geriatric age groups.pptxAbdukhalilYeshim
 
General prescribing guidelines for Pediatrics geriatrics pregnancy lactating...
 General prescribing guidelines for Pediatrics geriatrics pregnancy lactating... General prescribing guidelines for Pediatrics geriatrics pregnancy lactating...
General prescribing guidelines for Pediatrics geriatrics pregnancy lactating...Koppala RVS Chaitanya
 
Pharmacology Antibiotics
Pharmacology   AntibioticsPharmacology   Antibiotics
Pharmacology Antibioticspinoy nurze
 
What nelson forgot 2nd edn
What nelson forgot 2nd ednWhat nelson forgot 2nd edn
What nelson forgot 2nd ednGaurav Gupta
 
What nelson forgot 2nd edn
What nelson forgot 2nd ednWhat nelson forgot 2nd edn
What nelson forgot 2nd ednGaurav Gupta
 

Similar to Commonly used analgesics and anitbiotics in pediatric dentistry (2015 07-09 ralli's conflicted copy) (20)

Various drugs available in pediatric dentistry and calculation involved
Various drugs available in pediatric dentistry and calculation involvedVarious drugs available in pediatric dentistry and calculation involved
Various drugs available in pediatric dentistry and calculation involved
 
110445675-Drugs-Used-in-Pediatric-Dentistry.pptx
110445675-Drugs-Used-in-Pediatric-Dentistry.pptx110445675-Drugs-Used-in-Pediatric-Dentistry.pptx
110445675-Drugs-Used-in-Pediatric-Dentistry.pptx
 
antibiotic and using in common infection
antibiotic and using in common infection antibiotic and using in common infection
antibiotic and using in common infection
 
Antibioitcs guide choice for common infection (doc toon.page)
Antibioitcs guide choice for common infection (doc toon.page)Antibioitcs guide choice for common infection (doc toon.page)
Antibioitcs guide choice for common infection (doc toon.page)
 
Antibioitcs guide
Antibioitcs guideAntibioitcs guide
Antibioitcs guide
 
Antibioitcs choices for common infections (2013 edition)
Antibioitcs choices for common infections (2013 edition)Antibioitcs choices for common infections (2013 edition)
Antibioitcs choices for common infections (2013 edition)
 
Antituberculosis Drugs 1 Manisacan Et Al( Midterm 2)
Antituberculosis Drugs 1 Manisacan Et Al( Midterm 2)Antituberculosis Drugs 1 Manisacan Et Al( Midterm 2)
Antituberculosis Drugs 1 Manisacan Et Al( Midterm 2)
 
بحث البيدو المجموعه 6.pptx
بحث البيدو المجموعه 6.pptxبحث البيدو المجموعه 6.pptx
بحث البيدو المجموعه 6.pptx
 
مشروع البحث للطبع.pptx
مشروع البحث   للطبع.pptxمشروع البحث   للطبع.pptx
مشروع البحث للطبع.pptx
 
General Anesthesia in Pediatric Dentistry
General Anesthesia in Pediatric Dentistry General Anesthesia in Pediatric Dentistry
General Anesthesia in Pediatric Dentistry
 
General Prescribing Guidelines.pptx
General Prescribing Guidelines.pptxGeneral Prescribing Guidelines.pptx
General Prescribing Guidelines.pptx
 
Terapia en micosis superficiales
Terapia en micosis superficialesTerapia en micosis superficiales
Terapia en micosis superficiales
 
Anti emetics in gastroenteritis in children
Anti emetics in gastroenteritis in childrenAnti emetics in gastroenteritis in children
Anti emetics in gastroenteritis in children
 
L-24 Drug therapy in pediatric & geriatric age groups.pptx
L-24 Drug therapy in pediatric & geriatric age groups.pptxL-24 Drug therapy in pediatric & geriatric age groups.pptx
L-24 Drug therapy in pediatric & geriatric age groups.pptx
 
General prescribing guidelines for Pediatrics geriatrics pregnancy lactating...
 General prescribing guidelines for Pediatrics geriatrics pregnancy lactating... General prescribing guidelines for Pediatrics geriatrics pregnancy lactating...
General prescribing guidelines for Pediatrics geriatrics pregnancy lactating...
 
