H
Drug Class:
Corticosteroid, synthetic topical
Mechanism of Action
Therapeutic Effect: Reduces or prevents tissue response to the inflammatory process.
DermatosesPrecautions and Contraindications
History of hypersensitivity to halcinonide or other corticosteroids
Serious Reactions
! The serious reactions of long-term therapy and the addition of occlusive dressings are reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, manifestations of Cushing’s syndrome, hyperglycemia, and glucosuria.
Dental Considerations
Teach Patient/Family to:
Drug Class:
Topical corticosteroid, group VI potency
Mechanism of Action
Therapeutic Effect: Decreases or prevents tissue response to inflammatory process.
Pharmacokinetics
Variation in absorption among individuals and sites: scrotum 36%, forehead 7%, scalp 4%, forearm 1%.
Dermatoses, Corticosteroid-Unresponsivehaloperidol
(Apo-Haloperidol[can], Haldol, Haldol Decanoate, Novo-Peridol[can], Peridol[can], Serenace[aus])
Drug Class:
Indications and Dosages
Treatment of Psychotic Disorders
Treatment of Nonpsychotic Disorders, Tourette’s SyndromeDrug Interactions of Concern to Dentistry
• Increased sedation: other CNS depressants, alcohol, barbiturate anesthetics, opioid analgesics
• Hypotension, tachycardia: epinephrine
• Increased extrapyramidal effects: phenothiazines and related drugs (haloperidol, droperidol), metoclopramide
• Additive photosensitization: tetracyclines
• Increased anticholinergic effects: anticholinergics
• Suspected increase in neurologic side effects: fluconazole, itraconazole, ketoconazole
Serious Reactions
! Extrapyramidal symptoms appear to be dose related and typically occur in the first few days of therapy. Marked drowsiness and lethargy, excessive salivation, and fixed stare occur frequently.
! Less common reactions include severe akathisia (motor restlessness) and acute dystonias (such as torticollis, opisthotonos, and oculogyric crisis).
! Tardive dyskinesia (tongue protrusion, puffing of the cheeks, chewing or puckering of the mouth) may occur during long-term therapy or after discontinuing the drug and may be irreversible. Elderly female patients have a greater risk of developing this reaction.
Dental Considerations
General:
• Monitor vital signs at every appointment because of cardiovascular side effects.
• After supine positioning, have patient sit upright for at least 2 min before standing to avoid orthostatic hypotension.
• Assess salivary flow as a factor in caries, periodontal disease, and candidiasis.
• Avoid dental light in patient’s eyes; offer dark glasses for patient comfort.
• Assess for presence of extrapyramidal motor symptoms, such as tardive dyskinesia and akathisia. Extrapyramidal motor activity may complicate dental treatment.
• Geriatric patients are more susceptible to drug effects; use lower dose.
• Use vasoconstrictors with caution, in low doses and with careful aspiration. Avoid use of gingival retraction cord with epinephrine.
Consultations:
• Take precautions if dental surgery is anticipated and anesthesia is required.
• Confirm patient’s mental ability to give informed consent.
• Refer to physician if signs of tardive dyskinesia or akathisia are present.
• Physician should be informed if significant xerostomic side effects occur (e.g., increased caries, sore tongue, problems eating or swallowing, difficulty wearing prosthesis) so that a medication change can be considered.
Drug Class:
Gonadotropin releasing hormone agonist
Uses
Palliative treatment of advanced prostate cancer and children with central precocious puberty (CPP).
Drug Class:
Mydriasis and Cycloplegia for Refraction
Uveitishydralazine hydrochloride
high-dral′-ah-zeen high-droh-klor′-ide
Drug Class:
Antihypertensive, direct-acting peripheral vasodilator
Indications and Dosages
Moderate to Severe Hypertension
Dosage in Renal Impairment
Precautions and Contraindications
Coronary artery disease, lupus erythematosus, rheumatic heart disease
Serious Reactions
! High dosage may produce lupus erythematosus-like reaction, including fever, facial rash, muscle and joint aches and splenomegaly.
! Severe orthostatic hypotension, skin flushing, severe headache, myocardial ischemia, and cardiac arrhythmias may develop.
Dental Considerations
General:
• Monitor vital signs at every appointment because of cardiovascular side effects.
• Limit dose or avoid vasoconstrictor.
• Patients on chronic drug therapy may rarely have symptoms of blood dyscrasias, which can include infection, bleeding, and poor healing.
• Limit use of sodium-containing products, such as saline IV fluids, for patients with a dietary salt restriction.
• After supine positioning, have patient sit upright for at least 2 min to avoid orthostatic hypotension.
Edema, Hypertension
Usual Pediatric Dosage
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