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NBDHE May 2022 > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

QD

A

once/day

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2
Q

BID

A

twice/day

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3
Q

TID

A

Three times/day

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4
Q

QID

A

4 times/ day

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5
Q

PC

A

After meals

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6
Q

AC

A

before meals

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7
Q

PO

A

by mouth

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8
Q

PRN

A

as needed

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9
Q

HS

A

at bedtime

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10
Q

Brand Name

A

manufactures name - first letter capitalized

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11
Q

Generic Name

A

chemical makeup of drug; all letters lowercase

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12
Q

Enteral Administration

A

uses GI tract

safest, slowest, most variable route

can be sublingual, oral, or rectal

sublingual and rectal administration avoid first pass effect

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13
Q

Parenteral Administration

A

by-pass GI tract

IV ⇒ most rapid, complete absorption

IM ⇒ high blood volume

Subcutaneous ⇒ under skin

Intradermal ⇒ in dermis

Topical ⇒ absorbed by capillaries under skin

Inhalation ⇒ nitrous, albuterol

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14
Q

Pharmacokinetics

(Absorption)

A

entry of the therapeutic agent into bloodstream

depends on: food, pH, route, solubility

IV drugs skip this step

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15
Q

Pharmacokinetics

(Distribution)

A

from bloodstream to body

oral - liver

sublingual - heart

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16
Q

Bioavailability

A

x amount of drug will be available after administration to produce a biologic effect

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17
Q

Pharmacokinetics

(Metabolism)

A

breakdown of drugs for excretion

primary site is the liver

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18
Q

Pharmacokinetics

(Excretion)

A

removal of drug from body

Primary site is kidney

drug excretion occurs through urine/respiratory system

Glomerulus in nephrons filter blood and produce urine

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19
Q

Sympathetic Nervous System

A

“Fight or Flight”

Norepinephrine and epinephrine mediate response at the adrenergic receptors

Drugs contraindicated for angina, uncontrolled hypertension, uncontrolled hyperthyroidism

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20
Q

Parasympathetic Nervous System

A

“rest and digest”

acetylcholine mediates response at cholinergic response

Drugs contraindicated for asthma

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21
Q

Allergic Effects

A

Unpredictable, not dose related

Type 1 - intermediate

Type 2 - slowest

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22
Q

Therapeutic Index

A

determines safety of a drug

LD50/ED50

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23
Q

Therapeutic Action

A

desired result

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24
Q

Therapeutic Range

A

range between dose-causing minimum effect and

dose-causing minimum adverse effect

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25
Q

Potency

A

amount needed to achieve desired effect

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26
Q

Efficacy

A

maximum response attained

(highest point on graph is greatest efficacy)

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27
Q

Diuretics

A

“water pills”

  • blocks sodium reuptake in kidneys
  • more water is excreted
  • first line hypertensive agent
  • thiazide or loop diuretic
  • side effects ⇒ xerostomia, orthostatic hypotension
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28
Q

Beta-Adrenergic Blockers

A

decreases BP by decreasing cardiac output

  • Beta 1: increase heart muscle contraction
  • Beta 2: relax bronchial smooth muscle

Starts with B, E, A, or M

Ends in -olol

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29
Q

Calcium Channel Blockers

A

inhibit calcium (regulates muscle contractions)

  • systemic vasodilation decreases BP
  • side effects ⇒ xerostomia, gingival enlargement
  • ends in -pine
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30
Q

Angiotensin Converting Enzyme (ACE) Inhibitors

A

blocks angiotensin II, causing vasodilation

side effects ⇒ dry cough, altered taste, orthostatic hypotension

ends in -pril

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31
Q

Anti-Hypertensive Drug Classes

A

diuretics

ACE Inhibitors

beta-blockers

Calcium channel blockers

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32
Q

Anti-Bacterial Agents

A

Penicillin: most commonly prescribed, safe with pregnancy, anaphylaxis is common

Tetracycline: bacteriostatic, concentrates in GCF

Cephalosporin: similar action to penicillin

Clindamycin: premedication in penicillin allergy, GI effects

Metronidazole: treats periodontal infections and ANUG, *avoid alcohol

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33
Q

Anti-Viral Agents

A

Herpes tx: Acyclovir, Docosanol, Valtrex

HIV/AIDS: AZT, Retrovir

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34
Q

Anti-Fungal Agents

A

occurs more in immunocompromised pt’s

Nystatin: topical or oral administration, 5ml QID for 2 weeks

Fluconazole: administered orally

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35
Q

Anti-TB Agents

A

Rifampin, Isoniazid (prophylaxis), Pyrazinamide, Ethambutol

All used in combination for tx

36
Q

Acetominophin

A

NSAID

NOT and anti-inflammatory or an anti-platelet

hepatoxicity and liver necrosis

drug of choice for post-op periodontal treatment , children, pts with ulcers, or pts on anticoagulants

