Transcript DENT 1214 Clinical Concepts

DENT 1160
Pharmacology
1. Define PHARMACOLOGY
It is the branch of medicine that conducts
research and development in the use
and effects of drugs.
 A drug is a substance used to treat,
diagnose or prevent a disease
 Dentist need to know what the patient is
taking because those drugs may effect
treatment and interact with the drugs the
dentist needs to use.
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2. DRUGS

Over the counter or
Prescription (DEA #)
ID a drug by 3 names
 Chemical
acetylsalicylic acid
 Generic
aspirin
 Brand
Bayer, Bufferin
3&4. Physician Desk Reference

PDR in text or
computer format
 Tells: use, indications
and contraindications,
side effects
(predictable body
reaction)
 other sourcesUSP, NF, ADT,
How to use PDR
Obtain any of the following:
 The name of the drug
Turn to the Product Name Index - alphabetical
 A sample of the drug
Look in the Product Identification Section -pictures
 The prescription container with product name
Use the yellow Generic or Chemical Name Section
 The medical condition the drug is treating
Use the blue section -Product Category Index

Examples: analgesic

anticoagulant

diuretic
Page numbers will direct you to detailed information, classification,
purpose or use, side effects, contraindications
5. Routes of Administration

Oral- pill, capsule, liquid
 Topical- gel or ointment
on skin or mucosa
(subdermal patch)
 Inhalation- gas
 Sublingual- under
tongue, absorbed
 Injection
subcutaneous
IM
IV
Prescription
Is a written order by Dr or DDS ( with
DEA#) to dispense drugs.
 Keep Rx pads secure!!!
 Superscription- patient data
 Inscription- name and amount of drug
 Subscription- directions for dispensing
 Signature- directions for use( see list
text)
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Prescriptions

DA may call a Rx to
pharmacy but CAN
NOT PRESCRIBE or
dispense OTC
without DDS order
Controlled Substance Act 1970
Schedule I- no medical use, potential
abuse, LSD, heroine, marijuana
 II- has med use, potential abuse, no call
in or refill, opium, cocaine, morphine
 III- use and less potential abuse,
stimulants, depressants, Tylenol with
codeine
 IV- Valium, laibrium, Darvon
 V- cough meds with codeine

6. Antibiobitics

Dentists may prescribe an antibiotic to treat or
prevent a bacterial infection.
 Some common antibiotics are:
penicillins PenVee K, Amoxil
cephalosporins Keflex, Ceclor
erythromycins Zithromax, E-Mycin
tetracyclines
Minocin,Achromycin
clindamycin
Clindets, Dalacin
Oral Contraceptives?????????????????????
7. AHA Prophylactic Antibiotics

When needed? prevent endocarditis
Artificial heart valve
Shunt
Heart murmur
mitral valve prolapse
Use what?
Penicillin or ampicillin (2g)
clindamycin (500mg)
Take when?
One hr before appointment
ADA on Premeds

http://www.ada.org/public/media/videos/
minute/medi_premedication_broadband.
wmv
8&9. Analgesics
Also known as pain killers
 Non narcotic (OTC) relieve mild to
moderate pain
 Acetylsalicylic acid- Aspirin (cause
bleeding due to thinning of blood)
 Acetaminophen- tylenol
 Ibuprofen- Advil or Motrin

10. Narcotic Analgesics
Stronger and may be used for sedation,
analgesia and hypnosis
 morphine
 codeine
 meperdine- Demerol
 Oxycodone- Percodan
 Propoxyphene- Darvon, Davocet
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11. Premed Sedatives
Antianxiety agents given to reduce
nervousness prior to appointment
 Diazepam- Valium
 Chlordiazepoxide-Librium
 Meprobamate- Miltowm
 Hydroxyzine- Vistaril
 Xanax
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12. Instructions for Pre Op meds
Antibiotic- take as directed 1 hr prior to
apt.
 Sedative- take as instructed, do not drive
or drink alcohol
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14. Sedation (antianxiety)
Inhalation vs
IV
INHALATION
Nitrous oxide
Halothane(Fluothane)
Methoxyflurane
( Penthrane)


IV
Pentothal
Brevital
ADA on Nitrous
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http://www.ada.org/public/media/videos/
minute/treat_nitrous_broadband.wmv
13. Analgesia vs Anesthetic

Analgesic prevent or
relieve pain

Anesthetic produces
a loss of sensation,
numbs
15. Topical vs Local anesthesia
Topical- gel, ointment, liquid or spray
used to numb mucosa. A 5-20%
concentration of local anesthetic. Dry
area, apply and let set 1-2 min.
 Local- loss of sensation in area, 2-5%
concentration, lidocaine, mepivocaine,
xylocaine, lidocaine
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16. 3 actions of
VASOCONSTRICTOR
Constrict BV to prolong the effect
 Decrease bleeding in the area
 Reduces the amount of anesthetic
needed, safer


Epinephrine 1:50,000 or 1:20,000,
1:100.00
17. Contraindication for
vasoconstrictor
Hypertension
 Severe cardiovascular disease
 Hyperthyroid


Use nonepinephrine products like:
Levophed, Neo-Cobefrin
18. Assistant responsibility
You prepare the syringe!
1.Use correct anesthetic (per Dr) cartridge
2. Use correct needle length ( long mand,
short max)
3. Place stick shield
4. Engage harpoon
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19. Drugs of concern to dental
treatment
1. Antabuse- avoid product with high
alcohol content like mouthwash
 2. Aspirin, Fiorinal, Coumadin (warfarin)bleeding (anticoagulants)
 3. NSAID, Naprosyn, indomethacinbeware Diabetics & cause bleeding
 4. Albuterol or Ventolin- asthma
 5. Insulin- diabetic (food and insulin)
 6. Nitrogliceryn- angina
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19. Cont drugs of concern
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7. Lasix (furosemide)- HBP, restroom use
8. Lanoxin (digoxin)- heart problems
9. Prednisone- immune compromised,cancer
10. Oral Contraceptive- not effective with AB
11. Prozac (fluoxetine)- Do Not use nitrous
12. Zoloft- FATAL with Demeral (meperidine)
13. Dilantin- epilepsy
Dilantin for epilepsy
ADA on drug side effects

http://www.ada.org/public/media/videos/
minute/medi_sideeffects_broadband.wm
v
The End