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BDS2 - Pharmacology > drug use in dentistry > Flashcards

drug use in dentistry Flashcards

1
Q

name 2 hazards of drug use

A

1) death
- allergy
- toxicity

2) drug interactions
has an effect on the metabolism / absorption of other essential medicines such as warfarin (anticoagulant) and carbamazepine (anticonvulsant)

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2
Q

name 5 drug classes

A
  1. local anaesthetics
  2. antimicrobials
  3. drugs in pain and inflammation
  4. drugs used in sedation
  5. emergency medical drugs
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3
Q

what is the function of local anaesthetics

A

reduces awareness of pain

act on nerve ion channels to block propagation

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4
Q

name 4 local anaesthetics

A

lignocaine (lidocaine)
prolocaine
bupivicaine
mepivicaine

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5
Q

why do local anaesthetics often need vasoconstrictors added to them

A

LA are often vasodilators which open the blood flow
opening the blood flow washes the drug away from the area where you need it to act
adding a vasoconstrictor will prolong the action of the drug where you want it as it will slow down blood flow

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6
Q

name 3 antimicrobials

A
  1. antibiotics (bacteria)
  2. antiviral
  3. antifungals
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7
Q

name 4 antibiotics

A
  1. amoxycillin
  2. metronidazole
  3. doxicycline
  4. clindamycin
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8
Q

name an antiviral drug

A

aciclovir

can be used topical or systemic

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9
Q

what does systemic mean

A

drug gets distributed all over the body

usually in tablet form

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10
Q

what does topical mean

A

drug is just applied to one area

eg coldsore on lip

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11
Q

name antifungal drugs and state whether they are topical or systemic

A 
nystatin = topical
fluconazole = systemic (oral)
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12
Q

what does analgesic mean

A

painkiller

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13
Q

what type of drugs are used in treating pain and inflammation

A

–> drugs used to reduce the inflammatory mediators
eg NSAIDs

–> drugs used to reduce the inflammatory process
eg corticosteroids

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14
Q

what does NSAID stand for

A

non-steroidal anti-inflammatory drugs

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15
Q

describe paracetamol and it’s actions

A

anti-pyretic
analgesic
can be got over the counter - unrestricted
few side affects
dose = 1g 4 times daily
can be combined with other analgesics eg co-codamol = paracetamol and codiene

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16
Q

give examples of NSAIDs

A
  • salicylates eg aspirin
  • propionic acid derivatives eg ibuprofen
  • phenylacetic acid derivatives eg diclofenac
17
Q

describe how NSAIDs work

A 
true action unknown
inhibit prostaglandin synthesis
change the balance of PGE1 and PGE2 (anti-inflammatory)
cyclo-oxygenase (COX) enzyme inhibition 
COX1 inhibitors = aspirin, ibuprofen
COX2 inhibitors usually not as helpful
18
Q

describe aspirin

A
  • available without restriction = over the counter
  • NSAID
  • pharmacokinetics - rapid absorption from GIT, elimination from 1st order kinetics (unless overdose - enzyme saturation, toxic effects - acidosis)
  • inhibits COX1 = reduced synthesis of prostaglandins,
    reduced production of inflammatory mediators, anti-pyrexic
  • can be taken in anticipation of pain (before a procedure) = pre-emptive analgesia
19
Q

what are the side effects of aspirin

A

> gastric irritation = erosions, ulceration (worse with alcohol)

> inhabitation of platelet functioning = enhanced bleeding

> bronchospasm = exacerbate asthma

> allergic reaction = rash

> drug interactions = significant protein binding, warfarin potentiation

20
Q

describe ibuprofen

A
  • sold without restriction = over the counter
  • NSAID
  • same actions as aspirin
  • dose: 200-600mg 3 times daily
  • fewer side effects than aspirin
    (less people suffer the side effects of ibuprofen but those who do have problems are just as bad as aspirin)
21
Q

describe diclofenac

A
  • prescription only = not over the counter
  • more potent than ibuprofen
  • more effective anti-inflammatory action
  • dose: 50mg 3 times daily
  • side effects are worse = higher incidence of gastric bleeding, higher incidence of asthma triggering, allergic reaction (rash)
22
Q

how do corticosteroids reduce inflammation

A

they inhibit:
- capillary permeability

  • formation of bradykinins
  • migration of white blood cells
  • reduce eicosanoid synthesis

suppresses features of inflammation but doesn’t address the problem

23
Q

give examples of topical corticosteroids

A
  • steroid inhaler = asthma
  • hydrocortisone cream = eczema
  • steroid treatments for mouth ulcers such as
    >Beclomethasone inhalers
    >Hydrocortisone adhesive tablets
    >Betamethasone solutions
24
Q

give examples of systemic corticosteroids

A
  • prednisolone (tablets) = prevent transplant rejection and treat immunological diseases
  • dexamethasone (injection) = reduce swelling after injury eg after wisdom tooth removal
25
Q

what are the side effects of systemic corticosteroid use

A

the longer you take the steroids the more consequences there are

  • high blood pressure
  • weight gain (fluid)
  • fat distribution change (centripetal obesity and buffalo hump)
  • gastric ulceration
  • adrenal suppression
  • osteoporosis
  • diabetes
26
Q

what do anxiolytics do

A

reduce anxiety, used in sedation

27
Q

name 2 anxiolytics

A

1) benzodiazepines (taking every day will lead to addiction, make you forget what happened)
- diazepam
- midazolam

2) gas
- nitrous oxide

28
Q

how does benzodiazepines work

A

they stick onto GABA receptors and change the ion flow in cells

29
Q

describe how nitrous oxide works

A
  • inhaled as a gas
  • no needle technique
  • can adjust the amount used during the procedure
  • changes the way cells speak to each other but not sure how this happens
  • no organ metabolism issues
  • interferes with folic acid metabolism = don’t use during pregnancy

BDS2 - Pharmacology (3 decks)

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