PHARMACOLOGY - ANTIBIOTICS
PHARMACOLOGY - ANTIBIOTICSPHARMACOLOGY - ANTIBIOTICS
PHARMACOLOGY - ANTIBIOTICS
 
Pharmacology Antibiotics
Pharmacology   AntibioticsPharmacology   Antibiotics
Pharmacology Antibiotics
 
What nelson forgot 2nd edn
What nelson forgot 2nd ednWhat nelson forgot 2nd edn
What nelson forgot 2nd edn
 
What nelson forgot 2nd edn
What nelson forgot 2nd ednWhat nelson forgot 2nd edn
What nelson forgot 2nd edn
 
Antibiotics
AntibioticsAntibiotics
Antibiotics
 

More from Mahak Ralli

Zygomatic complex fractures
Zygomatic complex fracturesZygomatic complex fractures
Zygomatic complex fracturesMahak Ralli
 
Interim fixed restorations
Interim fixed restorationsInterim fixed restorations
Interim fixed restorationsMahak Ralli
 
Benign tumours of salivary glands
Benign tumours of salivary glandsBenign tumours of salivary glands
Benign tumours of salivary glandsMahak Ralli
 
Allergic and immunologic diseases of the oral cavity
Allergic and immunologic diseases of the oral cavityAllergic and immunologic diseases of the oral cavity
Allergic and immunologic diseases of the oral cavityMahak Ralli
 
Vital pulp therapy
Vital pulp therapyVital pulp therapy
Vital pulp therapyMahak Ralli
 
Stability in complete dentures
Stability in complete denturesStability in complete dentures
Stability in complete denturesMahak Ralli
 

More from Mahak Ralli (6)

Zygomatic complex fractures
Zygomatic complex fracturesZygomatic complex fractures
Zygomatic complex fractures
 
Interim fixed restorations
Interim fixed restorationsInterim fixed restorations
Interim fixed restorations
 
Benign tumours of salivary glands
Benign tumours of salivary glandsBenign tumours of salivary glands
Benign tumours of salivary glands
 
Allergic and immunologic diseases of the oral cavity
Allergic and immunologic diseases of the oral cavityAllergic and immunologic diseases of the oral cavity
Allergic and immunologic diseases of the oral cavity
 
Vital pulp therapy
Vital pulp therapyVital pulp therapy
Vital pulp therapy
 
Stability in complete dentures
Stability in complete denturesStability in complete dentures
Stability in complete dentures
 

Recently uploaded

Riti theory by Vamana Indian poetics.pptx
Riti theory by Vamana Indian poetics.pptxRiti theory by Vamana Indian poetics.pptx
Riti theory by Vamana Indian poetics.pptxDhatriParmar
 
AUDIENCE THEORY - PARTICIPATORY - JENKINS.pptx
AUDIENCE THEORY - PARTICIPATORY - JENKINS.pptxAUDIENCE THEORY - PARTICIPATORY - JENKINS.pptx
AUDIENCE THEORY - PARTICIPATORY - JENKINS.pptxiammrhaywood
 
DNA and RNA , Structure, Functions, Types, difference, Similarities, Protein ...
DNA and RNA , Structure, Functions, Types, difference, Similarities, Protein ...DNA and RNA , Structure, Functions, Types, difference, Similarities, Protein ...
DNA and RNA , Structure, Functions, Types, difference, Similarities, Protein ...AKSHAYMAGAR17
 
BÀI TẬP BỔ TRỢ TIẾNG ANH 11 THEO ĐƠN VỊ BÀI HỌC - CẢ NĂM - CÓ FILE NGHE (GLOB...
BÀI TẬP BỔ TRỢ TIẾNG ANH 11 THEO ĐƠN VỊ BÀI HỌC - CẢ NĂM - CÓ FILE NGHE (GLOB...BÀI TẬP BỔ TRỢ TIẾNG ANH 11 THEO ĐƠN VỊ BÀI HỌC - CẢ NĂM - CÓ FILE NGHE (GLOB...
BÀI TẬP BỔ TRỢ TIẾNG ANH 11 THEO ĐƠN VỊ BÀI HỌC - CẢ NĂM - CÓ FILE NGHE (GLOB...Nguyen Thanh Tu Collection
 
3.12.24 Freedom Summer in Mississippi.pptx
3.12.24 Freedom Summer in Mississippi.pptx3.12.24 Freedom Summer in Mississippi.pptx
3.12.24 Freedom Summer in Mississippi.pptxmary850239
 
Research Methodology and Tips on Better Research
Research Methodology and Tips on Better ResearchResearch Methodology and Tips on Better Research
Research Methodology and Tips on Better ResearchRushdi Shams
 
BBA 205 BE UNIT 2 economic systems prof dr kanchan.pptx
BBA 205 BE UNIT 2 economic systems prof dr kanchan.pptxBBA 205 BE UNIT 2 economic systems prof dr kanchan.pptx
BBA 205 BE UNIT 2 economic systems prof dr kanchan.pptxProf. Kanchan Kumari
 
