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Pharmacology > Drug Use in Dentistry > Flashcards

Drug Use in Dentistry Flashcards

1
Q

State hazards of drug use (2)

A
  1. Death

2. Drug interactions

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2
Q

What could cause death in relation to drug use?

A
  1. Allergy to drug

2. Toxicity to drug

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3
Q

Give an example of a hazardous drug interaction (2)

A

If the drug effects absorption/metabolism of other essential medicines

  1. Warfarin (anticoagulant)
  2. Carbamazepine (anticonvulsant)
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4
Q

List drug classes (5)

A
  1. LA
  2. Antimicrobials
  3. Drugs in pain and inflammation
  4. Drugs used in sedation
  5. Emergency medical drugs
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5
Q

How do LA’s function?

A

Act on nerve ion channels to block propagation

- Used to reduce awareness of pain

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6
Q

List examples of LA’s (4)

A
  1. Lidocaine
  2. Prilocaine
  3. Bupivicaine
  4. Mepivicaine
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7
Q

What does bupivicaine often require?

A

VASOCONSTRICTOR

- prolongs duration of LA action (more time to work)

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8
Q

What are LA’s sensitive to in tissues?

A

pH

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9
Q

List the different forms of antimicrobials (3)

A
  1. Antibiotics (bacteria)
  2. Antiviral
  3. Antifungals
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10
Q

List examples of commonly prescribed antibiotics

A
  1. Amoxycillin
  2. Metronidazole
  3. Doxicycline
  4. Clindamycin
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11
Q

Example of an antiviral drug

A

Aciclovir

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12
Q

How is aciclovir taken?

A

Systemic or topical use

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13
Q

Examples of anti fungal drugs (2)

A

Nystatin

Fluonazole

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14
Q

How is nystatin taken?

A

Topical

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15
Q

How is fluconazole taken?

A

Systemic - oral

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16
Q

Define analgesics

A

Drugs used to relieve pain

reduce the inflammatory mediators

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17
Q

List examples of analgesics (3)

A
  1. NSAIDs
  2. Paracetamol
  3. Codiene
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18
Q

What are the 2 types of drugs used in pain and inflammation

A
  1. Drugs used to reduce the inflammatory mediators
    - NSAIDs
  2. Drugs used to reduce the inflammation process
    - Corticosteroids
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19
Q

State an example of a drug used to reduce the inflammation process

A

Corticosteroids

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20
Q

Describe the type of drug paracetamol is (4)

A
  • Anti-pyretic
  • Analgesic
  • Little anti-inflammatory action
  • Few side effects
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21
Q

Dosage of paracetamol

A

1g 4x times daily

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22
Q

What is paracetamol often combined with?

A

Co-codamol (paracetamol and codeine)

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23
Q

List examples of NSAID’s (3)

A
  1. Salicylates
  2. Propionic acid derivatives
  3. Phenylacetic acid derivatives
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24
Q

Give an example of a salicylate

A

Aspirin

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25
Q

Give an example of a propionic acid derivative

26
Q

Give an example of a phenylacetic acid derivative

A

Diclofenac

27
Q

Function of NSAIDs

A

Inhibit prostaglandin synthesis

  1. Change the balance of PGE1 and PGE2
  2. Cox enzyme inhibition
    - COX 1 inhibitors
    - COX 2 inhibitors
28
Q

What kind of effect is changing the balance of PGE1 and PGE2

A

Anti-inflammatory

29
Q

How does COX inhibition result in reduced inflammation

A

Inhibits prostaglandin and thromboxane synthesis

30
Q

What is arachidonic acid?

A

Fatty acid involved in inflammation

31
Q

Dosage of aspirin

A

300-600mg up to 4x daily

32
Q

What are the pharmacokinetics of aspirin and ibuprofen? (2)

A
  • Rapid absorption from GIT

- Elimination by 1st order kinetic

33
Q

What could affect the elimination by 1st order kinetics of aspirin? (2)

A
  1. Overdose (enzyme saturation)

2. Toxic effects (acidosis)

34
Q

What does aspirin/ibuprofen inhibit?

