Emergencies & Records - Outcome 5

Question 1

Pharmacology definition

Answer 1

a branch of medicine concerned with the uses, effects, and actions of drugs

Question 2

Drug defintion

Answer 2

a substance used in the diagnosis, treatment, or prevention of disease

Question 3

Adverse Drug Effects

Answer 3

Adverse drug effects are the negative effects an individual experiences due to the administration of the drug into their body.

These drug effects can interfere with normal body function and may even become life threatening. Therefore it is critical to review and understand the purpose and effects of a drug before it is prescribed and administered

Question 4

Drug complications

Answer 4

All drugs have side effects that can lead to complications. The type of complication depends on a body’s reaction to a drug, the use of other drugs, the dosage, and the frequency of the drug taken.

Question 5

Drug complications include: Allergic Reactions

Answer 5

Allergic reactions are the body’s immune response to a drug. These reactions can be mild (rash) to life-threatening(anaphylactic shock).

Question 6

Drug complications include: Drug Toxicity

Answer 6

Drug toxicity occurs if too much of a drug is taken over a short period of time causing a biochemical change that can be damaging to the body.

Question 7

Drug complications include: Drug interaction

Answer 7

Drug-to-drug interactions describe how a drug affects the effects of another drug(s) when they are used together. Drug-to-drug interactions can dangerously enhance the effects of a drug that will affect normal body function and possibly become life-threatening. Therefore it is important for a dentist or a prescribing dental hygienist to be aware of drug relationships.

Question 8

Drug complications include: Drug tolerance

Answer 8

Drug tolerance occurs when a drug has been taken by a patient for a long period of time. The body gets used to the drug and loses its beneficial effects on the body. To regain the beneficial effects a higher dosage or a different drug will have to be prescribed.

Question 9

Drug complications include: Drug addiction

Answer 9

Drug addiction is the dependency on a drug

Question 10

Drug Sources

Answer 10

Drugs may be derived from a variety of sources including living organisms such as plants or animals, and inorganic compounds

Question 11

3 Types of Drug Identification

Answer 11

1. Chemical name: the atomic or molecular structure of the drug (I.e: N-(4_hydroyphenol) acetamide)
2. Generic name: a shorthand version of the drug’s chemical name which may be used by any company (I.e: acetaminophen)
3. Brand name or trade name: is controlled by a pharmaceutical company as a registered trademark (I.e. Tylenol)

Question 12

Purposes of Drugs

Answer 12

1. Diagnosis: A drug can be used to determine the nature of a disease
   Example: Radiopaque dyes can be used to assess a tissue sample for a biopsy.
2. Treatment: A drug can be used in the management and care of a disease or illness.
   Example: Epinephrine can be used to manage pain during dental treatment.
3. Prevention: A drug can be used to prevent the occurrence of an illness or disease.
   Example: Fluoride can be used to prevent cavities.
4. Health maintenance: A drug can be used to restore depleted body chemistry and maintain an internal equilibrium (homeostasis).
   Example: Insulin can be taken to help balance sugar levels for a diabetic patient.
5. Cure: A drug can be used to effectively treat a disease or illness.
   Example: A chlorohexidine rinse may be used to treat periodontal disease.
6. Contraception: A drug can be used to prevent conception or impregnation.
   Example: birth control can be used to prevent conception or impregnation.

Question 13

In Alberta, the following acts govern the use and handling of drugs:

Answer 13

1. Alberta’s Pharmacy & Drug Act
2. Canada’s Food and Drug Act
3. Canada’s Controlled Drugs and Substances Act

Question 14

Canada’s Food and Drug Act

Answer 14

Before a drug or a natural health product is authorized for sale and use in Canada, Health Canada reviews the product to assess safety, efficacy, and quality.

• When a product is approved for use in Canada it is regulated under Canada’s Food and Drug Act.
• Natural Health Products that require a prescription also encompassed
• Health Canada will also classify the health product into various types, such as medical devices, natural health products, or drug products
• Will also classifiy drug products further into additional categores - ex. controlled substances, biologic products, prescription drugs, or non-prescription drugs.
• Occurs by placing a drug on the schedules that are part of federal laws and regulations and thus is sometimes called drug scheduling

Question 15

Alberta Drug Schedules

Answer 15

-Alberta’s drug schedules are mostly aligned with and change according to the national rug scheduling model developed by NAPRA

Question 16

What is NAPRA?