PHARMACOGNOSY CHAPTER NO 5 CARMINATIVES AND G.pdf
PHARMACOGNOSY CHAPTER NO 5 CARMINATIVES AND G.pdfPHARMACOGNOSY CHAPTER NO 5 CARMINATIVES AND G.pdf
PHARMACOGNOSY CHAPTER NO 5 CARMINATIVES AND G.pdfSumit Tiwari
 
Plant Tissue culture., Plasticity, Totipotency, pptx
Plant Tissue culture., Plasticity, Totipotency, pptxPlant Tissue culture., Plasticity, Totipotency, pptx
Plant Tissue culture., Plasticity, Totipotency, pptxHimansu10
 
The basics of sentences session 8pptx.pptx
The basics of sentences session 8pptx.pptxThe basics of sentences session 8pptx.pptx
The basics of sentences session 8pptx.pptxheathfieldcps1
 
Quantitative research methodology and survey design
Quantitative research methodology and survey designQuantitative research methodology and survey design
Quantitative research methodology and survey designBalelaBoru
 
HỌC TỐT TIẾNG ANH 11 THEO CHƯƠNG TRÌNH GLOBAL SUCCESS ĐÁP ÁN CHI TIẾT - HK2 (...
HỌC TỐT TIẾNG ANH 11 THEO CHƯƠNG TRÌNH GLOBAL SUCCESS ĐÁP ÁN CHI TIẾT - HK2 (...HỌC TỐT TIẾNG ANH 11 THEO CHƯƠNG TRÌNH GLOBAL SUCCESS ĐÁP ÁN CHI TIẾT - HK2 (...
HỌC TỐT TIẾNG ANH 11 THEO CHƯƠNG TRÌNH GLOBAL SUCCESS ĐÁP ÁN CHI TIẾT - HK2 (...Nguyen Thanh Tu Collection
 
THYROID HORMONE.pptx by Subham Panja,Asst. Professor, Department of B.Sc MLT,...
THYROID HORMONE.pptx by Subham Panja,Asst. Professor, Department of B.Sc MLT,...THYROID HORMONE.pptx by Subham Panja,Asst. Professor, Department of B.Sc MLT,...
THYROID HORMONE.pptx by Subham Panja,Asst. Professor, Department of B.Sc MLT,...Subham Panja
 
AI Uses and Misuses: Academic and Workplace Applications
AI Uses and Misuses: Academic and Workplace ApplicationsAI Uses and Misuses: Academic and Workplace Applications
AI Uses and Misuses: Academic and Workplace ApplicationsStella Lee
 
POST ENCEPHALITIS case study Jitendra bhargav
POST ENCEPHALITIS case study  Jitendra bhargavPOST ENCEPHALITIS case study  Jitendra bhargav
POST ENCEPHALITIS case study Jitendra bhargavJitendra Bhargav
 
Auchitya Theory by Kshemendra Indian Poetics
Auchitya Theory by Kshemendra Indian PoeticsAuchitya Theory by Kshemendra Indian Poetics
Auchitya Theory by Kshemendra Indian PoeticsDhatriParmar
 
Alamkara theory by Bhamaha Indian Poetics (1).pptx
Alamkara theory by Bhamaha Indian Poetics (1).pptxAlamkara theory by Bhamaha Indian Poetics (1).pptx
Alamkara theory by Bhamaha Indian Poetics (1).pptxDhatriParmar
 
3.12.24 The Social Construction of Gender.pptx
3.12.24 The Social Construction of Gender.pptx3.12.24 The Social Construction of Gender.pptx
3.12.24 The Social Construction of Gender.pptxmary850239
 
BBA 205 BUSINESS ENVIRONMENT UNIT I.pptx
BBA 205 BUSINESS ENVIRONMENT UNIT I.pptxBBA 205 BUSINESS ENVIRONMENT UNIT I.pptx
BBA 205 BUSINESS ENVIRONMENT UNIT I.pptxProf. Kanchan Kumari
 

Recently uploaded (20)

Riti theory by Vamana Indian poetics.pptx
Riti theory by Vamana Indian poetics.pptxRiti theory by Vamana Indian poetics.pptx
Riti theory by Vamana Indian poetics.pptx
 
AUDIENCE THEORY - PARTICIPATORY - JENKINS.pptx
AUDIENCE THEORY - PARTICIPATORY - JENKINS.pptxAUDIENCE THEORY - PARTICIPATORY - JENKINS.pptx
AUDIENCE THEORY - PARTICIPATORY - JENKINS.pptx
 
DNA and RNA , Structure, Functions, Types, difference, Similarities, Protein ...
DNA and RNA , Structure, Functions, Types, difference, Similarities, Protein ...DNA and RNA , Structure, Functions, Types, difference, Similarities, Protein ...
DNA and RNA , Structure, Functions, Types, difference, Similarities, Protein ...
 
