Drug names and functions

Question 1

Sodium Valproate

Brand names?
Function?
Mechanism of action?
Dental implications?
Usual dosage?

Answer 1

Brand names: Epilim
Function: Antipsychotic, anticonvulsant/epileptic
Mechanism of action: Blockage of Na+ channels, increased brain levels of GABA (latter thought to cause the antimanic effects)
Dental implications: For high risk patients there is a sugar free liquid available
Usual dosage: 200mg per day start, can go up to 1000-2000mg/day). Children start 400mg/day and increase

Question 2

Apixaban

Brand name: 
Function:
Mechanism of action:
Dental Implications:
Usual dosage:

Answer 2

Brand name: Eliquis
Function: Anticoagulant
Mechanism of action: Inhibits FXa (which converts prothrombin to thrombin)
Dental Implications: Be wary with tooth extractions, but no adverse effects >1% reported
Usual dosage: 2.5mg twice daily

Question 3

Denosumab

Brand name:
Function:
Mechanism of action:
Dental Implications:
Usual dosage:

Answer 3

Brand name: Prolia (injection)
Function: Increase bone mass in patients with bone disease (e.g. osteoporosis, osteopenia)
Mechanism of action: Binds to RANKL preventing them from binding to RANK receptors in osteoclasts, thus inhibiting osteoclast action
Dental Implications: Osteonecrosis from extractions and other invasive procedures (similar to bisphosphonate), especially with poor oral hygiene, co-morbidity or concurrent treatment
Usual dosage: 60mg once every 6 months

Question 4

Frusemide

Brand name:
Function:
Mechanism of action:
Dental Implications:
Usual dosage:

Answer 4

Brand name: There are lots, most common seems to be apo-frusemide (tablets)
Function: Diuretic (very potent), increases urination, treatment of hypertension and some odemas
Mechanism of action: Inhibits sodium and chloride reabsorption in ascending loop of Henle and in proximal and distal tubules
Dental Implications: May cause dry mouth
Usual dosage: 20-80mg adult, 2mg/kg of body weight in children

Question 5

Atorvorstatin

Brand name:
Function:
Mechanism of action:
Dental Implications:
Usual dosage:

Answer 5

Brand name: Lipitor
Function: Anti-lipidemic (redcues cholesterol)
Mechanism of action: Inhits HMG-CoA (enzyme that converts co-enzyme A to mevalonate (sterol precursor). Amount of HMG-CoA available determines rate of conversion
Dental Implications: None
Usual dosage: 10-80mg per day

Question 6

Atenolol

Brand name:
Function:
Mechanism of action:
Dental Implications:
Usual dosage:

Answer 6

Brand name: Noten 
Function: Antihypertensive, arrhthymias, angina 
Mechanism of action: beta-blocker 
Dental Implications: None
Usual dosage: 50-100mg

Question 7

Thyroxine

Brand name:
Function:
Mechanism of action:
Dental Implications:
Usual dosage:

Answer 7

Brand name: Quite a few
Function: Increases metabolism, basically replaces thyroid hormone
Mechanism of action: Structure is similar to thyroxine so can bind to thyroid receptors
Dental Implications:None
Usual dosage: Initial 50-100micrograms daily, can increase to 100-200 micrograms daily

Question 8

Ramipril

Brand name:
Function:
Mechanism of action:
Dental Implications:
Usual dosage:

Answer 8

Brand name: Tritace
Function: Decrease blood pressure and prevent myocardial infarction, stroke
Mechanism of action: ACEI inhibitor–> prevents water reabsorption
Dental Implications: Dry mouth
Usual dosage: 2.5mg daily (but other doses depending on situation)

Question 9

Lercanidipine hydrochlorite

Brand name:
Function:
Mechanism of action:
Dental Implications:
Usual dosage:

Answer 9

Brand name: Zanidip
Function: Decrease hypertension 
Mechanism of action: Calcium channel blocker-->causes relaxation of cardiac and vascular smooth muscle 
Dental Implications: None
Usual dosage: 10mg daily

Question 10

Paracetamol

Brand name:
Function:
Mechanism of action:
Dental Implications:
Usual dosage:

Answer 10

Brand name: Panadol
Function: Pain relief
Mechanism of action: Inhibits prostaglandin synthesis in central nervous system
Dental Implications: None, though sometimes used for dental pain relief
Usual dosage: 2 tablets 3x per day; no more than 6 in 24 hours

*Panadol osteo has higher dosage of active ingredient and formulated for slower, sustained release

Question 11

Vitamin B-12 supplement

Answer 11

Brand name: N/A
Function: DNA synthesis (purine (A/G) and pyrimidine (T/C)), cellular energy production, maintenance of nerve cells
Mechanism of action: Supplements natural vitamin B-12
Dental Implications: None
Usual dosage: ?

