Pharmacology - Drug-to-Drug Interactions in Dentistry

Question 1

What drug(s) should not be mixed with diazepam or triazolam?

Answer 1

1. Itraconazole
2. Clarithromycin
3. any CYP450 inhibitor

Question 2

What happens if you mix a benzodiazepine with itraconazole, clarithromycin, or another CYP450 inhibitor?

Answer 2

Increased sedation due to lowered metabolism of the benzodiazepine

Question 3

What drug(s) should not be mixed with Tetracyclines?

Answer 3

oral antacids

Question 4

What happens if you mix tetracyclines with oral antacids?

Answer 4

reduced absorption of tetracyclines

Question 5

What drug(s) should not be mixed with aspirin?

Answer 5

1. Anticoagulants
2. Probenecid
3. Methotrexate

Question 6

What happens if you mix aspirin with another anticoagulatn?

Answer 6

increased bleeding to the point that it might be dangerous to undergo invasive dental procedures

Question 7

What happens if you mix aspirin with Probenecid?

Answer 7

decreased efficacy of the probenecid (used to treat too much uric acid. aka gout)

Question 8

What happens if you mix aspirin and Methotrexate?

Answer 8

increased toxicity of methotrexate (used for leukemia and other forms of cancer)

Question 9

What drug(s) should not be mixed with Acetominophen?

Answer 9

Alcohol (aka ethanol)

Question 10

What happens if you mix acetominophen with alcohol?

Answer 10

increased liver toxicity in alcoholics (too much can lead to cirrhosis or death)

Question 11

What drug(s) should not be mixed with Local Anesthetics?

Answer 11

Cholinesterase inhibitors

Question 12

What happens if you mix local anesthetics with cholinesterase inhibitors?

Answer 12

1. Antagonism of cholinesterase inhibitors (ACh cannot be broken down so there is neural overstimulation causing twitching, spasms, convulsions, etc)
2. Reduced efficacy of Chol. inhibitor in pt with Myasthenia Gravis