3. Drug Use in Dentistry Flashcards
Hazards of drug use and explanations (2)
Death - allergy to drug/toxicity of drug
Drug interactions - effect on absorption/metabolism of other essential medicines
Classes of drugs used in dentistry (5)
LAs Antimicrobials Drugs in pain and inflammation Drugs used in sedation Emergency medical drugs
Function of LA
Reduce awareness of pain
Action of LA
Act on nerve channels to block propagation/nerve transmission
Examples of LA (5)
Lignocaine/lidocaine Articaine Bupivicaine Prilocaine Mepivicaine
Classes of antimicrobials (3)
Antibiotics
Antivirals
Antifungals
Examples of antibiotics (4)
Amoxicillin
Metronidazole
Doxycycline
Clindamycin
Example of antiviral
Acyclovir
Examples of antifungals (2)
Nystatin (topical)
Fluconazole (systemic)
Drugs used to reduce inflammatory mediators
NSAIDs
Drugs used to reduce inflammation process
Corticosteroids
Drugs involved with immunosuppresion
Steroids
Action of NSAIDs (2)
Inhibit prostaglandin synthesis
Change balance of PGE1 and PGE2 (anti-inflammatory).
COX (COX1/2 inhibitors)
Types of NSAIDs and examples (3)
Salicylates - aspirin
Propionic acid derivatives - ibuprofein
Phenylacetic acid derivatives - diclofenac )POM)
Aspirin dosage
300-600mg up to 4 times daily
Aspirin benefit
Reduces MI/bowel cancer risk
Aspirin pharmacokinetics (4)
Rapidly absorbed from GIT
Eliminated by first order kinetics
COX1 inhibitor, anti-pyrexic
Can be taken pre-emptively
Aspirin overdose cause/effects (2)
Enzyme saturation
Can lead to toxic effects including acidosis
Aspirin side effects (5)
Gastric irritation (erosions, ulcerations - worse with alcohol) Platelet function inhibition (enhanced bleeding) Bronchospasm (exacerbates asthma) Allergic reaction (rash) Drug interactions - significant protein binding
Ibuprofen dosage
200-600mg three times daily
Ibuprofen side effects (6)
Same as aspirin, but less problematic
Gastric irritation (erosions, ulcerations - worse with alcohol)
Platelet function inhibition (enhanced bleeding)
Bronchospasm (exacerbates asthma)
Allergic reaction (rash)
Drug interactions - significant protein binding
Diclofenac dosage and potency (2)
50mg three times daily
More potent than ibuprofen, therefore more effective anti-inflammatory
COX2 inhibitors vs COX1 inhibitors (2)
COX2 - reduced gastric side effects
Better for long-term use (arthritis) but can lead to cardiac death
COX2 inhibitor example
Arcoxia
Corticosteroids reduce inflammation by (4)
Inhibiting capillary permeability Inhibiting bradykinin formation Inhibiting WBC migration Reducing eiconsanoid synthesis Corticosteroids suppress the features of inflammation but do not address the underlying cause
Examples of topical corticosteroids and uses (4)
Steroid inhalers (asthma)
Hydrocortisone cream (eczema)
Steroid treatment for mouth ulcers (beclomethasone inhalers, hydrocortisone adhesive tablets, betamethasone solution)
Triamcinolone
Examples of systemic corticosteroids and uses (2)
Prednisolone tablets - prevent transplant rejection, treat immunological diseases
Dexamethasone injection - reduce post-ope swelling
Side effects of systemic corticosteroids (7)
High blood pressure Weight gain (fluid) Fat distribution change (centripetal obesity and buffalo hump) Gastric ulceration Adrenal suppression Osteoporosis Diabetes
Prednisolone dosage
1-100mg (varies with desired level of immune suppression)
POM
Paracetamol action (3)
Anti-pyretic
Analgesic
Few side effects
Paracetamol dosage
1g (1000mg) four times daily
Paracetamol combined drugs (2)
Co-codamol - with codeine
Co-drydamol - with dihydrocodeine
Anxiolytic classes and examples (2)
Benzodiazepines - diazepam and midazolam
Gas - nitrous oxide