BÀI TẬP BỔ TRỢ TIẾNG ANH 11 THEO ĐƠN VỊ BÀI HỌC - CẢ NĂM - CÓ FILE NGHE (GLOB...
BÀI TẬP BỔ TRỢ TIẾNG ANH 11 THEO ĐƠN VỊ BÀI HỌC - CẢ NĂM - CÓ FILE NGHE (GLOB...BÀI TẬP BỔ TRỢ TIẾNG ANH 11 THEO ĐƠN VỊ BÀI HỌC - CẢ NĂM - CÓ FILE NGHE (GLOB...
BÀI TẬP BỔ TRỢ TIẾNG ANH 11 THEO ĐƠN VỊ BÀI HỌC - CẢ NĂM - CÓ FILE NGHE (GLOB...
 
3.12.24 Freedom Summer in Mississippi.pptx
3.12.24 Freedom Summer in Mississippi.pptx3.12.24 Freedom Summer in Mississippi.pptx
3.12.24 Freedom Summer in Mississippi.pptx
 
Research Methodology and Tips on Better Research
Research Methodology and Tips on Better ResearchResearch Methodology and Tips on Better Research
Research Methodology and Tips on Better Research
 
BBA 205 BE UNIT 2 economic systems prof dr kanchan.pptx
BBA 205 BE UNIT 2 economic systems prof dr kanchan.pptxBBA 205 BE UNIT 2 economic systems prof dr kanchan.pptx
BBA 205 BE UNIT 2 economic systems prof dr kanchan.pptx
 
PHARMACOGNOSY CHAPTER NO 5 CARMINATIVES AND G.pdf
PHARMACOGNOSY CHAPTER NO 5 CARMINATIVES AND G.pdfPHARMACOGNOSY CHAPTER NO 5 CARMINATIVES AND G.pdf
PHARMACOGNOSY CHAPTER NO 5 CARMINATIVES AND G.pdf
 
Plant Tissue culture., Plasticity, Totipotency, pptx
Plant Tissue culture., Plasticity, Totipotency, pptxPlant Tissue culture., Plasticity, Totipotency, pptx
Plant Tissue culture., Plasticity, Totipotency, pptx
 
The basics of sentences session 8pptx.pptx
The basics of sentences session 8pptx.pptxThe basics of sentences session 8pptx.pptx
The basics of sentences session 8pptx.pptx
 
Quantitative research methodology and survey design
Quantitative research methodology and survey designQuantitative research methodology and survey design
Quantitative research methodology and survey design
 
HỌC TỐT TIẾNG ANH 11 THEO CHƯƠNG TRÌNH GLOBAL SUCCESS ĐÁP ÁN CHI TIẾT - HK2 (...
HỌC TỐT TIẾNG ANH 11 THEO CHƯƠNG TRÌNH GLOBAL SUCCESS ĐÁP ÁN CHI TIẾT - HK2 (...HỌC TỐT TIẾNG ANH 11 THEO CHƯƠNG TRÌNH GLOBAL SUCCESS ĐÁP ÁN CHI TIẾT - HK2 (...
HỌC TỐT TIẾNG ANH 11 THEO CHƯƠNG TRÌNH GLOBAL SUCCESS ĐÁP ÁN CHI TIẾT - HK2 (...
 
ANOVA Parametric test: Biostatics and Research Methodology
ANOVA Parametric test: Biostatics and Research MethodologyANOVA Parametric test: Biostatics and Research Methodology
ANOVA Parametric test: Biostatics and Research Methodology
 
THYROID HORMONE.pptx by Subham Panja,Asst. Professor, Department of B.Sc MLT,...
THYROID HORMONE.pptx by Subham Panja,Asst. Professor, Department of B.Sc MLT,...THYROID HORMONE.pptx by Subham Panja,Asst. Professor, Department of B.Sc MLT,...
THYROID HORMONE.pptx by Subham Panja,Asst. Professor, Department of B.Sc MLT,...
 