Answer 16

National Association of Pharmacy Regulation Authority

Question 17

Schedule 1 Drugs

Answer 17

-can be sold with a prescription only

• drugs in this schedule include all federally scheduled drugs, in the Food and Drug Regulations (Canada), and others that are specific to Alberta

Question 18

Schedule 2 Drugs

Answer 18

-are less strictly regulated

-they do not require a prescription, but they do require professional intervention with a qualified healthcare professional

• these items must be sold from an area to which there is no public access and no opportunity for self-selection

Question 19

Schedule 3 Drugs

Answer 19

• are suitable for self-selection, but may pose risks for certain groups of people and should be sold where a qualified health care professional is available to provide advice when required

Question 20

Unscheduled Drugs

Answer 20

• can be sold without professional supervision
  -labeling is believed to be sufficient to ensure that the client makes a safe and effective choice and uses the drug appropriately

Question 21

Controlled Drugs and Substances Act (CDSA)

Answer 21

The CDSA and its regulations are administered by Health Canada and establish a legislative framework that regulates the possession, import, export, production, assembly, distribution, sale, transport, provision, sending, and delivery of controlled substances and precursors that can be used in the manufacture of illegal drugs

Question 22

Health Canada administers the CDSA to:

Answer 22

allow access for lawful purposes, and to reduce the risk that controlled substances will be used for illegal purposes

Question 23

Narcotic Control Regulations

Answer 23

The NCR outlines the circumstances under which activities with narcotics listed in the Regulations are permitted. Examples of narcotics regulated under the NCR include oxycodone, cocaine, opium, codeine, morphine, and cannabis

Question 24

Triplicate Prescription Program

Answer 24

In Alberta, dentists are able to prescribe some drugs that fall under the CDSA using the Triplicate Prescription Program. The Triplicate Prescription Program monitors the use of drugs that have a high addiction potential and are prone to misuse and abuse for non-medical purposes. This process is designed to discourage and document prescription forgeries, control “double doctoring” in which individuals visit two physicians/dentists for the same complaint and thus receive two prescriptions, and obtain general information about prescribing practices in this province. The College of Physicians and Surgeons of Alberta administers the Triplicate Prescription Program

Question 25

Examples of Drug Resources include..

Answer 25

Compendium of Pharmaceutical and Specialties (CPS)
Mosby’s Drug Reference handbook
Package inserts
Bugs and Drugs

Question 26

Pharmacokinetics

Answer 26

How drugs are handled by the body, specifically drug absorption, distribution, metabolism, and elimination (what the body does to the drug)

Question 27

Pharmacodynamics

Answer 27

the study of the effects that drugs produce on various body systems (what the drug does to the body)

Question 28

Drug Pharmacokinetics

Answer 28

When a drug enters the body, it must cross cell membranes to enter the circulation and access its target site. The amount of the drug crossing a membrane and the rate at which it moves influence the rate of onset and the duration of the drug action.

Question 29

Drug Action (Transport) - Drugs undergo 4 stages in the body from the moment it enters to the moment it leaves the body.

Answer 29

1. Absorption: the rate at which a drug leaves the site of administration and enters the circulations, and the extent to which this occurs
2. Distribution: the process of moving the drug to different sites in the body
3. Metabolism: the process of chemical alteration of drugs in the body
4. Elimination: the process by which a drug or metabolite is eliminated from the body

Question 30

Drug action refers to:

Answer 30

1. Location – Where is the drug affecting?
2. Effect – What is the drug doing?

Question 31

2. Effect – What is the drug doing?

Answer 31

Drugs may act:

Locally: the drug affects the immediate area of administration.
Example: local anesthetic used during dental treatment

Systemically: the drug affects tissues throughout the body.
Example: anxiety drugs used in dentistry will cause effects on the entire body

Question 32

Effect – What is the drug doing?

Answer 32

Drugs can cause:

Stimulation: drugs enhance or increase bodily function
Example: Salagen® is a medication used to increase saliva flow for patients with dry mouths.

Depression: drugs decrease or lessen bodily function

Question 33

Drug Routes

Answer 33

Many routes of drug administration are used during the delivery of oral health care services. All routes have advantages and disadvantages. The route of administration of a drug affects both the onset and the duration of the drug actions.

Question 34

Drug routes are classed as:

Answer 34

1. Enteral- placed directly in GI tract
2. Parenteral- bypass the GI tract

Question 35

Classification
Route of Drug Administration: Enteral

Answer 35

oral
sublingual
buccal
rectal

Question 36

Classification
Route of Drug Administration: Parenteral

Answer 36

inhalation
topical
subgingival
subcutaneous
transdermal
intravenous
intramuscular
intradermal
intrathecal
intraperitoneal

Question 37

In a dental practice the use of drugs may include the following situations:

Answer 37

-antibiotic prophylaxis
-management or prevention of oral infections and diseases
-pain control and management
-tobacco cessation
-management of xerostomia
-management of anxiety

Question 38

Local Anesthetics

Answer 38

Local anesthetics are frequently used in dentistry to manage pain during dental treatment.

Dental local anesthetics can be divided chemically into two major categories: esters and amides.

