bnf dental formulary Flashcards
acyclorvir cream
method of action:
uses:
side effects:
contraindications:
Method of Action: Stops the viral replication cycle, useful in the early stages of infection
Uses: Recurrent Herpes Labialis or severe Acute Herpetic Gingivostomatitis
Side effect: Nausea, Vomiting and Diarrhoea
Contraindications: Hypersensitivity, Renal failure,
amoxicillin
method of action:
uses:
side effects:
contraindications:
Method of Action: Inhibits the formation of the bacterial cell wall during replication (beta lactam) and is broad spectrum. Can be inhibited if bacteria produce beta lactamases (antibiotic resistance).
Uses: Odontogenic infections
Side effect: Nausea, Vomiting, Stomach pain, Rash and Diarrhoea
Contraindications: Hypersensitivity, alters warfarin metabolism (check INR)
artificial saliva
method of action: uses: side effects: contraindications: example:
Method of Action: Increase saliva flow, lower risk of tooth decay and freshens breath
Uses: People suffering from xerostomia due to reasons such as previous radiotherapy, medication or Sjogren’s syndrome
Side effect:
Contraindications: Hypersensitivity,
Example: Biotene
aspirin
method of action:
uses:
side effects:
contraindications:
Method of Action: Inhibits the cyclo-oxygenase 2 enzyme leading to reduced proinflammatory cytokine production so reduced inflammatory response
Uses: Prescribed as analgesia following invasive dental procedures such as XLA
Side effect: Hypersensitivity, anticoagulant effect,
Contraindications: Not to be used in under 16s due to Reye’s syndrome (hepatic encephalopathy), don’t prescribe to people already on an antithrombic drug, don’t prescribe to people taking NSAIDs, people on an anticoagulant
azithromycin
method of action:
uses:
side effects:
contraindications:
Method of Action: Prevents bacterial protein synthesis by binding to 50s ribosome
Uses: Antibiotic for treating dental infections, third line of defence
Side effect: Diarrhoea, nausea and abdominal pain
Contraindications: Hypersensitivity, liver or kidney parafunction, heart irregularities, myasthenia gravis and diabetes (contains sugar)
beclomethasone
method of action:
uses:
side effects:
contraindications:
Method of Action: An aerosol corticosteroid
Uses: Anti-inflammatory treatment of mucosal inflammation and ulceration, can be used for lichen planus and other orally presenting autoimmune diseases
Side effect: Increased risk of oral candida, dry mouth, tunnel vision
Contraindications: People with active TB, decreased adrenal gland function, interactions with warfarin
benzydamine hydrochloride
method of action:
uses:
side effects:
contraindications:
Method of Action: An NSAID mouthwash, so blocks COX2 to reduce pain and inflammation
Uses: Sore throat, oral inflammation and ulceration
Side effect: Numbness in mouth or throat, dry mouth and cough
Contraindications: Hypersensitivity, people who take NSAIDs and people who are unable to swallow
betamethasone
method of action:
uses:
side effects:
contraindications:
Method of Action: A corticosteroid with anti-inflammatory effects
Uses: Treatment of oral inflammatory skin conditions such as ulceration
Side effect: Dry mouth, exogenous cushings syndrome and burning mouth syndrome
Contraindications: Hypersensitivity, untreated serious infection and people taking NSAIDs (gastric ulceration will be unable to heal)
carbamazepine
method of action:
uses:
side effects:
contraindications:
Method of Action: Causes reuptake of Na+ by neurones leading to a reduction in neurogenic pain
Uses: Trigeminal neuralgia and other oral neuropathies
Side effect: Nausea, dry mouth, visual disturbances and thrombocytopenia
Contraindications: Caution in pregnancy as it is teratogenic
cefalexin
method of action:
uses:
side effects:
contraindications:
Method of Action: inhibits bacterial cell wall synthesis (beta lactam) and is broad spectrum (a cephalosporin)
Uses: Odontogenic infections
Side effect: Gastrointestinal disturbances such as nausea and diarrhoea
Contraindications: Galactose intolerance and hypersensitivity
cefradine
method of action:
uses:
side effects:
contraindications:
Method of Action: Inhibits bacterial cell wall synthesis (beta lactam) and is broad spectrum (a cephalosporin)
Uses: Odontogenic infections
Side effect: Gastrointestinal disturbances such as nausea and diarrhoea
Contraindications: Hypersensitivity
chlorhexidine
method of action:
uses:
side effects:
contraindications:
Method of Action: Bacteriostatic and bactericidal, disrupts the cell membrane leading to osmotic lysis. Has the property of substantivity – has a negative charge so is able to stay in the oral cavity for longer.
