Medication Flashcards

1
Q

Who said penicillin has no effect on the pain of untreated irreversible pulpitis?

A

Nagle 1990

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2
Q

Nagle 1990

irreversible pulpitis?

A

Penicillin has no effect on the pain of untreated irreversible pulpits

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3
Q

Don’t take nitrous oxide percent over what in children

A

50%

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4
Q

Two contraindications for nitrous oxide in children

A

acute otitis media (N2O can enter tympanic space and rupture the eardrum).
active pulmonary infection

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5
Q

How do NSAIDs work? Biggest danger?

A

They are non-selective COX inhibitors that thereby inhibit synthesis of prostaglandins (promote inflammation, but also pain). GI bleeding issues.

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6
Q

Why can NSAIDs cause stomach bleeding?

A

They are non-selective inhibitors of COX (cyclooxygenase). COX 1 and COX 2 are affected. Both COX’s produce prostaglandins, but COX 1 also protects the stomach.

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7
Q

How does acetaminophen work? Biggest danger?

A

Not well understood–weak COX inhibitor-does not show much anti-inflammatory activity. Hepatotoxicity.

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8
Q

How does penicillin work?

A

Inhibits cell wall synthesis (bactericidal)

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9
Q

What makes augmentin different from amoxicillin?

A

It has clavulanic acid, which inhibits the bacterial beta lactamase that inactivates amoxicillin.

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10
Q

How does clindamycin work?

A

Bacteriostatic. Inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit.

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11
Q

Biggest danger with clindamycin?

A

Clostridium difficile overgrowth–leads to pseudomembranous colitis.

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12
Q

How do azithromycin and erythromycin work?

A

Bacteriostatic. Inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit.

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13
Q

How do tetracyclines work?

A

Bacteriostatic. Inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit.

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14
Q

How does metranidazole work? What is it ineffective against?

A

It inhibits nucleic acid synthesis (disrupts DNA of microbial cells). Ineffective against facultative anaerobes

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15
Q

Two things to avoid with metronidazole?

A

Alcohol-causes nausea and vomiting (disulfiram-like rxn)

Lithium- avoid since metronidazole decreases excretion of lithium (could lead to toxicity)

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16
Q

Which blood pressure medication to be careful with if using epi in local anesthetic?

A

Non-selective beta blockers (propranolol etc.)-can cause an increase in bp with bradycardia.

17
Q

What anxiolytic medicine to use? according to?

A

Triazolam (halcion) (a type of benzodiazapine) is safe and effective for dental outpatients. Hargreaves and Dionne 1993

18
Q

How do statins work?

A

They competatively inhibit the HMG-CoA reductase that plays a role in production of cholesterol in the liver

19
Q

What are statins?

A

HMG-CoA reductase inhibitors

20
Q

How do NSAIDs work?

A

They are non-selective inhibitors of COX (cyclooxygenase)

21
Q

What does COX do?

catalyzes formation of what two things from what?

A

Catalyzes formation of prostaglandins and thromboxane from arachidonic acid

22
Q

Which drug non-reversibly inhibits COX?

A

Aspirin

23
Q

Which drug is a weak Cox-2 inhibitor (and therefore does not mess with thromboxanes i.e. clotting)

A

APAP

24
Q

Three ways metformin works?

A

Decreases hepatic glucose production
Decreases intestinal absorption of glucose
Improves insulin sensitivity

25
Q

What class of drugs is lisinopril?

A

An ace inhibitor

26
Q

How do ace inhibitors work?

A

Competitive inhibitor of angiotensin converting enzyme, which converts angiotensin 1 to angiotensin 2

27
Q

What is angiotensin 2?

A

A potent vasoconstrictor. If it is decreased, there is an increase in plasma renin activity, and a decrease in aldosterone (aldosterone acts on the kidneys to increase BP)

28
Q

What does aldosterone do?

A

Acts on the kidneys to increase BP

29
Q

How does HCTZ work?
what does it work on?
Causes increased excretion of what four things?

A

It is a diuretic that inhibits Na reabsorption in the distal tubules, causing increased excretion of Na, water, K and H ions

30
Q

What class of drugs is bupropion (wellbutrin)?

A

Dopamine re-uptake inhibitor

31
Q

What is singulair (montelukast)?

A

A leukotriene-receptor antagonist

32
Q

How does singulair work?

A

inhibits the cysteinyl leukotriene receptor, which has been correlated with the pathophysiology of asthma

33
Q

What is celexa (citalopram)

A

An SSRI (selective seratonin reuptake inhibitor) It’s non-tricyclic, so no CI with vasoconstrictors

34
Q

How does aspirin work to “thin blood”

A

It irreversibly inhibits platelet aggregation, by inhibiting formation of prostaglandin derived thromboxane A2

35
Q

How long for effects of aspirin to wear off?

A

7-10 days