37
Q

Aspirin

A

Analgesic, anti-inflammatory, antipyretic, antiplatelet (7-10days)

Adverse reactions: GI, bleeding, Reyes Syndrome, hypersensitivity

Overdose: tinnitus (ringing in ears)

38
Q

NSAIDS

A

Antipyretic, analgesic, anti-inflammatory

Ibuprofen, Acetaminophen (non anti-inflammatory), Aspirin

Adverse effects: GI irritation, ulcers

Contraindications: gastric ulcers, heart disease

  • NSAIDS decrease effectiveness, of many drugs
39
Q

Nitrous Oxide

A

analgesic and anti-anxiety

no biotransformation, wears off once mask is removed

  • contraindications: respiratory issues, pregnancy, emotional illness, substance abuse

NOTE

Nitrous - blue

Oxygen - green

40
Q

Opioids

A

Analgesic

anti-tussive (cough suppressor)

sedation

euphoria (abuse)

Adverse rxn: respiratory depression, sedation, nausea, constipation, abuse

Naloxone: REVERSES effects

Methadone: TREATS withdrawal/dependance

41
Q

Anti-Anginal Agents

A

Angina: Chest Pain

tx: nitroglycerin (vasodilator) administered sublingually

42
Q

Congestive Heart Failure Agents

A

Ianoxine (digoxine), Digitalis, Aldactone

  • increases force of cardiac contraction
  • side effects: dizziness, fatigue, headache, anxiety, GI upset, altered taste, blurred vision
  • use Epinephrine (0.4mg) and Levonordephrine (0.2mg) with caution
43
Q

Anti-Coagulants

A

Blood thinners, need INR >3

Warfarin (prevents vitamin K formation), Aspirin

  • used for stroke, myocardial infarction
  • use Acetaminophen with prescription, not Aspirin to avoid access bleeding
44
Q

Anti-Arrhythmia Agents

A

treats irregular heart rhythms

SA node controls heart contractions

  • Class 1: Sodium channel blockers slow impulse in heart muscle
  • Class 2: beta-blockers slow impulses at SA node
  • Class 3: potassium channel blockers slow impulses in all heart cells
  • Class 4:Calcium channel blockers slow conduction at SA and AV nodes

Tx: pacemaker, Lidocaine, beta-blocker, calcium channel blockers

45
Q

Antidepressants

A

xerostomia is most common side effect

  • SSRI’s stimulate CNS, inhibit serotonin reuptake
  • TCA’s increase serotonin and norepinephrine
  • MAOI’s: first antidepressant, since replaced
  • NDRI’s
  • Lithium: tx for bipolar disorder, interact with NSAIDS
46
Q

Antipsychotics

A

xerostomia common side effect

ends in -zine or -apine

47
Q

Antianxiety

A

Induce sleep, causes xerostomia

benzodiazepines enhance GABA

ends in -zepam or -zolam

48
Q

Organ Transplant Agent

A

Cyclosporine

Causes gingival overgrowth

49
Q

Corticosteroids

A

decreases inflammation and allergic reactions

side effects - infection, ulcers, osteoporosis

causes buffalo hump and moon face by fat deposition in those areas

ends in -asone or -alone

50
Q

Anti-Allergy Agents

A

A

Antihistamine

  • blocks H1 receptors (causes vasodilation, broncoconstriction, pain, itching) and H2 receptors (gastric acid secretion)

Corticosteroids

  • suppresses allergy inflammation

Epinephrine

  • used for severe reactions (epi-pen)
51
Q

Anttihyperlipidemics

A

controls high-cholesterol

ends in - statin

drugs lower LDL

avoid grapefruit juice

52
Q

Thyroid Medications

(tx hypothyroidism, hyperthyroidism)

A

Antihypothyroidism: Levothyroxine

Antihyperthyroidism: PTU, Tapazole, surgery

caution with epinephrine

Thyroid produces thyroxine and epinephrine

53
Q

Diabetes Agents

A

Type 1: body cant produce insulin, insulin injection needed

Type 2: cant use insulin, diet and obesity is a risk

tx is Metformin or Prandin

54
Q

Anticonvulsants

A

seizure tx

Phenytoin (gingival overgrowth), Phenobarbital (sedative), Carbamazepine

55
Q

Pregnancy Anaesthetic

A

Prilocaine, Lidocaine best options

56
Q

When is it BEST to provide dental tx to pregnant patients?