Uses: Debridement of pericoronitis, a chemical antiplaque to and periodontal disease treatment
Side effect: Browning of teeth, dry mouth
Contraindications: Breast feeding and hypersensitivity
chlorphenamine
method of action:
uses:
side effects:
contraindications:
Method of Action: An antihistamine so blocks histamine receptor, reducing the severity of an inflammatory response
Uses: Allergic reaction or anaphylaxis in the dental chair
Side effect: Dry mouth, drowsiness, blurred vision and nervousness
Contraindications: Hypersensitivity
choline salicylate
method of action:
uses:
side effects:
contraindications:
Method of Action: A topical COX-2 inhibitor related to aspirin
Uses: Oral and perioral inflammatory lesions such as recurrent apathous stomatitis
Side effect: Vomiting, peptic ulceration, haematopoiesis, oral burns due to low pH and tinnitus
Contraindications: Children under 16 due to Reye’s syndrome
clarithromycin
method of action:
uses:
side effects:
contraindications:
Method of Action: Inhibits bacterial protein synthesis
Uses: Odontogenic infections
Side effect: Gastrointestinal problems, diarrhoea, vomiting and rash
Contraindications: Hypersensitivity, hypokalaemia, rapid heart beat
clindamycin
method of action:
uses:
side effects:
contraindications:
Method of Action: Inhibits bacterial protein synthesis
Uses: Odontogenic infections, prophylaxis when placing implants,
Side effect: Gastrointestinal problems, diarrhoea, vomiting and rash
Contraindications: Hypersensitivity, hypokalaemia, rapid heart beat, Crohns disease or ulcerative colitis
co-amoxiclav
method of action:
uses:
side effects:
contraindications:
Method of Action: A beta lactam antibiotic so prevents bacterial peptidoglycan cell wall synthesis, a mixture of amoxicillin and clavulanic acid so is able to evade beta lactamases
Uses: Odontogenic infection
Side effect: Diarrhoea, tooth staining and nausea
Contraindications: Hypersensitivity, people with amoxicillin-clavulanate-associated jaundice/hepatic dysfunction.
diazepam
method of action:
uses:
side effects:
contraindications:
Method of Action: A sedative/muscle relaxant that increases GABA levels in the brain
Uses: An emergency medication if someone is having an epileptic seizure
Side effect: Drowsiness, fatigue, ataxia, tremor and dizziness
Contraindications: Respiratory weakness, myasthenia gravis
diclofenac
method of action:
uses:
side effects:
contraindications
Method of Action: A NSAID that inhibits the COX2 enzyme, leading to pain relief and reduced inflammation
Uses: Post op analgesic following invasive treatments such as XLA
Side effect: Indigestion, stomach pain and diarrhoea
Contraindications: hypersensitivity, third trimester pregnancy, taking another NSAID and active gastrointestinal ulceration
dihydrocodeine
method of action:
uses:
side effects:
contraindications
Method of Action: A weak opioid so binds to opioid receptors in the CNS causing neural depression
Uses: Post op analgesic following invasive treatments such as XLA
Side effect: Nausea, constipation and dry mouth
Contraindications: Any condition that causes diarrhoea, ulcerative colitis or Crohns disease
doxycycline
method of action:
uses:
side effects:
contraindications
Method of Action: Antibiotic that inhibits bacterial protein synthesis
Uses: Odontogenic infections, sinusitis, given prophylactically following reimplantation of avulsed tooth, antibiotic treatment of periodontal disease, oroantral fistula presence, can break open the capsule and add to water as a mouthwash to treat recurrent aphthous stomatitis
Side effect: Nausea, diarrhoea, hives and tetracycline staining (in people with developing teeth)
Contraindications: Hypersensitivity, previous antibiotic colitis, liver or kidney disease and people who still have developing teeth to prevent staining
ephedrine
method of action:
uses:
side effects:
contraindications
nasal drops
Method of Action: A nasal decongestant that reduces swelling and constricting blood vessels in the nose
Uses: To allow decongestion in people with OACs so they don’t need to blow their nose
Side effect: Nervousness, dry mouth, dizziness and headache
Contraindications: MAO inhibitor therapy
