DENT 1160
Pharmacology
1. Define PHARMACOLOGY
It is the branch of medicine that conducts research and development in the use and effects of drugs.
A drug is a substance used to treat, diagnose or prevent a disease
Dentist need to know what the patient is taking because those drugs may effect treatment and interact with the drugs the dentist needs to use.
2. DRUGS
Over the counter or Prescription (DEA #)
ID a drug by 3 names Chemical acetylsalicylic acid Generic aspirin Brand Bayer, Bufferin
3&4. Physician Desk Reference
PDR in text or computer format
Tells: use, indications and contraindications, side effects (predictable body reaction)
other sources-
USP, NF, ADT,
How to use PDR
Obtain any of the following: The name of the drug Turn to the Product Name Index - alphabetical A sample of the drug Look in the Product Identification Section -pictures The prescription container with product name Use the yellow Generic or Chemical Name Section The medical condition the drug is treating Use the blue section -Product Category Index Examples: analgesic anticoagulant diureticPage numbers will direct you to detailed information, classification, purpose or use, side effects, contraindications
5. Routes of Administration
Oral- pill, capsule, liquid Topical- gel or ointment
on skin or mucosa (subdermal patch)
Inhalation- gas Sublingual- under
tongue, absorbed Injection subcutaneous IM IV
Prescription
Is a written order by Dr or DDS ( with DEA#) to dispense drugs.
Keep Rx pads secure!!!Superscription- patient dataInscription- name and amount of drugSubscription- directions for dispensingSignature- directions for use( see list
text)
Prescriptions
DA may call a Rx to pharmacy but CAN NOT PRESCRIBE or dispense OTC without DDS order
Controlled Substance Act 1970
Schedule I- no medical use, potential abuse, LSD, heroine, marijuana
II- has med use, potential abuse, no call in or refill, opium, cocaine, morphine
III- use and less potential abuse, stimulants, depressants, Tylenol with codeine
IV- Valium, laibrium, DarvonV- cough meds with codeine
6. Antibiobitics
Dentists may prescribe an antibiotic to treat or prevent a bacterial infection.
Some common antibiotics are:penicillins PenVee K, Amoxilcephalosporins Keflex, Ceclorerythromycins Zithromax, E-Mycintetracyclines Minocin,Achromycin clindamycin Clindets, DalacinOral Contraceptives?????????????????????
7. AHA Prophylactic Antibiotics
When needed? prevent endocarditis
Artificial heart valve
Shunt
Heart murmur
mitral valve prolapse
Use what? Penicillin or ampicillin (2g)
clindamycin (500mg)
Take when? One hr before appointment
ADA on Premeds
http://www.ada.org/public/media/videos/minute/medi_premedication_broadband.wmv
8&9. Analgesics
Also known as pain killersNon narcotic (OTC) relieve mild to
moderate painAcetylsalicylic acid- Aspirin (cause
bleeding due to thinning of blood)Acetaminophen- tylenolIbuprofen- Advil or Motrin
10. Narcotic Analgesics
Stronger and may be used for sedation, analgesia and hypnosis
morphine codeinemeperdine- DemerolOxycodone- PercodanPropoxyphene- Darvon, Davocet
11. Premed Sedatives
Antianxiety agents given to reduce nervousness prior to appointment
Diazepam- ValiumChlordiazepoxide-LibriumMeprobamate- MiltowmHydroxyzine- VistarilXanax
12. Instructions for Pre Op meds
Antibiotic- take as directed 1 hr prior to apt.
Sedative- take as instructed, do not drive or drink alcohol
14. Sedation (antianxiety)Inhalation vs IV
INHALATION
Nitrous oxide
Halothane(Fluothane)
Methoxyflurane
( Penthrane)
IV
Pentothal
Brevital
ADA on Nitrous
http://www.ada.org/public/media/videos/minute/treat_nitrous_broadband.wmv
13. Analgesia vs Anesthetic
Analgesic prevent or relieve pain
Anesthetic produces a loss of sensation, numbs
15. Topical vs Local anesthesia
Topical- gel, ointment, liquid or spray used to numb mucosa. A 5-20% concentration of local anesthetic. Dry area, apply and let set 1-2 min.
Local- loss of sensation in area, 2-5% concentration, lidocaine, mepivocaine, xylocaine, lidocaine
16. 3 actions of VASOCONSTRICTOR
Constrict BV to prolong the effectDecrease bleeding in the areaReduces the amount of anesthetic
needed, safer
Epinephrine 1:50,000 or 1:20,000, 1:100.00
17. Contraindication for vasoconstrictor
HypertensionSevere cardiovascular diseaseHyperthyroid
Use nonepinephrine products like: Levophed, Neo-Cobefrin
18. Assistant responsibility
You prepare the syringe!
1.Use correct anesthetic (per Dr) cartridge
2. Use correct needle length ( long mand, short max)
3. Place stick shield
4. Engage harpoon
19. Drugs of concern to dental treatment
1. Antabuse- avoid product with high alcohol content like mouthwash
2. Aspirin, Fiorinal, Coumadin (warfarin)- bleeding (anticoagulants)
3. NSAID, Naprosyn, indomethacin- beware Diabetics & cause bleeding
4. Albuterol or Ventolin- asthma5. Insulin- diabetic (food and insulin)6. Nitrogliceryn- angina
19. Cont drugs of concern
7. Lasix (furosemide)- HBP, restroom use 8. Lanoxin (digoxin)- heart problems 9. Prednisone- immune compromised,cancer 10. Oral Contraceptive- not effective with AB 11. Prozac (fluoxetine)- Do Not use nitrous 12. Zoloft- FATAL with Demeral (meperidine) 13. Dilantin- epilepsy
Dilantin for epilepsy
ADA on drug side effects
http://www.ada.org/public/media/videos/minute/medi_sideeffects_broadband.wmv
The End
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