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BDS2 BAMS - Pharmacology and therapeutics > Drug use in Dentistry > Flashcards

Drug use in Dentistry Flashcards

1
Q

What are the hazards of drug use?

A 
•	Death
o	Allergy
o	Toxicity
•	Drug interactions
o	Effect on absorption or metabolism of other essential medicines
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2
Q

2 exaples of drug interactions

A

Warfarin (anticoagulant)

Carbamazepine (anticonvulsant)

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3
Q

What are the different drug classes

A
  • Local anaesthetics
  • Antimicrobials
  • Drugs in pain and inflammation
  • Drugs used in sedation
  • Emergency medical drugs
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4
Q

What are local anaesthetics used for?

A

Used to reduce awareness of pain, act on nerve ion channels to block propagation

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5
Q

Name 4 local anaestheics

A
  • Lignocaine (lidocaine)
  • Prilocaine
  • Bupivacaine
  • Mepivicaine
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6
Q

Bupivacaine often requires vasoconstrictor to prolong duration of action, what are the positives and negatives of this?

A

Positives: stop the drugs being washed away by blood
Negatives: Makes LA more toxic, patients can have reactions e.g. heart racing

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7
Q

What are the 3 classes of antimicrobials

A

antibiotics, antivirals, antifungals

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8
Q

Name 4 antibiotics used in dentistry

A
  • Amoxycillin
  • Metronidazole
  • Doxycycline
  • Clindamycin
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9
Q

Name an antiviral

A

aciclovir

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10
Q

Name 2 antifungals

A
  • Nystatin (topical)

* Fluconazole (systemic – oral)

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11
Q

What are the 2 types of analgesics

A
  • Drugs used to reduce the inflammatory mediators (NSAIDs)

* Drugs used to reduce the inflammation process (corticosteroids)

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12
Q

What are the effects of paracetamol

A
  • Anti-pyretic (brings temp down) and analgesic
  • Little anti-inflammatory action
  • Few side effects
  • Often combined with other analgesics
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13
Q

Name 3 NSAIDs

A
  • Salicylates (Asprin)
  • Propionic acid derivatives (Ibuprofen)
  • Phenylaetic acid derivative (Diclofenac)
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14
Q

How do NSAIDs work?

A
  • True action unknown
  • INHIBIT prostaglandin synthesis
  • Change the balance of PGE1 and PGE2 (Anti-inflammatory)
  • Cyclo-oxygenase (COX) enzyme inhibition (COX inhibitors, COX 2 inhibitors)
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15
Q

What does arachidonic acid do?

A

cause inflammation?

via COX and therefore prostaglandins?????

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16
Q

How does asprin work?

A

Parmacokinetics
o Rapid absorbtion from GIT
o Elimination by 1st order kinetics (Unless overdose (enzyme saturation), Toxic effects – acidosis)

Inhibits COX 1
o Reduced synthesis of prostaglandins
o Reduced production of inflammatory mediators
o Anti-pyrexic
o Can be taken BEFORE inflammatory process starts (Pre-emptive analgesia)

17
Q

What are the side effects of asprin?

A

Gastric irritation
 Erosions, ulceration
 Worse with alcohol

Inhibition of platelet function
 Enhanced bleeding

Bronchospasm
 Exacerbate asthma

Allergic reactions (rash)

Drug interactions
 Significant protein binding – WARFARIN potentiation

18
Q

What drug has the same actions as aspirin but the side effects affect fewer people

A

ibuprofen

19
Q

Can you buy diclofenac over the counter

A

no. prescription only

20
Q

What are the effects of diclofenac

A 
•	More potent than ibuprofen 
o	Higher incidence of gastric bleeding
o	Higher incidence of asthma triggering 
o	Allergic reactions (rash)
o	More effective anti-inflammatory action 
o	Dose 50mg 3 times a day
21
Q

How do corticosteroids reduce inflammation?

A 
By inhibiting:
o	Capillary permeability
o	Formation of brady kinin
o	Migration of white blood cells
o	Reduce eicosanoid synthesis

(suppresses features of inflammation, doesn’t address the cause)

22
Q

What do topical corticosteroids affect

A

just the area applied to

23
Q

what do systemic corticosteroids affect

A

the whole organism

24
Q

examples of topical corticosteroids

A 
•	Steroid inhalers in asthma
•	Hydrocortisone cream – eczema
•	Steroid treatments for mouth ulcers
o	Beclomethasone inhalers
o	Hydrocortisone adhesive tablets
o	Betamethasone solutions
25
Q

examples of systemic corticosteroids

A

• Prednixolone (tablets)
o Prevent transplant rejection
o Treat immunological diseases

• Dexamethasone (injection)
o Reduce swelling after surgery e.g. wisdom tooth removal

26
Q

side effects of systemic corticosteroids

A
  • High bp
  • Weight gain
  • Fat distribution change
  • Gastric ulceration
  • Adrenal suppression
  • Osteoporosis
  • Diabetes

BDS2 BAMS - Pharmacology and therapeutics (3 decks)

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