Pharmacology Soup

for the

Dental Hygiene Soul

Paragon Hygiene Academy

November 14 & 15 2013

Ted A. Beitelschees, DDS

Pharmacology Soup for the

Dental Hygiene Soul

Goals Consider some clinically significant adverse rxns

to the Top 50 drugs Discuss some pharm “wrinkles” to selected dental

drugs Look at some emerging trends in perio/oral health

care and how they relate to pharmacology Give you tools for next week!

Pharmacology Soup for the Dental Hygiene Soul

Review the Top 50

DrugsHydrocodone/APAP MetFORMIN Gabapentin Warfarin Aoxicillin & Clavulanate

Potassium

Lisinopril Lipitor Ibprofen ClonazePAM Ciprofloxacin

Simvastatin Furosemide (Oral) NexIUM Lexapro Pravastatin

Levothyroxine Metoprolol PredniSONE (oral) Fluticasone TraZODone

Amoxicillin Atenolol TraMADol Cyclobenzaprine ProAir HFA

AmLODIPine Sertraline Plavix Cephalexin Lovastatin

Azithromycin Metoprolol XL Singulair Sulfamethoxazike &

Trimethoprim

Hydrochlorothiaszide and Triamterene

ALPRAZolam Zolpidem Lisinopril & Hydricholrothiazide

Crestor Carvedilol

Hydrochlorothiazide Oxycodone and APAP FLUoxetine Fexofenadine Advair Diskus

Omeprazole Citalopram LORazepam Synthroid Alendronate

Top 50 Drugs Breakdown

10 Cardiac Drugs

5 Statins

4 Pain Control

5 Antibiotics

5 Respiratory Drugs

5 Sedative/Hyp

Top 50 Drug Review - adverse reactions

Xerostomia

Orthostatic Hypotension

Polypharmia

Gingival Enlargement (Hyperplasia)

Xerostomia

Selected alcohol-free products Biotene

Oxyfresh products

Listerine Zero & Total Care

Zero

Butler GUM chlorhexidine

gluconate 0.12% rinse

Flouride Treatment – varnish, rinse, gel,

toothpaste, tray Restorative materials – bonding agents,

composites, glass ionomer cements

Sodium Laurel Sulfate (SLS)–free toothpastes

Arm & Hammer Advance White for SensitiveTeeth

Burt's Bees Natural Toothpaste

Biotene Sensitive

Sensodyne - Original, Iso-Active, ProNamel, Extra

Whitening, Cool Gel, Fresh Impact, Tartar Control plus

Whitening, Fresh Mint

Tom's of Maine Peppermint SLS-free Anticavity Plus

Whitening Clean and Gentle

Orthostatic Hypotension

Polypharmia

Drugs that can cause Ginvigal Enlargement (Hyperplasia)

phenytoin (Dilantin) nifedipine (Procardia, Adalat) diltiazem (Cardizem) verapimil (Calan) amlodipine (Norvasc)

Pharm wrinkles with dental drugs

Local Anesthetics

Tricks with CVD Patients– Use 1:200,000 epi LA– Mix plain LA with LA & vaso

Still must watch total dosage!

Local Anesthetics

Infiltration of mandibular molars with

4% articane (Septocaine) w/ 1:100,000

or 1:200,000 epi75% success on 1st molars

50% success on 2nd molars

Refractory Perio Aces

Metronidazole (Flagyl)

Great against anaerobes

Gets into GCF

Watch alcohol

Refractory Perio Aces

Doxycycline hyclate (Vibramycin)

Dosed once daily

4x concentration in GCF !

Watch sun worshippers

How serious is the disease?(Not all bears are the same!)

First-Line Antihypertensives

hydrochlorothiazide (HCTZ, Diazide)metaprolol (Tenormin)ACE Inhibitors

captopril (Capoten) and enalpril (Vasotec)

Trouble on the HTN front

reserpine (Serpasil)guanethidine (Ismelin)

Other centrally acting (CNS) drugsMultiple drugs

Future Trends

Future Trends

Future TrendsOld Dogs, New Tricks

Reducing Vascular Inflammation

Statins– e.g. rosuvastatin (Crestor)

ACE inhibitors– e.g. ramipril (Altace)

Future Trends

Perio Therapy will be considered

Preventive Care

Pharmacology Soup for the

Dental Hygiene Soul

Thank You !

Ted Beitelschees, DDS

drted@WestgateFamilyDental.com

419.578.4100

Pharmacology Soup for the

Dental Hygiene Soul

Questions ?