Transcript MDA Ch 30&37 Study Guide

Chapter 30
Principles of Pharmacology
Pharmacology
• The science or branch of medicine that
conducts research and development in the
use and effects of drugs
Drug
• A substance used in the prevention,
diagnosis, or treatment of a disease.
• All drugs must be recognized and defined
by the US Food, Drug and Cosmetic Act
before they can be marketed to the public
in the US
A drug is identified by three names
• Chemical name: which is the chemical
formula of a drug
• Generic name: which may be used by any
company; acetaminophen is an example
of a generic name
• Brand name, or trade name: which is
controlled by business firm as a registered
trademark; such as Tylenol is brand name
for acetaminophen
Dispensing
• Patent medicines: drugs that can be
obtained without a prescription; also
known as over-the-counter drugs
• Ethical drugs: Prescription drugs (from a
physician or dentist), supplied to patients
only by a pharmacist.
Prescriptions
• A written order by a physician or dentist for
preparation and administration of a
medicine
• Persons legally authorized to prescribe
medications are issued a Federal Drug
Enforcement Agency (DEA) identification
number.
• Dental assistants cannot prescribe
medications
Terminology of Prescriptions
• Superscription: patient name, address,
the date and symbol Rx
• Inscription: name and quantity of the drug
• Subscription: directions for mixing the
medication
• Signature: instructions for the patient on
how to take the medication, when and how
much
Telephone Guidelines
• Narcotics cannot be ordered without a
written prescription
• It is illegal for a Dental assistant to “call in”
a prescription
• Notify the dentist if the Pharmacist calls
the office
• Never attempt to evaluate a patient’s
reaction to a drug.
Mosby’s Drug Consult
• Annual source of information supplied by
drug companies
• It is a bound text, as well as a electronic
source
Drugs
• Local-acting drug
– Affects only the specific area of the body to
which it is applied, such as a topical ointment
• Systemic drug
– Taken internally
– Can affect the whole body by way of
circulatory system
Administration
• Four stages
– Absorption
• Absorbed from site of entry—speed varies, slowest is orally
– Distribution
• Enters bloodstream, attaches to proteins within blood, and
circulates throughout the body
– Metabolism
• Compound is released, and drug becomes metabolized and
is then excreted through liver or kidneys
– Excretion
• Drug leaves the body by way of kidneys, liver, breast milk or
sweat
Routes
• Oral—tablets, liquid
• Topical—apply on surface of mucosa
• Transdermal –patch that continuously
releases medication
• Inhalation—breathing in substance
• Sublingual—medication placed under the
tongue
Controlled Substances Act
• Drugs that are covered under the Federal
Comprehensive Drug Abuse Prevention
and Control Act are divided into five
schedules
Schedules
• Schedule I
– No current accepted medical use/high potential for abuse
• Schedule II
– High potential for abuse, some medical usefulness
• Schedule III
– Less abuse potential than Schedule I and II, and has accepted
medical usefulnes
• Schedule IV
– Low abuse potential and have accepted medical usefulness
• Schedule V
– Lowest abuse potential and accepted medical usefulness/no
prescription needed
Chapter 37
• Anesthesia and Pain Control
Topical Anesthesia
• Provides numbing effect in an area where
in injection is to take place
– Ointments, liquids, sprays or patches
Local Anesthesia
• Most frequently used form of pain control
in dentistry
• Obtained by injecting an anesthetic
solution near a nerve where treatment is to
take place
• Each local anesthetic cartridge contains
– Local anesthetic drug
– Sodium choloride
– Distilled water
Uses of Vasoconstrictors
• Slows down the intake of an anesthetic
agent and increases the duration of action
• Prolongs the effect of the anesthetic agent
by decreasing the blood flow in immediate
area of the injection
• Decreases bleeding in the injected area
Contraindications to
Vasoconstrictors
• May cause strain on the heart
• Not recommended for patients with a
history of:
– Angina
– Chest pain (heart related)
– Recent myocardial infarction
– Coronary artery bypass surgery
– Untreated or severe hypertension
– Congestive heart failure
Duration of Anesthetics
• Know the duration (in minutes) of each of
the following
– Short-acting local anesthetic
– Intermediate-acting local anesthetic
– Long-acting local anesthetic
Injection Techniques
• Infiltration Anesthesia
– Usually used for Maxillary arch
– Also used for secondary injection to block
gingival tissues surrounding mandibular teeth
• Block Anesthesia
– Usually used for mandibular arch
– Block nerves for the quadrant
Syringe
• Know the parts of the syringe and their
functions
Cartridges/Disposable Needle
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Know the color-coding system
Know the parts of the cartridge
Know the parts of the needle
Know the size of the needle for dentistry
Lumen—the hollow center of the needle-how the
anesthetic flows through needle
– The larger the gauge number—thinner the needle
– The smaller the gauge number—thicker the needle
Complications and Precautions
• Know in detail
– Injection into a blood vessel
– Infected areas
– Toxic reactions
– Systemic reactions
– Temporary numbness
– paresthesia
Inhalation sedation
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Know the chemical make-up
Advantages of Nitrous Oxide Use
Contraindications of Nitrous Oxide Use
Equipment
• Intravenous sedation
– Understand the uses of IV sedation
• General Anesthesia
– Know definition
– Know in detail the four stages of anesthesia
• Happy Testing