Medication Flashcards
Who said penicillin has no effect on the pain of untreated irreversible pulpitis?
Nagle 1990
Nagle 1990
irreversible pulpitis?
Penicillin has no effect on the pain of untreated irreversible pulpits
Don’t take nitrous oxide percent over what in children
50%
Two contraindications for nitrous oxide in children
acute otitis media (N2O can enter tympanic space and rupture the eardrum).
active pulmonary infection
How do NSAIDs work? Biggest danger?
They are non-selective COX inhibitors that thereby inhibit synthesis of prostaglandins (promote inflammation, but also pain). GI bleeding issues.
Why can NSAIDs cause stomach bleeding?
They are non-selective inhibitors of COX (cyclooxygenase). COX 1 and COX 2 are affected. Both COX’s produce prostaglandins, but COX 1 also protects the stomach.
How does acetaminophen work? Biggest danger?
Not well understood–weak COX inhibitor-does not show much anti-inflammatory activity. Hepatotoxicity.
How does penicillin work?
Inhibits cell wall synthesis (bactericidal)
What makes augmentin different from amoxicillin?
It has clavulanic acid, which inhibits the bacterial beta lactamase that inactivates amoxicillin.
How does clindamycin work?
Bacteriostatic. Inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit.
Biggest danger with clindamycin?
Clostridium difficile overgrowth–leads to pseudomembranous colitis.
How do azithromycin and erythromycin work?
Bacteriostatic. Inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit.
How do tetracyclines work?
Bacteriostatic. Inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit.
How does metranidazole work? What is it ineffective against?
It inhibits nucleic acid synthesis (disrupts DNA of microbial cells). Ineffective against facultative anaerobes
Two things to avoid with metronidazole?
Alcohol-causes nausea and vomiting (disulfiram-like rxn)
Lithium- avoid since metronidazole decreases excretion of lithium (could lead to toxicity)
Which blood pressure medication to be careful with if using epi in local anesthetic?
Non-selective beta blockers (propranolol etc.)-can cause an increase in bp with bradycardia.
What anxiolytic medicine to use? according to?
Triazolam (halcion) (a type of benzodiazapine) is safe and effective for dental outpatients. Hargreaves and Dionne 1993
How do statins work?
They competatively inhibit the HMG-CoA reductase that plays a role in production of cholesterol in the liver
What are statins?
HMG-CoA reductase inhibitors
How do NSAIDs work?
They are non-selective inhibitors of COX (cyclooxygenase)
What does COX do?
catalyzes formation of what two things from what?
Catalyzes formation of prostaglandins and thromboxane from arachidonic acid
Which drug non-reversibly inhibits COX?
Aspirin
Which drug is a weak Cox-2 inhibitor (and therefore does not mess with thromboxanes i.e. clotting)
APAP
Three ways metformin works?
Decreases hepatic glucose production
Decreases intestinal absorption of glucose
Improves insulin sensitivity
What class of drugs is lisinopril?
An ace inhibitor
How do ace inhibitors work?
Competitive inhibitor of angiotensin converting enzyme, which converts angiotensin 1 to angiotensin 2
What is angiotensin 2?
A potent vasoconstrictor. If it is decreased, there is an increase in plasma renin activity, and a decrease in aldosterone (aldosterone acts on the kidneys to increase BP)
What does aldosterone do?
Acts on the kidneys to increase BP
How does HCTZ work?
what does it work on?
Causes increased excretion of what four things?
It is a diuretic that inhibits Na reabsorption in the distal tubules, causing increased excretion of Na, water, K and H ions
What class of drugs is bupropion (wellbutrin)?
Dopamine re-uptake inhibitor
What is singulair (montelukast)?
A leukotriene-receptor antagonist
How does singulair work?
inhibits the cysteinyl leukotriene receptor, which has been correlated with the pathophysiology of asthma
What is celexa (citalopram)
An SSRI (selective seratonin reuptake inhibitor) It’s non-tricyclic, so no CI with vasoconstrictors
How does aspirin work to “thin blood”
It irreversibly inhibits platelet aggregation, by inhibiting formation of prostaglandin derived thromboxane A2
How long for effects of aspirin to wear off?
7-10 days
