Locally Acting Drugs

I- Obtundants
II- Mummifying agents
III- Antiseptics & Disinfectants
5 minutes BREAK
IV- Local Antifungal Agents
V- Demulcents
VI- Emollients
VII- Astringents

I-

Obtundants

Drugs
sensation of dentine tissue to
allow easy painless excavation.

* Ideal obtundant

1- Do not stain the teeth

2- No initial stimulation
3- Penetrate quickly but not deep
to avoid pulp inflammation

* Members
(Local Anodynes & Astringents):

A) Local Anodynes :
1- They paralyze the nerve endings, but they produce initial stimulation
2- Example: Clove oil (Eugenol)

B) Astringents:
1- They precipitate cellular protein of nerve fiber
2- Examples
a- Alcohol 70%: ***

Astringet + Antiseptic

(Cavity should be DRY, otherwise it will be diluted Not Effective)

b- Phenol.
c- Silver nitrate: Very powerful, but it stain the teeth black
d- Zinc chloride: Does not penetrate deep nor stain & nontoxic.
e- Para-formaldehyde Liberates formalin. Doesnt stain the teeth.
f- Solution of Na ethylate freshly prepared in 18% in 90% Alcohol
Decompose in tissue NaOH + Alcohol.
No initial stimulation& No staining of tissues
Rapid action, Deep penetration

II- Mummifying agents

Produce aseptic dryness & hardness of pulp tissue & root canal.
They are applied when pulp or contents of root cannot be removed.
They are astringent & antiseptic
All mummifying agents are obtundants,
but not all obtundants are mummifying agents
* Examples:
1- Tannic acid
2- lodoform
3- Formaldehyde 10%
4- Para-formaldehyde
5- Cresol
6- Beta naphthol 3% in alcohol
7- Ammoniated silver nitrate Stains teeth black Not in frontal teeth.

III- Antiseptics & Disinfectants

Antiseptic Kill or growth of M.O, applied to living tissues.
Disinfectant Destroy M.O, applied to inert matter

1- Phenol & Phenol Analogues:

A) Phenol (Carbolic Acid):

Denaturate
proteins

Phenol
Local
Anesthetic

Bactericidal

1-Domestic
2-Liquified phenol (Phenol in 10% distilled water):
- Analgesic & obtundant in toothache.

B) Phenol Analogues:
1- Cresol
2- Chloroxylenol (Dettol):
Antiseptic
3- Thymol:
-Bactericidal
-Fungicidal
-Anthelmintic

2) Alcohols:
Ethyl alcohol 70% Dehydration of proteins Denaturation
Precipitation Antiseptic and astringent useful in bed sores.

3) Acids:
1- Salicylic acid: Antiseptic, fungicidal & keratolytic.
2- Boric acid:
- Sodium borate (Borax) in glycerin (12% w/v) Paint for gum.

4) Aldahydes:
- Formaldehyde 37% solution Formalin:
a- 2-5% Disinfectant for instruments & gloves.
b- 10% Preserve & harden tissues
for histolopathology.
(Mummifying Agent)

5) Oxidizing Agents:
They release nascent oxygen Antibacterial action.
A) Peroxides:
e.g - Hydrogen peroxide: Antiseptic, deodorant & hair bleeching.
By tissues peroxidase enzyme Release of nascent O2

(act on living tissue which contain peroxidase enzyme so it is antiseptic and not disinfectant)

B) Permanganate:
e.g Zinc permanganate: Disinfectant & astringent.

C) Perborate: Sodium perborate

1- 2% Mouth wash for gingivitis &
Vincents angina(Trench Mouth: ulcerative bacterial infection)

6) Halogens & Halogen Containing Compounds:

A) Iodine:
1- Iodine glycerin 2% Mouth paint for gingivitis.
2- Iodophors: Povidone-iodine 10% solution (Betadin).
Iodine + Stabilizing agent or carrier
Slow release of iodine

B) Chlorine:
Chlorine in aqueous solution Hypochlorous acid
Oxidation of SH-containing enzymes & destroys cell membrane of bacteria.
1- Hypochlorites: Germicidal & dissolve necrotic tissue.
- Calcium hypochlorite (Eusol).
2- Chloramines: - Halazone tablets Disinfect drinking water.

7) Heavy Metal Salts:

They inhibit SH-containing enzymes & precipitate proteins of bacteria.
Mercury, Zinc, Silver, Copper

A) Mercury Compounds:
- Merbromin (Mercurochrome): Bacteriostatic skin disinfectant.

B) Zinc Compounds:
- Zinc peroxide. (Oxidizing agent + H.M salt= pptn of prtn& enzymes)

C) Silver compounds:
- Silver nitrate eye drops (OBSOLETE).
Argyrosis = Blackening of the sclera

D) Copper Compounds: e.g. Copper sulphate:

- Molluscicide for bilharzial snails. (COMMON)

8) Dyes:
- Rosaniline dyes e.g. Gentian violet (crystal violet)
Antiseptic paint for infected wounds &
Thrush(infection)= monilial stomatitis (white patches)

9) Surface-Active Agents (Surfactant , Detergents)

They accumulate at bacterial cell membrane surface tension
Escape of enzymes, coenzymes & metabolites Bactericidal.
Anionic + Cationic Incompatibility. They are NOT mixed together
1- Anionic surfactants:
e.g. Soft soap (as liquid)& Sodium lauryl sulphate.
Gram +ve organisms (Except Staph aureus) and NOT Gram ve ones.
2- Cationic surfactants
e.g. Benzalkonium chloride (Zephiran) & Cetyl-trimethyl-ammonium bromide (Cetavlon).

More active & broader spectrum (Gram +ve & -ve BUT NOT viruses).
3- Non-ionic surfactants:
e.g. Polysorbates Emulsifying agent & NOT antiseptic.