*Deficiency will cause megaloblastic anaemia–>red blood cell with DNA defects causing enlarged size

Question 12

Allupurinol

Brand name:
Function:
Mechanism of action:
Dental Implications:
Usual dosage:

Answer 12

Brand name: Progout
Function: Treatment of gout
Mechanism of action: Prevents uric acid production by inhibiting xanthine oxidase (catalyses conversion of hypoxanthine to xanthine and xanthine to uric acid)
Dental Implications: If not under control could compromise oral hygiene due to dexterity
Usual dosage: 100-200mg in mild condition, 300-600 moderate, 700-900mg in severe condition

*Excessive uric acid production causing it to end up in joints and form urate is what causes inflammation in gout arthritis

Question 13

Iron

Answer 13

Brand name: Ferro-F-Tab
Function: Increase production of haemoglobin and other iron containing enzymes
Mechanism of action: increases body iron levels
Dental Implications: None
Usual dosage: ?

Question 14

Telmisartan

Answer 14

Brand name: APO-Telmisartan Tablet
Function: Antihypertensive
Mechanism of action: Angiotensin II receptor antagonist-->prevents water reabsorption (binds to receptor site to prevent angiotensin II from binding)
Dental Implications: Dry mouth
Usual dosage: 40mg once daily

Question 15

Brinzolamide

Answer 15

Brand name: Brinzoquin eye drops
Function: Decrease ocular pressure in glaucoma and ocular hypertension
Mechanism of action: Inhibits carbonic anhydrase in ciliary process of eye, decreases its ability to secrete aqueous humour by decreasing sodium bicarbonate production causing decrease in fluid transport
Dental Implications: Dry mouth (uncommon)
Usual dosage: one drop twice daily

(Note: carbonic anhydrase catalyses conversion of CO2 and water to bicarbonate ion and H+ which is the buffering system in the oral cavity)

Question 16

Diltiazem

Brand name:
Function:
Mechanism of action:
Dental Implications:
Usual dosage:

Answer 16

Brand name: Cardizem
Function: Treatment of angina (chest pains caused by continued by insufficient blood supply to heart)
Mechanism of action: Calcium channel blocker–> dilator of coronary arteries through prevention of spasms to increase blood supply and decreased heart rate and systemic blood pressure to reduce oxygen demand
Dental Implications: Dry mouth (uncommon)
Usual dosage: 30mg 4x per day

Question 17

Digoxin

Brand name:
Function:
Mechanism of action:
Dental Implications:
Usual dosage:

Answer 17

Brand name: Lanoxin
Function: Congestiive heart failure, atrial fibrillation
Mechanism of action: Inhibits ATPase activity–>decrease action of 3Na(out)/2K+(in) exchange of Na/K pump–>increases resting membrane potential of muscle cell–> Augments calcium ion influx thus increasing contractility of cardiac muscles without increasing rate of contraction
Dental Implications: None
Usual dosage: ?

Question 18

Latanoprost

Answer 18

Brand name: Apo-Latanoprost Eye drops
Function: Reduces intraocular pressure in glaucoma
Mechanism of action: Increases outflow of aqueous humour
Dental Implications: none
Usual dosage: one eye drop in affected eye once daily

Question 19

Aclidinium Bromide

Answer 19

Brand name: Bretaris Genuair (inhaler)
Function: Treatment of chronic obstructive pulmonary disease
Mechanism of action: Competitively binds to and antagonises acetylcholine musclarinic receptors causing bronchodilation
Dental Implications: Dry mouth (uncommon, <1%)
Usual dosage: 322 microgram twice daily, not for use in children

Question 20

Warfarin

Brand name:
Function:
Mechanism of action:
Dental Implications:
Usual dosage:

Answer 20

Brand name: Coumadin, Marevan
Function: Anticoagulant
Mechanism of action: Inhibit production of vitamin K dependant clotting factors by (VII, IX, X, II)
Dental Implications: Increased bleeding on extraction
Usual dosage: Depends on patient