Antiseptics, astringents and sialogogues

overview of antiseptics, antringents and sialogogues with detailed information on pharmacological action, mechanism, use and adverse effect for both dental and medical students

1. Antiseptics, Astringents And Sialogogues BIBI UMEZA Department of Pharmacology

2. ANTISEPTICS Antiseptics are substances which destroy or prevent the growth of microorganisms, applying to living tissue.

3. Properties Desirable in Antiseptics Chemically stable. Cheap . Nonstaining with agreeable colour and odour . Cidal and not merely static, destroying spores as well Active against all pathogens—bacteria, fungi, viruses, protozoa. Require brief time of exposure.

4. Able to spread through organic films and enter folds and crevices. Active even in the presence of blood, pus, exudates and excreta

5. In addition it should be: Rapid in action and exert sustained protection . Nonirritating to tissues, should not delay healing . Nonabsorbable , produce minimum toxicity if absorbed . Nonsensitizing (no allergy ). Compatible with soaps and other detergents

6. Spectrum of activity Reflecting nonselective of action . some are selective , e.g. hexachlorophene, quaternary ammonium antiseptics, acriflavin , etc are more active on gram-positive than gram-negative bacteria; silver nitrate is highly active against gonococci benzoyl peroxide against P. acnes.

7. Mechanisms of action Germicides are varied, but can be grouped into : Oxidation of bacterial protoplasm. Denaturation of bacterial proteins including enzymes. Detergent like action increasing permeability of bacterial membrane.

8. CLASSIFICATION Phenol derivatives : Phenol, Cresol, Hexylresorcinol, Chloroxylenol , Hexachlorophene. Oxidizing agents: Pot. permangnate , Hydrogen peroxide, Benzoyl peroxide. Halogens : Iodine, Iodophores , Chlorine, Chlorophores . Biguanide : Chlorhexidine . Quaternary ammonium (Cationic): Cetrimide , Benzalkonium chloride, Dequalinium chloride. Soaps : of Sod. and Pot. Alcohols : Ethanol, Isopropanol.

9. Aldehydes : Formaldehyde, Glutaraldehyde . Acids : Boric acid, Acetic acid. Metallic salts: Silver nitrate, Silver sulfadiazine, Mild silver protein, Zinc sulfate , Calamine, Zinc oxide. Dyes: Gentian violet, Acriflavine , Proflavine . Furan derivative: Nitrofurazone .

10. ASTRINGENT “Brings about protein precipitation.” E.g.: Alum

11. USES For Styptic action Anti inflammatory Anti perspirant Anti microbial To remove unwanted skin

12. They form a protective coating and harden the surface. Astringents check minor hemorrhages—arrest capillary oozing as they promote clotting and precipitate proteins on the bleeding surface. Astringents are therefore used as obtundents , styptics and mummifying agents.

13. Types of Astringents Vegetable astringents—tannic acid, gall Metallic astringents—salts of zinc, copper, iron, aluminum and silver; also alum Miscellaneous—alcohol , dilute acids.

14. Uses: Uses: Astringents are used as mouthwashes, paints, lotions and dentifrices in aphthous ulcers, stomatitis, gingivitis and as local hemostatics

15. SIALOGOGUES

16. SIALOGOGUES Sialogogues are agents which enhance salivary secretions. Pilocarpine is generally used as a sialogogue . Cevimeline a newly introduced drug enhances salivary secretion by directly stimulating the muscarinic receptors

17. USES Sialogogues are used to treat acute symptoms of sialoadenitis that may be seen in sialolithiasis . Surgical excision is required in most cases Xerostomia —often follows radiotherapy of the head and neck. It may be troublesome because it causes difficulty in speaking and swallowing. It may be treated with pilocarpine Sjögren’s syndrome— cevimeline is used.

18. Antisialogogues An antisialogogue is a substance that reduces salivary secretion. Propantheline bromide an atropine substitute is commonly used.

19. Uses Sialocele : An antisialogogue is used to suppress glandular function during healing or to encourage spontaneous resolution of the sialocele . Postsurgical : An antisialogogue is used for a short period following surgeries of the salivary glands and salivary ducts. Temporary reduction in the flow of saliva is thought to be helpful in faster wound healing

20. In post-traumatic parotid fistulas and sialoceles Trauma to the salivary gland and salivary ducts

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