Chapter 30 Principles of Pharmacology. Pharmacology The science or branch of medicine that conducts...
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Transcript of Chapter 30 Principles of Pharmacology. Pharmacology The science or branch of medicine that conducts...
Chapter 30
Principles of Pharmacology
Pharmacology
• The science or branch of medicine that conducts research and development in the use and effects of drugs
Drug
• A substance used in the prevention, diagnosis, or treatment of a disease.
• All drugs must be recognized and defined by the US Food, Drug and Cosmetic Act before they can be marketed to the public in the US
A drug is identified by three names
• Chemical name: which is the chemical formula of a drug
• Generic name: which may be used by any company; acetaminophen is an example of a generic name
• Brand name, or trade name: which is controlled by business firm as a registered trademark; such as Tylenol is brand name for acetaminophen
Dispensing
• Patent medicines: drugs that can be obtained without a prescription; also known as over-the-counter drugs
• Ethical drugs: Prescription drugs (from a physician or dentist), supplied to patients only by a pharmacist.
Prescriptions
• A written order by a physician or dentist for preparation and administration of a medicine
• Persons legally authorized to prescribe medications are issued a Federal Drug Enforcement Agency (DEA) identification number.
• Dental assistants cannot prescribe medications
Terminology of Prescriptions
• Superscription: patient name, address, the date and symbol Rx
• Inscription: name and quantity of the drug
• Subscription: directions for mixing the medication
• Signature: instructions for the patient on how to take the medication, when and how much
Telephone Guidelines
• Narcotics cannot be ordered without a written prescription
• It is illegal for a Dental assistant to “call in” a prescription
• Notify the dentist if the Pharmacist calls the office
• Never attempt to evaluate a patient’s reaction to a drug.
Mosby’s Drug Consult
• Annual source of information supplied by drug companies
• It is a bound text, as well as a electronic source
Drugs
• Local-acting drug– Affects only the specific area of the body to
which it is applied, such as a topical ointment
• Systemic drug– Taken internally– Can affect the whole body by way of
circulatory system
Administration
• Four stages– Absorption
• Absorbed from site of entry—speed varies, slowest is orally
– Distribution• Enters bloodstream, attaches to proteins within blood, and
circulates throughout the body
– Metabolism• Compound is released, and drug becomes metabolized and
is then excreted through liver or kidneys
– Excretion• Drug leaves the body by way of kidneys, liver, breast milk or
sweat
Routes
• Oral—tablets, liquid
• Topical—apply on surface of mucosa
• Transdermal –patch that continuously releases medication
• Inhalation—breathing in substance
• Sublingual—medication placed under the tongue
Controlled Substances Act
• Drugs that are covered under the Federal Comprehensive Drug Abuse Prevention and Control Act are divided into five schedules
Schedules
• Schedule I– No current accepted medical use/high potential for abuse
• Schedule II– High potential for abuse, some medical usefulness
• Schedule III– Less abuse potential than Schedule I and II, and has accepted
medical usefulnes
• Schedule IV– Low abuse potential and have accepted medical usefulness
• Schedule V– Lowest abuse potential and accepted medical usefulness/no
prescription needed
Chapter 37
• Anesthesia and Pain Control
Topical Anesthesia
• Provides numbing effect in an area where in injection is to take place– Ointments, liquids, sprays or patches
Local Anesthesia
• Most frequently used form of pain control in dentistry
• Obtained by injecting an anesthetic solution near a nerve where treatment is to take place
• Each local anesthetic cartridge contains– Local anesthetic drug– Sodium choloride– Distilled water
Uses of Vasoconstrictors
• Slows down the intake of an anesthetic agent and increases the duration of action
• Prolongs the effect of the anesthetic agent by decreasing the blood flow in immediate area of the injection
• Decreases bleeding in the injected area
Contraindications to Vasoconstrictors
• May cause strain on the heart• Not recommended for patients with a
history of:– Angina– Chest pain (heart related)– Recent myocardial infarction– Coronary artery bypass surgery– Untreated or severe hypertension– Congestive heart failure
Duration of Anesthetics
• Know the duration (in minutes) of each of the following– Short-acting local anesthetic– Intermediate-acting local anesthetic– Long-acting local anesthetic
Injection Techniques
• Infiltration Anesthesia– Usually used for Maxillary arch– Also used for secondary injection to block
gingival tissues surrounding mandibular teeth
• Block Anesthesia– Usually used for mandibular arch– Block nerves for the quadrant
Syringe
• Know the parts of the syringe and their functions
Cartridges/Disposable Needle
• Know the color-coding system• Know the parts of the cartridge• Know the parts of the needle • Know the size of the needle for dentistry• Lumen—the hollow center of the needle-how the
anesthetic flows through needle– The larger the gauge number—thinner the needle– The smaller the gauge number—thicker the needle
Complications and Precautions
• Know in detail– Injection into a blood vessel– Infected areas– Toxic reactions– Systemic reactions– Temporary numbness– paresthesia
Inhalation sedation
• Know the chemical make-up
• Advantages of Nitrous Oxide Use
• Contraindications of Nitrous Oxide Use
• Equipment
• Intravenous sedation– Understand the uses of IV sedation
• General Anesthesia– Know definition– Know in detail the four stages of anesthesia
• Happy Testing