AI Uses and Misuses: Academic and Workplace Applications
AI Uses and Misuses: Academic and Workplace ApplicationsAI Uses and Misuses: Academic and Workplace Applications
AI Uses and Misuses: Academic and Workplace Applications
 
POST ENCEPHALITIS case study Jitendra bhargav
POST ENCEPHALITIS case study  Jitendra bhargavPOST ENCEPHALITIS case study  Jitendra bhargav
POST ENCEPHALITIS case study Jitendra bhargav
 
Auchitya Theory by Kshemendra Indian Poetics
Auchitya Theory by Kshemendra Indian PoeticsAuchitya Theory by Kshemendra Indian Poetics
Auchitya Theory by Kshemendra Indian Poetics
 
Alamkara theory by Bhamaha Indian Poetics (1).pptx
Alamkara theory by Bhamaha Indian Poetics (1).pptxAlamkara theory by Bhamaha Indian Poetics (1).pptx
Alamkara theory by Bhamaha Indian Poetics (1).pptx
 
3.12.24 The Social Construction of Gender.pptx
3.12.24 The Social Construction of Gender.pptx3.12.24 The Social Construction of Gender.pptx
3.12.24 The Social Construction of Gender.pptx
 
BBA 205 BUSINESS ENVIRONMENT UNIT I.pptx
BBA 205 BUSINESS ENVIRONMENT UNIT I.pptxBBA 205 BUSINESS ENVIRONMENT UNIT I.pptx
BBA 205 BUSINESS ENVIRONMENT UNIT I.pptx
 

Commonly used analgesics and anitbiotics in pediatric dentistry (2015 07-09 ralli's conflicted copy)