erythromycin
method of action:
uses:
side effects:
contraindications
Method of Action: Antibiotic that inhibits bacterial protein synthesis
Uses: Odontogenic infections
Side effect: Gastric ulceration, nausea, abdominal pain and diarrhoea
Contraindications: People suffering from diarrhoea, myasthenia gravis and hypersensitivity
fluconazole
method of action:
uses:
side effects:
contraindications
Method of Action: An azole antifungal which disrupts ergosterol in the fungal cell wall, preventing wall synthesis (systemic)
Uses: Oral candidiasis
Side effect: Headache, nausea, vomiting and rash (especially in immunocompromised patients)
Contraindications: Alters warfarin metabolism, pregnancy, interaction with statins
hydrocortisone
method of action:
uses:
side effects:
contraindications
Method of Action: A corticosteroid which reduces inflammation
Uses: Inflammatory oral lesions such as lichen planus or steroid cover
Side effect: Headache, dizziness and fatigue
Contraindications: Hypothyroidism, diabetes, cushings syndrome, hypokalaemia and pheochromocytoma
H2O2 (6%)
method of action:
uses:
side effects:
contraindications
Method of Action: An oxidising agent that produces fee radicals, removing staining molecules from the teeth
Uses: Tooth bleaching
Side effect: Sensitivity, gingival irritation
Contraindications: People who suffer from dental hypersensitivity, pregnancy, active dental decay.
ibuprofen
method of action:
uses:
side effects:
contraindications
Method of Action: An NSAID which acts by selective COX2 inhibition causing analgesia and reduction in inflammation
Uses: Analgesia and inflammation reduction following invasive dental treatment such as XLA
Side effect: Bloating, diarrhoea, nausea and rash
Contraindications: Hypersensitivity, taking another NSAID or active GI ulceration
lansoprazole
method of action:
uses:
side effects:
contraindications
Method of Action: Block the gastric Na+/K+ pump (proton pump) of the parietal cells of the stomach lowering stomach acid production
Uses: GORD or peptic/duodenal ulceration
Side effect: Bloating, Diarrhoea and Stomach Cramps
Contraindications: Hypersensitivity
lidocaine
method of action:
uses:
side effects:
contraindications
Method of Action: Blocks neuronal Na+ channels preventing pain sensation
Uses: Anaesthesia for dental treatment
Side effect: Low blood pressure, erythema at site of injection, constipation, red spots on skin and swelling
Contraindications: ADR to amide local anaesthetics (CAINE)
loratadine
method of action:
uses:
side effects:
contraindications
Method of Action: An antihistamine that blocks the histamine receptor leading to reduced inflammation
Uses: Emergency treatment of a mild allergic reaction
Side effect: Drowsiness, dry mouth and eyes, stomach pain and headache
Contraindications: Hypersensitivity to an antihistamine
menthol and eucalyptus
method of action:
uses:
side effects:
Method of Action: Nasal decongestant that is inhaled with steam
Uses: Sinusitis
Side effect: Epigastric burning, CNS depression and abdominal pain
metronidazole
method of action:
uses:
side effects:
contraindications
Method of Action: An antibiotic that inhibits bacterial DNA synthesis of ONLY strict anaerobes
Uses: Odontogenic infection, necrotising gingivitis/periodontitis, pericoronitis
Side effect: Rash, diarrhoea, stomach pain, nausea and black hairy tongue
Contraindications: Hypersensitivity, alcohol (Disulfiram effect) and affects warfarin metabolism
Disulfiram effect – inhibits certain enzymes so alcohol is partially metabolised to acetaldehyde rather than H2O and CO2, acetaldehyde enters the blood causing nausea
nystatin
method of action:
uses:
side effects:
contraindications
Method of Action: An antifungal that binds to the fungal cell membrane with a fungicidal action, better than azole antifungals such as fluconazole in pregnancy (topical)
Uses: Pseudomembranous Candidiasis treatment (particularly in pregnant patients)
Side effect: Mouth soreness, hives, skin irritation and nausea
Contraindications: Hypersensitivity, interaction with statin
omeprazole
method of action:
uses:
side effects:
contraindications