35
Q

List the effects of aspirin/ibuprofen inhibiting COX 1 (3)

A
  1. Reduced synthesis of prostaglandins
  2. Reduced production of inflammatory mediators
  3. Anti-pyrexic
36
Q

List side effects of aspirin

A
  1. Gastric irritation
    - Erosions
    - Ulcers
  2. Inhibition of platelet function
    - Enhanced bleeding
  3. Bronchospasm
    - Exacerbate asthma
  4. Allergic reactions
    - Rash
  5. Drug interactions
    - Significant protein binding (warfarin potentiation)
37
Q

How do the side effects of ibuprofen relate to aspirin?

A

Same effects but less problematic

38
Q

Dosage of ibuprofen

A

200-600mg 3x daily

39
Q

Compare diclofenac to ibuprofen

A
  • Only available on prescription
  • More potent than ibuprofen
    1. Higher incidence of gastric bleeding
    2. Higher incidence of asthma triggering
    3. Allergic reactions (rash)
40
Q

Dosage of diclofenac

A

50mg 3x daily

41
Q

How do corticosteroids reduce inflammation? (4)

A
  1. Capillary permeability
  2. Formation of bradykinin
  3. Migration of WBCs
  4. Reduce eicosanoid synthesis
42
Q

Define topical use of a drug

A

On the surface of the desired tissue

43
Q

Define systemic use of a drug

A

Given to the whole organism

44
Q

Examples of topical drugs (3)

A
  1. Steroid inhalers in asthma
  2. Hydrocortisone cream (eczema)
  3. Steroid tx’s for mouth ulcers
45
Q

Examples of systemic drugs (2)

A
  1. Prednisolone tablets

2. Dexamethasone injections

46
Q

Functions of prednisolone tablets (2)

A
  1. Prevent transplant rejection

2. Treat immunological diseases

47
Q

Functions of dexamethasone injections

A

To reduce swelling after injury

- Wisdom teeth removal

48
Q

Side effects of systemic steroids (7)

A
  1. High BP
  2. Weight gain
  3. Fat distribution change
  4. Gastric ulceration
  5. Adrenal suppression
  6. Osteoporosis
  7. Diabetes
49
Q

Examples of fat distribution changes due to systemic steroids (2)

A

Centripital obesity

Buffalo hump

50
Q

State the drugs class used in sedation

A

Anxiolytics - reduce anxiety

51
Q

List examples of anxiolytics (2)

A
  1. Benzodiazepines

2. Nitrous oxide - inhaled as gas

52
Q

Examples of benzodiazepines (2)

A
  1. Diazepam

2. Midazolam

53
Q

How does benzodiazepine work?

A

Enhances neurotransmitter GABA at GABA A receptor to work as a sedative

54
Q

Give examples of benzodiazepines that work by phase 1 metabolism (3)

A
  1. Diazepam
  2. Chlordiazopexide
  3. Clobazam
55
Q

Give examples of benzodiazepines that work by phase 2 metabolism (3)

A
  1. Iorazepam
  2. Oxazepam
  3. Temezepam
56
Q

List advantages of using nitrous oxide as a sedative (2)

A
  1. Amount of effect can be adjusted during procedure

2. No organ metabolism issues - excreted unchanged as a gas

57
Q

Name a disadvantage of using nitrous oxide as a sedative

A

Interferes with folic acid metabolism - so avoid in pregnancy

58
Q

State when Medical Emergency Drugs would be used (4)

A
  1. Asthma
  2. Heart attacks
  3. Diabetic emergencies
  4. Seizures
59
Q

List mediators of inflammation (2)

A
  1. Histamine

2. Kinin

60
Q

Dosage of prednisolone

A

1-100mg per day

Varies with desired levels of immune suppression

Pharmacology (3 decks)

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