  • 1. -BY MAHAK RALLI ROL NO. 41 THIRD YEAR BDS
  • 2.  The most common clinical situations in dentistry amenable to drug therapy in children are pain and infection.  Drug control is vital to all phases of dentistry and a thorough knowledge of the art and science of analgesic therapy is essential for proper patient care.  In management of dental pain in paedriatic patient has lagged markedly behind than that in the adult patient resulting from misconceptions regarding the existence of pain sensation and its tolerance in children.
  • 3.  They have higher tolerance to pain  Pain perception is low because of immunologic immaturity  Little or no memory of a painful experience  They are more sensitive to side effects of analgesics  There is special risk for addiction to narcotics
  • 4.  Most of the dental pain is associated with inflammation.  Hence, it responds well to drugs with anti- infammatory components  A good understanding of pain reaction and pain perception is required for proper pain management.  Pain is objective and measurable, initiated by physical and chemical stimuli.  Pain perception may be similar in all patients.
  • 5.  In contrast to pain perception, pain reaction depends upon learned experience, ethnic background, emotional status and presence of fear and anxiety.
  • 6.  Analgesics can be broadly classified into- I. Centrally acting (narcotic) analgesics eg. Morphine, codeine, pethidine. II. Peripherally acting (non-narcotic) analgesics eg. Diclofenac, paracetamol. III. Topical analgesics eg. Ethyl aminobenzoate
  • 7.  These are the most effective against acute pain, but have a greater incidence of adverse effects  They are administered parenterally and are devoid of anti-inflammatory and anti-pyretic effects.  Serious drug dependence and abuse liability has limited their use in paedriatic dentistry, eg, morphine, codeine, pethedine, methadone, dextro propoxyphene.
  • 8.  Less effective against sever pain, lower incidence of adverse effects  Administered orally and used for chronic lower grade of pain  Some possess anti-inflammatory and anti- pyretic effect  Frequently combined with other drugs  Low drug-dependance and abuse liability has increased the scope in paedriatic dentistry  Eg- ibuprofen, diclofenac, paracetamol, nimesulide
  • 9.  These are used to reduced soft tissue pain associated with local anesthetic administration and in management of gum pain during teething and other soft tissue irritation.  Available in as gels, liquids, ointments, patch and pressurized spray form.  Smallest effective amount is used for children to avoid anesthetizing the pharyngeal tissues.  Eg. : ethyl aminobenzoate (benzocaine- an ester local anesthetic)
  • 10. Dosage Children <12 yrs : 4-10mg/kg/dose every 6-8 hours (max daily dose – 40mg/kg/day) Children >12yrs and adults : 200-400mg every 6 hrs (max daily dose – 1.2g/day) Advantages Anti-inflammatory, good for moderate to sever pain and can be used as anti-pyretic. Side effects Gastric irritant, may impair clotting Supplied as • suspension, oral drops: 40 mg/ml • suspension, oral : 100mg/5ml • Tab, chewable : 50mg, 100mg contains phenlyanaline • Tab : 200mg, 400mg, 600mg
  • 12.  Dosage : single dose every 4-6 hours max. dosage- 1.2g AGE (year) DOSE (mg) Under 1 60 1-6 60-120 6-12 150-300
  • 13. Precautions The drug should not be administered for more than 10 days, as it is available without prescription Side effects 1. causes renal injury 2. Overdose leads to hepatic necrosis and death if more than 3g is taken by children under 2 years of age Availability • drops-60mg/0.6ml and 120mg/2.5ml • elixir-120mg/5ml and 150mg/2.5ml • tablets-325mg and 500mg • chewable tablets-120mg • suppositories- 120mg, 300mg, 600mg, 900mg
  • 14. Crocin 500mg tab, calpol 250mg suspension, pyrigesic 500mg tab, syrup 120mg/5ml
  • 16. Dosage Children : 5-10mg/kg/dose, every 8-12 hours Adult : oral- 220mg every 8-12 hours, up to 660mg/day. Advantages Anti-inflammatory and good for severe pain Side effects Gastric irritant and may delay onset of bleeding. Supplied as Suspension- 125mg/ml Tablets- 250mg, 375mg, 500mg.
  • 18. Dosage Children : 10-15mg/kg/dose every 4-6hrs, up to a total of 80-100mg. Adult : oral, rectal – 325mg to 650mg every 4-6 hours up to 4g/day. Advantages Analgesic, antipyretic and anti-inflammatory properties Side effects Allergic reaction in patients with pre-existing asthma, atopy and nasal polyp Development of Reye Syndrome Gastric ulcers Last choice of drug in children Supplied as Chewable tablets – 81mg Caplets, tablets- 325mg, 500mg Suppository, rectal- 300mg, 600mg
  • 19. Disprin chewable tablets300 mg, ecosprin 75mg, 150mg, 325mg
  • 20.  Combinations of two analgesics having different mechanisms (central or peripheral) might be expected to produce addictive effects and may not be true for the analgesics acting by the same mechanisms.  The common combinations of analgesics used in our practice are: 1. ibuprofen and paracetamol 2. diclofenac sodium and paracetamol 3. nimesulide and paracetamol 4. mefenamic acid and paracetamol
  • 21. Dosage Children </= 44kg-oral : Codiene- 0.5to 1mg/kg/dose every 4-6hrs Acetaminophen- 10 to 15mg/kg/dose every 4-6hrds up to 2.6g/day Children >/= 44kg-oral : Codeine-30 to 60mg/dose every 4-6 hours Acetaminophen-325mg to 650mg/dose every 4-6 hours, up to 4g daily. Advantage 1. Codeine acts at central site of pain 2. Acetaminophen acts at the peripheral site for enhanced analgesia