Method of Action: Block the gastric Na+/K+ pump (proton pump) of the parietal cells of the stomach lowering stomach acid production
Uses: GORD or peptic/duodenal ulceration
Side effect: Bloating, Diarrhoea and Stomach Cramps
Contraindications: Hypersensitivity
oxytetracycline
method of action:
uses:
side effects:
contraindications
Method of Action: Antibiotic that inhibits bacterial protein synthesis
Uses: Odontogenic infections
Side effect: Nausea, diarrhoea, hives and tetracycline staining (in people with developing teeth)
Contraindications: Hypersensitivity, previous antibiotic colitis, liver or kidney disease and people who still have developing teeth to prevent staining
paracetamol
method of action: uses: side effects: contraindications: max dose:
Method of Action: A mild analgesic that inhibits arachidonic acid metabolism leading to reduced production of prostaglandin, a pro-inflammatory molecule
Uses: Analgesia following invasive dental treatments
Side effect: Minimal side effects unless overdose – fever, nausea, rash, jaundice and clay coloured stools
Contraindications: Renal or hepatic failure
Maximum dose: 4g (8 tablets) in 24h
phenoxymethylpenicillin
method of action:
uses:
side effects:
contraindications:
Method of Action: Inhibits the formation of the bacterial cell wall during replication (beta lactam) and is broad spectrum. Can be inhibited if bacteria produce beta lactamases (antibiotic resistance).
Uses: Odontogenic infections
Side effect: Nausea, Vomiting, Stomach pain, Rash and Diarrhoea
Contraindications: Hypersensitivity
promethazine
method of action:
uses:
side effects:
contraindications:
Method of Action: An antihistamine which blocks the histamine receptors leading to a reduced inflammatory response, also leading to a sedative response
Uses: IV sedation in dentistry
Side effect: Blurred vision, ringing in ears, tiredness and blurred vision
Contraindications: Decreased bone marrow function (anaemia, thrombocytopenia, leukopenia)
saliva stimulating tablets
method of action:
uses:
side effects:
considerations:
Method of Action: Fruit acid tablets that stimulate salivation
Uses: Xerostomia
Side effect: Allergic reaction, erosion due to low pH
Don’t eat 15 minutes after using
sodium chloride
method of action:
uses:
Method of Action: Saline, has a high water potential so bacteria are killed by osmotic lysis
Uses: Flushing dry socket and pericoronitis
sodium fluoride
method of action:
uses:
side effects:
considerations:
Method of Action: Aids remineralisation of enamel to form fluorapatite and is bacteriostatic
Uses: Prevention of caries
Side effect: Fluorosis if in concentrations greater than 2ppm
Can be prescribed in toothpaste form – 2880 or 5000ppm
sodium fusidate
method of action:
uses:
side effects:
contraindications:
Method of Action: An antibiotic that inhibits bacterial protein synthesis
Uses: Odontogenic infections and osteomyelitis
Side effect: Easy bruising or bleeding
Contraindications: Hypersensitivity
temazepam
method of action:
uses:
side effects:
contraindications:
Method of Action: A sedative/muscle relaxant that increases GABA levels in the brain
Uses: Oral dental sedation
Side effect: Drowsiness, fatigue, ataxia, tremor and dizziness
Contraindications: Respiratory weakness, myasthenia gravis
tetracycline
method of action:
uses:
side effects:
contraindications:
Method of Action: Antibiotic that inhibits bacterial protein synthesis
Uses: Odontogenic infections, sinusitis, given prophylactically following reimplantation of avulsed tooth, antibiotic treatment of periodontal disease, oroantral fistula presence
Side effect: Nausea, diarrhoea, hives and tetracycline staining (in people with developing teeth)
Contraindications: Hypersensitivity, previous antibiotic colitis, liver or kidney disease and people who still have developing teeth to prevent staining, taking in pregnancy can lead to tetracycline staining
miconazole
method of action:
uses:
side effects:
contraindications:
Method of Action: Inhibits formation of fungal cell membranes (topical)
Uses: Oral Candidiasis
Side effect: Burning, stinging, sensitivity, tenderness and flaking/sloughing
Contraindications: Hypersensitivity, interactions with statins, increases effect of warfarin
