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BDS2 BAMS Pharmacology > Drug use in Dentistry > Flashcards

Drug use in Dentistry Flashcards

1
Q

how can drug use result in death

A

allergy to the drug
toxicity of the drug
drug interactions

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2
Q

what is drug interactions

A

drugs can have an effect on the absorption/metabolism of other essential medicines

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3
Q

what is warfarin

A

warfarin is an anti-coagulant which inhibits numerous coagulation factors
the effect of warfarin is changed by many prescription including antimicrobials, antifungals and antivirals

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4
Q

what is carbamazepine

A

used for the treatment of epilepsy

prone to drug interactions

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5
Q

what are the drug classes

A 
 Local anesthetic 
 Antimicrobials 
 Drugs in pain and inflammation 
 Drugs used in sedation
 Emergency medical drugs (e.g used for anaphylaxis)
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6
Q

what is local anesthetic

A

used to reduce the awareness of pain

they are all pH sensitive in the tissues

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7
Q

how does local anesthetic work

A

acts on nerve ion channels to block the propagation of the action potential and hence block the reception of pain

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8
Q

what is the effect of local anesthetic on blood flow

A

vasodilator

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9
Q

what are examples of local anesthetics

A

lignocaine
prilocaine
bupivacaine
mepivacaine

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10
Q

what are antimicrobials

A

they include antibiotics, antiviral and antifungals

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11
Q

what are the most commonly prescribed antibiotics

A

amoxycillin
metronidazole
doxycycline
clindamycin

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12
Q

what is the most commonly prescribed antiviral

A

aciclovir - herpes (systemic or topical)

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13
Q

what is the most commonly prescribed anti fungal

A

nystatin - topical

fluconazole - systemic

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14
Q

what are non steroidal antiinflammatory drugs used for

A

reduce the inflammatory mediators

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15
Q

what are corticosteroids

A

drugs that are used to reduce the inflammatory process

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16
Q

describe the features paracetamol

A 
antipyretic and analgesic
little anti inflammatory action
few side effects
unrestricted sale
1g four times daily 
often combined with other analgesics
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17
Q

what are the different classes of NSAID

A

salicylates
propionic acid derivatives
phenyl acetic acid derivatives

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18
Q

what is an example of a salicylate NSAID

A

aspirin

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19
Q

what is an example of a propionic acid derivative NSAID

A

ibuprofen

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20
Q

what is an example of a phenyl acetic acid derivative NSAID

A

diclofenac

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21
Q

when is diclofenac used

A

it is prescription only

very effective as an analgesic when there is inflammatory based pain

22
Q

how do NSAIDs work

A

inhibit prostaglandin synthesis by changing balance of PGE1 and PGE2
they inhibit cycle-oxygenase enzyme which regulates the production of prostaglandins from arachidonic acid

23
Q

what are side effects of NSAID

A

platelet inhibition - harder to clot

problems for severely asthmatic patients

24
Q

what is the dose for aspirin

A

300-600mg up to 4 times daily

25
Q

what is the pharmacokinetics for aspirin

A

rapid absorption from the GIT
eliminated by 1st order kinetics - easily metabolized
inhibits cox 1

26
Q

what happens to the body during overdose of aspirin

A

enzyme saturation

acidosis

27
Q

what does inhibition of COX-1 by aspirin result in

A

o Reduced synthesis of prostaglandins
o Reduced production of inflammatory mediators
o Anti-pyrexic – reduces fever
o Can be taken BEFORE inflammatory process starts (pre-emptive analgesia)

28
Q

what are the side effects of aspirin

A 
gastric irritation 
inhibition of platelet function
bronchospasm 
allergic reaction 
drug interaction
29
Q

what is the dose for ibuprofen

A

200-600mg 3 times daily

30
Q

describe the features of diclofenac

A

prescription only
more effective than ibuprofen
dose is 50mg 3 times daily

31
Q

how to corticosteroids reduce inflammation

A

by inhibiting:

  • capillary permeability
  • formation of bradykinin
  • migration of white blood cells
  • reduce eicosanoid synthesis
32
Q

what are examples of topical corticosteroids

A 
steroid inhalers (asthma)
hydrocortisone cream (eczema) 
steroid treatment for mouth ulcers
33
Q

what are the different types steroid treatments for mouth ulcers

A

beclomethasone inhalers
hydrocortisone adhesive tablets
betamethasone solutions

34
Q

what are examples of systemic corticosteroids

A

prednisolone (tablets)

dexamethasone (injection)

35
Q

what is prednisolone for

A

prevent transplant rejection

treat immunological diseases

36
Q

what is dexamethasone for

A

to reduce swelling after surgery

37
Q

what are the side effects of systemic steroids

A
  • High blood pressure
  • Weight gain (fluid)
  • Fat distribution change
  • Gastric ulceration
  • Adrenal suppression
  • Osteoporosis
  • Diabetes
38
Q

what are drugs used in sedation that reduce anxiety called

A

anxiolytics

39
Q

what are the types of anxiolytics

A

benziodiazepines - diazepam, madapolam

gas - nitrous oxide

40
Q

describe the action of benzodiazepine

A

act on GABA receptors (gaba A)
have an allosteric effect on receptor and increase action of GABA receptor
greater influx of negative ions makes it less likely that a neuron will fire an action potential

41
Q

what is a big disadvantage to benzodiazepine

A

rebound effect, less effective when taken for longer

42
Q

what happens in phase 1 of metabolizing benzodiazepine

A

converted into metabolites of lesser, equal or greater activity

43
Q

what happens in phase 2 of metabolizing benzodiazepine

A

conversion to inactive metabolites

44
Q

describe the features of nitrous oxide

A

inhaled as gas
no needle technique
no organ metabolism issues - excreted unchanged
interferes with folic acid metabolism

45
Q

what are the medical emergency drugs used for

A

Asthma
Heart attacks
Diabetic emergencies
Seizures

46
Q

what is the dose for ibuprofen

A

200-600mg 3 times daily

47
Q

what is the dose for diclofenac

A

50g 3 times daily

48
Q

why is diclogenac prescription only

A

higher incidence of gastric bleeding, higher incidence of asthma triggering, allergic reaction (rash)
have to risk assess

49
Q

what is given in a diabetic emergency

A

glucagon

50
Q

How does aspirin work

A

inhibits platelet aggregation by altering the balance between thromboxane A2/prostacyclin

BDS2 BAMS Pharmacology (4 decks)

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