  • 22. Side effects Codeine can cause nausea, vomiting, sedation, constipation and dependency Acetaminophen may cause liver damage in overdose Supplied as Suspension : acetaminophen 120mg and codeine phosphate 12mg/5ml Tablets : acetaminophen 300mg and codeine phosphate 60mg
  • 23.  Most pain resulting from paedriatic dental procedures may be treated with mild analgesics, such as aspirin and acetaminophen. In case they are ineffective, codeine may be administered in combination to provide adequate relief.  Stronger analgesics must be provided only if all the other efforts at pain control have proven in effective.
  • 25. • DEVELOPMENT OF ORAL MICROFLORA  Oral cavity is usually sterile at birth  Number of microorganisms increase following 6- 8hrs after birth  At 12 months of age, most children have the following microorganisms in their oral cavity. 1. Streptococcus (S. salivarius, S. mutans) 2. Staphlyococcus 3. Actinomyces 4. Veillonella 5. Lactobacilli 6. Nocardia 7. Fusobacterium
  • 26.  Antibiotics provide time for normal host defenses to gain control and eliminate the infectious process.  Antibiotics for children are similar to those in adults (as adjusted by body weight).  The exceptions are infants, who require a lower antibiotic dosing.
  • 27.  Antibiotics act through specific mechanisms dictated by the site of action- 1. Cell membrane 2. Cell wall loss of integrity rupture bactericidal 3. Nucleic acid content interferes with ribosomal function replication, protein synthesis and information transfer is disrupted 4. Intermediary metabolism metabolic pathways interrupted suppression of growth
  • 28. Beta lactams Penicillins effective against – gram +ve oragnisms. Eg : streptococci, clostridia, H. influenzae, Staph. Aureus (when used with clavalunic acid) Cephalosporins effective against gram +ve (first gen.) and gram –ve (second and third gen.) and organisms that show high resistance to beta lactamase (fourth gen.) Sulphonamides Effective against gram +ve and gram-ve bacteria. Eg : strep. Pyogens, H. influenzae, vibrio cholerae, E.coli, Nocardia Cotrimoxazole Effective against Salmonella typhi, seratia, klebsiella, enterobacter, shigella, H. influnzae, E.coli, etc Nitroimidazoles Metronidazole- effective against protozoal organisms. Eg : Entamoeba histolytica and giardia lamblia -anaerobic bacteria like Veilonella, Clostridia, Fusobacterium, treponema vaginalis, etc.
  • 29.  Dentists seldom treat infants, but doses for paediatric patient require an adjustment from the usual adult dose, as determined by body surface area and weight.  The following two formulae are used for calculating paediatric doses- 1. Clark’s rule 2. Young’s rule
  • 30.  Clark’s rule child’s weight in lb X adult dose = child dose 150  Young’s rule Age of child X adult dose = Child’s dose age + 12  Anders in 1992  Administration of drug based on infants weight is seldom appropriate. dose p = dose a X weight pd weight ad
  • 31.  Children vary considerably in size and weight at the same age levels.  The dose of many drugs is not always a simple linear function of body weight. Surface area is a more accurate method in determining the dose since it can be easily determined by knowing the height and weight and referring to the nomograms which relate these body parameters.
  • 34.  Resistance to a particular drug could be either due to improper dose or duration.  The only practical method to delay or restrict antibiotic resistance is to limit the antibiotic use to proper indication, dosages and duration.  Instructions by the physician or manufacturers should be followed.
  • 35.  Administration of antibiotics to patients without the evidence of infection to prevent bacterial colonization, to reduce subsequent post-operative complications.  Example : Antibiotic prophylaxis is required in a patient with rheumatic heart disease to prevent infective endocarditis. It is also required in case of immunosuppressed patients with blood dyscrasias, cancer chemotherapy and graft recipients.
  • 36.  Prophylaxis for children with rheumatic or other valvular disease; congenital heart disease, idiopathic hypertrophic subaortic stenosis, mitral valve prolapse syndrome with mitral insufficiency and cardiac valvular prosthesis.  Two regimen given by WHO- 1. Regimen A 2. Regimen B
  • 37. Regimen A Regimen B 1. Parenteral-oral combined : A. Aqueous crystalline penicillin (30, 000 U/kg IM) mixed with procaine penicillin G (600, 000 U IM) 30- 60mins prior to dental procedure. B. Then penicillin V – 500mg orally every 6 hours for eight doses. C. In children<60 pounds, penicillin V – 250mg orally every 6 hourly for 8 doses 2. Orally only : A. Penicillin V – 2g orally 30-60mins prior to dental procedure, then 500mg every 6 hours for 8 doses. B. In children<60 pounds, penicilllin V- 1g orally, 30-60mins prior to dental procedures then 250mg every 6 hours for 8 doses. 1. Aqueous crystalline penicillin G (30, 000 U/kg IM) mixed with procaine penicillin G (60, 000 U IM) + streptomycin (20mg/kg IM), 30-60 mins prior to dental procedures. 2. Followed by oral penicillin V- 500mg every 6 hours for 8 doses. 3. In children<60 pounds, oral penicillin V- 250mg every 6 hours for 8 doses. 4. For patients allergic to penicillin- A. Parenteral vancomycin + erythromycin (vancomycin – 20mg/kg IV over 30-60mins + oral erythromycin 10mg/kg every 6hours for 8 doses) B. Oral erythromycin- 20mg/kg orally 1.5-2hours prior to the dental procedure and 10mg/kg every
