CHAPTER 9 Pharmacology
Understanding a pharmacological effect on a patient and possible interaction with other drugs is essential to safe dental care. Thorough medical history helps identify adverse effects and potential drug interactions with current prescription (Rx) drugs, dental drugs, over-the-counter (OTC) drugs. Dental settings are advised to have the current Physician’s Desk Reference (PDR) Index for reference information concerning drug information by brand and generic names, product categories, manufacturers.
Effective prescription writing requires accurate diagnosis; proper selection of drug, dosage form and route of administration; proper size and timing of dose; precise dispensing; accurate labeling; and correct packaging. Prescription is provided by a physician, osteopath, dentist, or other approved practitioner. Note that OTC drugs do not require a prescription but must be included with drug history.
|q.d.||Once per day|
|q.i.d.||4 times per day|
|q.o.d.||Every other day|
|q6h||Every 6 hours|
|t.i.d.||3 times per day|
Adrenergic blockers inhibit α- and β-receptors, including (1) α-adrenergic blockers such as tolazoline (Priscoline) and phentolamine (Regitine); (2) β-adrenergic blockers, including nonspecific blockers such as propranolol (Inderal) and nadolol (Corgard) and specific blockers such as metoprolol (Lopressor) and atenolol (Tenormin); (3) α- and β-adrenergic blockers such as labetalol (Normodyne, Trandate). See later discussion of patient with CVD.
Anticholinergics (parasympathomimetics) inhibit body functions by blocking muscarinic cholinergic receptors. Include atropine (oral, Sal-Tropine; ophthalmic, Atropair) and propantheline bromide (Pro-Banthine).
|Sex||Male Female||The patient is scheduled for an oral prophylaxis today. He has generalized dental biofilm and slight calculus deposits throughout, with only slight to moderate gingivitis.|
|Chief Complaint||“I hate being here but I know that I have to keep up my mouth.”|
Analgesics inhibit perception of pain. Nonopioids reduce pain perception by inhibiting prostaglandin synthesis; MORE effective if they are taken before onset of pain. Opioids depress pain perception in CNS by binding with opioid receptors (Tables 9-3, 9-4, and 9-5).
Decrease antihypertensive effects of ACE inhibitors (captopril), beta blockers, loop diuretics, and thiazide diuretics
ACE, Angiotensin converting enzyme; NSAIA, nonsteroidal antiinflammatory agent; VA, valproic acid.