A

Second trimester

57
Q

Pregnancy Drug Classes

A

A: best, no risk to fetus

B: good in animal studies

C: animal studies show adverse effects on fetus

D: human fetal risk

X: fetal abnormalities

58
Q

Local Anaesthetic

Esters

A

Drug names have 1 “i”

  • metabolized in plasma
  • more likely to cause allergy than amides
    • eg. Procaine, Cocaine, Benzocaine, Tetracaine
59
Q

Local Anaesthetic

Amides (5)

A

Drug names have 2+ “i”s

  • Lidocaine: metabolized in liver, treats cardiac arrhythmia
  • Mepivacaine: metabolized in liver, used for epinephrine contraindication
  • Articaine: metabolized by plasma, used with liver disease
  • Prilocaine: metabolized in liver, used for pts with liver disease
  • Bupivacaine: metabolized in liver, long (12hr) relief
60
Q

Local Anaesthetics

A

Blocks influx of sodium through channels

Vasodilation

Epinephrine decreases bleeding

61
Q

Best LA for Cardiovascular Disease

A

0.04mg Epinephrine

62
Q

LA Contraindication for Hyperthyroidism

A

Epinephrine

63
Q

LA Contraindication for Plasma Cholinesterase

A

Esters

64
Q

LA Contraindication for Methymoglobinemia

A

benzocaine

prilocaine

65
Q

Street Drugs LA Contraindication

A

Epinephrine

66
Q

Laxatives

A

Constipation tx (IBS)

abuse causes hypokalaemia

Consists of: bulking agents, lubricants, stool softeners

67
Q

Antisecratory Drugs

A

decreases acid secretion in stomach

  • Histamine H2 Receptor Agonists
  • protein pump inhibitor
  • prostiglandin analogue
  • antimuscanaric drugs
  • mucosal protectants
68
Q

Antidiarrheal Drugs

A

rehydrating, antibacterial, anti-motility, antispasmodic

-opioid analgesics slows peristalsis

69
Q

Antispasmodic Drugs

A

decreases pain and cramping from IBS

70
Q

Antacids

A

Causes halitosis, xerostomia, taste alteration

  • aluminum and magnesium
  • sodium bicarbonate (additive)
  • bismuth and calcium NOT recommended
71
Q

Antiemetics

A

tx for nausea and vomiting

72
Q

Side Effects of Bismuth-Salicylate

A

dark tongue and stool

73
Q

Side Effects of Antihistamines

A

drowsiness, xerostomia

74
Q

Side Effects of Dopamine Antagonist

A

xerostomia, tinnitus, fatigue

75
Q

Side Effects of Neurokin Agonist

A

xerostomia, decreased urination, GERD

76
Q

Side Effects of Serotonin Agonist

A

xerostomia, fatigue, constipation

77
Q

Side Effects of Corticosteroids

A

indigestion, acne, increased appetite, thrush

78
Q

Side Effects of Cannibinoids

A

dizziness

79
Q

COPD Tx

A

Short acting: (emergency); Albuterol, Ipratropium

  • causes xerostomia, headache, cough

Long acting: (1-2x/day); Formeterol, Aclidinium

  • causes cerostomia, headache, dizziness

Corticosteroids: Fluticasone, Prednisone

  • Decreases inflammation
  • causes thrush, cold-like symptoms, headache, weight gain, stomach upset
80
Q

Antitussive Agents

A

Bronchodilator (Albuterol)

Corticosteroid (long term, causes xerostomia, candidiasis)

Long-acting Beta antagonists (Salmeterol, inhaled)

Leukotriene Modifiers (anti-inflammatory)

Combination Drug (bronchodilator + corticosteroid)

81
Q

Premedications

A

Amoxycillin 2.0g (50mg/kg for children)

Clindamycin 600mg (20mg/kg for children) for PCN allergy

Ampicillin 2.0g IM or IV (50mg/kg for children) if unable to take oral medications

Administer 30-60 mins BEFORE tx OR 2 hours after

82
Q

Heart Conditions Requiring Antibiotic Premedication

A

Artificial heart valve

History of infective endocarditis

Congenital heart conditions

Cardiac transplant with issues with heart valve

83
Q

Antibiotic Premedication

Joint Replacement

A

Artificial joints do not require antibiotic premedication prior to dental procedures

*If complications with procedure occurred, consult with physician before invasive procedures

84
Q

Heart Conditions not Requiring Antibiotics

A

mitral valve prolapses

rheumatic heart disease

bicuspid valve disease

calcified aortic stenosis

congenital heart conditions such as ventricular septal defect, atrial septal defect, and hypertrophic cardiomyopathy

85
Q

US DEA Drug Schedule

A

Schedule 1: Drugs with no currently accepted medical use and a high potential of abuse

Cannabis, Heroin, LSD

Schedule 2: High potential for abuse with use potentially leading to severe psychological or physical dependance

Vicodin, Cocaine, Methamphetamine

Schedule 3: A moderate to low potential for physical and psychological dependance. Abuse potential is less than schedule 1 or 2 drugs

Ketamine, Anabolic steroids, Testosterone

Schedule 4: drugs with a low risk of abuse and dependance

Xanax, Ambien, Valium

Schedule 5: drugs with a lower potential for abuse than schedule 4 and consist of a preparation containing limited quantities of certain narcotics. Usually used for antidiarrheal, antitussive, and analgesic purposes

Lyrica, Motofen, Robutissin A-C

NBDHE May 2022 (12 decks)

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