Question 39

Esther Anesthetics

Answer 39

widely used in topical anesthetics
cause vasodilations of local blood vessels
High incidence of allergic reactions from byproduct para-aminobenzoic acid.
Example: Benzocaine and Tetracaine topical anesthetics

Question 40

Amide Anesthetic

Answer 40

causes vasodilation of local blood vessels
extremely low incidence of allergic reactions
potential for toxicity or drug overdose making total drug dose critical
used with or without vasoconstrictor (i.e.; epinephrine). If a local anesthetic with epinephrine is required for dental treatment, conditions such as cardiovascular disease, stroke, hypertension, hyperthyroidism, significant liver or kidney disease, patients taking beta-blockers, cimetidine on a regular basis, steroid dependant asthmatics may be contraindicated for use.
Examples: Articaine, Bupivacaine. Lidocaine, Mepivacaine, and Prilocaine

Question 41

Drugs Commonly Prescribed in Medicine that May Affect Dental Treatment

Answer 41

Many patients seen in the dental office will be taking prescription and/or over-the-counter drugs because of a medical condition.

It is important to have knowledge about the drugs the patients are taking to understand the purpose and the effects of the drug, and how they may interfere with dental care.

Question 42

Cancer Treatment

Answer 42

Patients receiving cancer treatment can be given chemotherapeutic drugs that affect the rapidly dividing cancer cells at different points in the cell cycle. This can cause dry mouth, altered taste sensations, sensitivity to teeth and gums, mucosal pain and ulceration, and gingival hemorrhaging. Poor oral hygiene can result in local and systemic infections. Therefore it is recommended that patients receive dental care and education prior to their chemotherapeutic treatment

Question 43

Seven Rights of Medication Administration

Answer 43

The seven rights of medication administration ensure that patients will receive medications safely and appropriately.

1. Right patient: ensure that the patient receiving the drug is the patient that has been prescribed the drug.
2. Right drug: ensure that the correct drug is being administered by comparing the medication, container label, and prescription.
3. Right dose: ensure that the correct dosage is being administered by comparing the medication prescription or checking with the prescriber.
4. Right route: ensure that the correct route is being administered by comparing the medication prescription or checking with the prescriber.
5. Right time and frequency: ensure that the medication is administered at the correct time by comparing the medication prescription or checking with the prescriber
6. Right reason: ensure that the medication is being given for the right reason (e.g., tylenol for teething pain)
7. Right documentation: ensure that the proper documentation is completed upon administration of all medications. Include the exact generic drug name, the dose administered, the route of administration used, and the time that the drug was administered. All practitioners must sign the patient’s chart to verify this process.

Question 44

Care of Medications

Answer 44

It is important that medications are appropriately cared for to reduce the risk of potential harm to the patient. The following are guidelines to ensure safe drug administration.

1. Always read the labels for instructions on each drug you are required to assist in administering.
2. Do not use a drug that has changed in colour or appearance.
3. Some drugs are sensitive to air moisture and must be kept in coloured containers, usually dark brown.
4. Some drugs are sensitive to light and must be kept in coloured containers, usually dark brown.
5. Some drugs deteriorate with time and will have an expiry date. Remember to check the dental drug kit once a month for expired drugs.
6. Some drugs are only stable in powder form. Once mixed with a liquid they deteriorate. The time of deterioration varies with the drug.

Question 45

Storage of Medications

Answer 45

Medications must be stored according to the manufacturer’s instructions to ensure the safety and effectiveness of a medication.

Guidelines for Storage

Keep all medications in their original labeled containers.
Dispose of expired medications
Store controlled drugs securely.

Question 46

Prescription

Answer 46

A prescription is a written instruction provided by a physician or dentist for the preparation and administration of a medicine. The physician/dentist who is authorized to prescribe a medication is issued an identification number and can write a prescription. Under no circumstances can any member of the dental team prescribe medications. The dental assistant may dispense medicine according to explicit instructions and under the direct supervision of the dentist

Question 47

Prescription Pads

Answer 47

Prescriptions are handwritten on preprinted prescription forms that are assembled into pads. Prescription pads are to be kept in a locked drawer and should never be visible or available to use as notepaper (Robinson, 2024).

Each drug prescribed must be documented in the patient record for future reference

Question 48

Telephone Guidelines for Prescriptions

Answer 48

Controlled substances cannot be prescribed over the phone (Example: opioid pain medication and amphetamines)
It is illegal for a dental assistant to “call in” a prescription
When a pharmacist calls, notify the dentist, do not try to relay information between them
Never attempt to evaluate a patient’s reaction to a drug, only the dentist and pharmacist are qualified to evaluate drug effects

Question 49

Dental assistants may give non-prescription medications (over-the-counter, non-controlled substances) to patients under direct supervision of a dentist provided the dentist has:

Answer 49

Reviewed the patient’s chart
Confirmed with the patient there are no known allergies or contraindications to the medication; and,
Provided the dental assistant with explicit instruction on dosage

Question 50

Inscription Meaning

Answer 50

the drug name, strength and dose

Question 51

Superscription Meaning

Answer 51

The patients information for identification

Question 52

Rx meaning

Answer 52

Derived from the Latin word “recipe” meaning “take”