3. Drug Use in Dentistry Flashcards

1
Q

Hazards of drug use and explanations (2)

A

Death - allergy to drug/toxicity of drug

Drug interactions - effect on absorption/metabolism of other essential medicines

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2
Q

Classes of drugs used in dentistry (5)

A
LAs
Antimicrobials
Drugs in pain and inflammation
Drugs used in sedation
Emergency medical drugs
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3
Q

Function of LA

A

Reduce awareness of pain

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4
Q

Action of LA

A

Act on nerve channels to block propagation/nerve transmission

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5
Q

Examples of LA (5)

A
Lignocaine/lidocaine
Articaine
Bupivicaine
Prilocaine
Mepivicaine
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6
Q

Classes of antimicrobials (3)

A

Antibiotics
Antivirals
Antifungals

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7
Q

Examples of antibiotics (4)

A

Amoxicillin
Metronidazole
Doxycycline
Clindamycin

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8
Q

Example of antiviral

A

Acyclovir

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9
Q

Examples of antifungals (2)

A

Nystatin (topical)

Fluconazole (systemic)

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10
Q

Drugs used to reduce inflammatory mediators

A

NSAIDs

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11
Q

Drugs used to reduce inflammation process

A

Corticosteroids

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12
Q

Drugs involved with immunosuppresion

A

Steroids

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13
Q

Action of NSAIDs (2)

A

Inhibit prostaglandin synthesis
Change balance of PGE1 and PGE2 (anti-inflammatory).
COX (COX1/2 inhibitors)

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14
Q

Types of NSAIDs and examples (3)

A

Salicylates - aspirin
Propionic acid derivatives - ibuprofein
Phenylacetic acid derivatives - diclofenac )POM)

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15
Q

Aspirin dosage

A

300-600mg up to 4 times daily

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16
Q

Aspirin benefit

A

Reduces MI/bowel cancer risk

17
Q

Aspirin pharmacokinetics (4)

A

Rapidly absorbed from GIT
Eliminated by first order kinetics
COX1 inhibitor, anti-pyrexic
Can be taken pre-emptively

18
Q

Aspirin overdose cause/effects (2)

A

Enzyme saturation

Can lead to toxic effects including acidosis

19
Q

Aspirin side effects (5)

A
Gastric irritation (erosions, ulcerations - worse with alcohol)
Platelet function inhibition (enhanced bleeding)
Bronchospasm (exacerbates asthma)
Allergic reaction (rash)
Drug interactions - significant protein binding
20
Q

Ibuprofen dosage

A

200-600mg three times daily

21
Q

Ibuprofen side effects (6)

A

Same as aspirin, but less problematic
Gastric irritation (erosions, ulcerations - worse with alcohol)
Platelet function inhibition (enhanced bleeding)
Bronchospasm (exacerbates asthma)
Allergic reaction (rash)
Drug interactions - significant protein binding

22
Q

Diclofenac dosage and potency (2)

A

50mg three times daily

More potent than ibuprofen, therefore more effective anti-inflammatory

23
Q

COX2 inhibitors vs COX1 inhibitors (2)

A

COX2 - reduced gastric side effects

Better for long-term use (arthritis) but can lead to cardiac death

24
Q

COX2 inhibitor example

A

Arcoxia

25
Q

Corticosteroids reduce inflammation by (4)

A
Inhibiting capillary permeability
Inhibiting bradykinin formation
Inhibiting WBC migration
Reducing eiconsanoid synthesis
Corticosteroids suppress the features of inflammation but do not address the underlying cause
26
Q

Examples of topical corticosteroids and uses (4)

A

Steroid inhalers (asthma)
Hydrocortisone cream (eczema)
Steroid treatment for mouth ulcers (beclomethasone inhalers, hydrocortisone adhesive tablets, betamethasone solution)
Triamcinolone

27
Q

Examples of systemic corticosteroids and uses (2)

A

Prednisolone tablets - prevent transplant rejection, treat immunological diseases
Dexamethasone injection - reduce post-ope swelling

28
Q

Side effects of systemic corticosteroids (7)

A
High blood pressure
Weight gain (fluid)
Fat distribution change (centripetal obesity and buffalo hump)
Gastric ulceration
Adrenal suppression
Osteoporosis
Diabetes
29
Q

Prednisolone dosage

A

1-100mg (varies with desired level of immune suppression)

POM

30
Q

Paracetamol action (3)

A

Anti-pyretic
Analgesic
Few side effects

31
Q

Paracetamol dosage

A

1g (1000mg) four times daily

32
Q

Paracetamol combined drugs (2)

A

Co-codamol - with codeine

Co-drydamol - with dihydrocodeine

33
Q

Anxiolytic classes and examples (2)

A

Benzodiazepines - diazepam and midazolam

Gas - nitrous oxide