  • 38. Antibiotics Generic Names Brand Names Penicillins Oral penicillin G Penicillin V Pentids, Pizerpen, Ledercillin VK, Veracillin, V-cillin-K Cephalosporins Cephalexin Cephradine Keflex, Anspor, Velosef Erythromycin Erythromycin base Erythromycin succinate Erythromycin stearate Erythromycin estolate E-mycin, erythrocin, Pedia mycin, eryhtrocin ilosone Lincosamides Lincomycin Clindamycin Lincocin Cleocin
  • 39.  Amoxicillin  Amoxicillin + Clavulanate potassium  Amoxicillin + cloxacillin  Ampicillin  Cephalexin  Cotrimoxazole  Erythromycin  Metronidazole
  • 40. Actions Interferes with cell replication of susceptible organisms, the cell wall rendered osmotically unstable, swells and bursts from osmotic pressure Dosage Per oral 20-40mg/kg/day in three doses Availability Capsule-250mg, 500mg Tablet-125mg, 250mg Powder for suspension- 50mg/ml Side effects Increased thirst, nausea, vomiting, diarrhoea, pruritis, urticaria, angioneurotic oedema, bronchospasm, anaphylaxis.
  • 43. Action Interferes with cell wall replication of susceptible organisms, the cell wall rendered osmotically unstable, swells and bursts from osmotic pressure Dosage and route Per oral 20-40mg/kg/day in three divided doses Available forms Capsule 250mg, 500mg Chewable tablets 125mg and 250mg Powder for oral suspension 125mg, 250mg/ml. Side effects Discoloured tongue, glossitis, increased thirst, nausea, vomiting, diarrhoea, hyperkalemia, puritis, urticaria, bronchiospam, anaphylaxis Contra indications Hypersensitivity to penicillin
  • 44. Augmentin duo, clavam 375mg (250mg+125mg), 625mg (500+125mg) tablet Augmentin duo syrup 228mg/5ml
  • 45. Action Interferes with cell wall replication of susceptible organisms, the cell wall rendered osmotically unstable, swells and bursts from pressure Dosage and route 50-100mg/kg of combination, divided in 3 divided doses Available forms Tab 250mg and 500mg Capsule 250 and 500mg Powder for oral suspension 125mg, 150mg/15ml Side effects Increased thirst, Nausea, Vomitting, Hyperkalemia, Pruritis, Urticaria, Bronchospasm, Anaphylaxis Contra indications Hypersensitivity to penicillin
  • 46. Action Interferes with cell wall replication of susceptible organisms, the cell wall rendered osmotically unstable, swells and bursts from osmotic pressure Dosage Per oral 50-100mg/kg/day in four divided doses (6 hourly) Available forms Cap 200mg and 500mg Powder for oral suspension 125mg/5ml Side effects Discoloured tongue, glossitis, rash, urticaria, glomerulonephritis, puritis, angioneurotic oedema, bronchospams, anaphylaxis, nausea, vomiting, Diarrhoea. Contra indications Hypersensitivity to penicillin
  • 48. Actions Inhibits bacterial wall synthesis , rendering the cell wall osmotically unstable Dosage and route Per oral 50-100mg/kg/day in 4 divided doses Available forms Capsule 250mg, 500mg Tablet 250mg, 500mg Oral suspension 125mg, 250mg/5ml and 100mg/ml Side effects Candidiasis, glossitis, NVD, anorexia, pseudomembranous colitis, nephrotoxicity, urticaria, rash, anapylaxis Contra indications Hypersensitivity, pregnancy, infants <1 months.
  • 52. Actions Sulfamethazole interferes with bacterial biosynthesis of proteins by competitive antagonism of PABA; trimethoprim blocks synthesis of tetrahydrofolic acid, this combination blocks consecutive synthesis of essential nucleic acids, proteins. Dosage and route Per oral 8mg/kg (TMP) + 40mg (SMZ) [double strength] 160mg TMP/800mg SMZ Suspension 40mg+200mg/5ml Side effects Candidiasis, Stevens-Johnson Syndrome, anaphylaxis, SLE, NVD, hepatitis, leukoopenia, agranulocytosis, renal failure Contra indications Hypersensitivity to trimethoprim, sulfamethoxazole, megaloblasic anemia, infants of 2 months, pregnancy and lactation
  • 55. Action Binds to ribosomal units of susceptible bacteria and supress protein synthesis Dosage and route Per oral 30-5-mg/kg/day in 4 divided doses Available forms Tab 250mg, 500mg Suspension 250mg/5dl Side effects Candidiasis, rash, urticaria, pruritis, hypersensitivity, NVD, hepatotoxicity, abdominal pain, pseudomembranous tnnitus Contra indications Hypersensitivity to pre existing hepatic disease
  • 57. Actions In anaerobic microorganisms, metronidazole is converted to active form by reduction of its nitrogroup. This gets bound to DNA and prevents nucelic acid formation Dosage and route Per oral 5mg/kg/TID Available forms Tab 200mg, 400mg Suspension 200mg/5ml Side effects Dry mouth, furry tongue, bitter taste, metallic taste, leukopenia, bone-marrow aplasia, rash, urticaria, NVD, abdominal pain, nehprotoxicity Contra indications Hypersensitivity to drug, renal disease, pregnancy and lactations, hepatic disease, alcoholic patients (disulfuram like reactions)
  • 59.  Paediatric drug therapy and immunization by RK Suneja.  Textbook of paediatric dentistry by Braham and Morris.  Text book of paediatric dentistry by Shobha Tandon.

Editor's Notes

  1. Dose p = dose of child Dose a = dose of adult Weight pd = weight of child Weight ad = weight of adult