Emergencies & Records - Week 10 PP

Question 1

Pharmacology is…

Answer 1

is the science or branch of medicine that includes the research, development, and manufacturing of drugs.

Question 2

A Drug is…

Answer 2

a substance taken for the prevention, diagnosis, and treatment of a disease

A wide variety of drugs are available on the market, and each drug produces a different effect

Question 3

DA Role in Pharmacology..

Answer 3

Your role in understanding pharmacology is to become familiar with the drugs used in dentistry, the drugs your patients are taking for a specific medical condition, the terminology and use of prescriptions, and the drug reference materials available.

Question 4

The most probable situations in which the dental assistant will be required to identify drug types include the following:

Answer 4

1. When reviewing a patient’s medical history
2. hen assisting in a dental procedure that requires premedication
3. When assisting in a specific dental procedure for which pain control is required
4. when assisiting in a medical emergency

Question 5

Drugs can be identified three ways:

Answer 5

1. Chemical name: The anatomic or molecular structure of the drug
2. Generic Name: The shorthand version of the drug’s chemical name, structure, or formual; a name that any business firm may use
3. Brand name or trade name: controlled by a pharmaceutical company as a registered trademark (ie. Advil, Motrin, Nuprin - brand names of generic ibuprofen)

Question 6

Example of Chemical Name, Generic Name & Brand Name/Trade Name

Answer 6

Chemical Name: 2-(4-isobutylphenyl) propionic acid

Generic Name: Ibuprofen

Brand name: Advil, Motrin

Question 7

Classification of Drugs

Answer 7

Patent medicines
Prescription Drugs

Question 8

Patent Medicines

Answer 8

No prescription needed
-also referred to as over the counter (OTC) drugs

Question 9

Prescription Drugs

Answer 9

Licensed medicines, regulated by legislation, and require prescription.

1. Also referred to as ethical drugs
2. Non-controlled
3. Controlled

Question 10

Common Adverse Effects of Medications

Answer 10

1. Hyperexcitability
2. Insomnia (Sleeplessness)
3. Gastrointestinal
   disturbances (Stomach)
4. Central nervous system
   effects
5. Hypotension and fainting
6. Weight/Appetite changes
7. Skin changes/ edema8. Sexual dysfunction
8. Opportunistic infections (Yeast, fungal)
9. Xerostomia (Dry mouth)

Question 11

Drug Complications

Answer 11

1. Allergic Reaction - a drug triggers the immune response, reactions can range from a common rash to life-threatening anaphylactic shock
2. Drug Toxicity - Toxin-induced cell damage and cell death
3. Drug interaction - When multiple drugs are introduced to the body system
4. Drug Tolerance - Loss of effectiveness of drug over time
5. Drug Addiction - Phyisical dependence on a drug

Question 12

Opioids are a class of drugs that include:

Answer 12

1. Heroin
2. Fentanyl
3. Pain relievers like oxycodone, acetaminophen and hydrocodone combination (Vicodin), codeine, morphine, and many others..

Question 13

Opioid Addictions - Recommendations by ADA

Answer 13

1. Consider using non-narcotic pain relievers as first line of treatment
2. When an opioid pain reliever is indicated, consider prescribing fewer pills
3. Counsel patients about benefits and drawbacks of using opioid analgesics
4. Learn to recognize when a patient might have a substance abuse use disorder or be prone to addiction

Question 14

In Alberta, the following acts govern the use and handling of drugs:

Answer 14

1. Alberta’s Pharmacy and Drug Act
2. Canada’s Food and Drug Act
3. Canada’s Controlled Drugs and Substances Act

Question 15

Canada’s Food & Drug Act - What is the purpose of this regulation?

Answer 15

Help to protect the health and safety of Canadians with respect to the sale of food and drug products

Question 16

Canada’s Food and Drug Act - What are the key elements of this regulation?

Answer 16

Set out requirements for the manufacture, packaging, labelling, storage, importation, distribution and sale of foods, and prescription and non-prescription drugs in Canada. Requirements for drug clinical trials are also set out in the regulations.

Question 17

Schedule 1 Drugs - How to access? Type?

Answer 17

Access - Can be sold with a PRESCRIPTION only

Type - Tylenol 3, Penicillin, Lipitor

Question 18

Schedule 2 Drugs - How to access? Type?

Answer 18

Access - They do not require a prescription but they do require professional intervention with a qualified healthcare professional (BEHIND THE COUNTER)

Types:
1. Gravol
2. Iron > 30mg
3. Tylenol #1

Question 19

Schedule 3 Drugs - How to access? Type?

Answer 19

Access: Suitable for self-selection but may pose risks for certain groups of people and should be sold where a qualified health care professional is available to provide advice when required.

Types:
- Plan b
-Yeast infection products

Question 20

Unscheduled Drugs - How to access? Type?

Answer 20

Access: Can be sold without professional supervision

Types:
-Advil, Tylenol, Aspirin

Question 21

Examples of controlled substances and precursors include substances explicitly listed in the Controlled Drugs and Substances Act (CDSA) such as:

Answer 21

1. Cocaine
2. Fentanyl
3. Morphine
4. Methamphetamine
5. Ephedrine

Question 22

Drug Reference Materials

Answer 22

Printed drug references such as the Physicians’ Desk Reference (PDR) or Mosby’s Dental Drug Reference are comprehensive

◦ Physicians’ Desk Reference
 Updated source of information supplied by drug companies about their products
 Available as a bound text and electronically

◦ Mosby’s Dental Drug Reference
 Dental-specific source

Question 23

Package Inserts

Answer 23

Information sheet that describes the drug

Specific information includes the following:
1. How the drug will affect the body - what the purpose is
2. For what condition the drug is being prescribed
3. Any adverse effects (e.g., drowsiness) - short term side effects
4. Any adverse long-term effects -
5. Special precautions to follow when taking the drug - ie. sensitivity to sun
6. Contraindications to taking the drug - what you shouldn’t be taking with this drug
7. Dosage and route for the drug - how much you’re taking, how you are taking it

Question 24

Drug Dosage

Answer 24

A dose is the amount of a drug that a patient takes

Question 25

Specific factors in determining the dosage are

Answer 25

1. Age of the patient, with it affecting the newborn and aged the most 2. Weight of the patient has a direct relation to the effect of the medication 3. The time of day the drug is to be taken is important because the body's rhythm plays an important part in the effects of some drugs 4. Patient tolerance to the drug

Question 26

Administration of Medications - Forms of Drugs

Answer 26

1. Pills 2. Capsules 3. Liquids, drops 4. Ointments - rubbed into skin 5. Sprays - for skin, or under tounge 6. Gases 7. Lotions The way a drug is administered determines how quickly it takes effect

Question 27

Local-action drug...

Answer 27

applied directly to site of use

Question 28

Systemic action drug..

Answer 28

can affect the whole body by way of the circulatory system - swallow or by IV

Question 29

Stages of Drug Action in the Body

Answer 29

Absorption: Drug is absorbed from the site of entry Distribution: The chemical compound of a drug attaches to protiens within the blood and is circulated throughout the body to be released and take effect where it was meant to act Metabolism: Once the chemical compound is released, the drug becomes metabolized and is then excreted through the liver or kidneys Excretion: The drug leaves the body by way of kidneys, liver, saliva, breast milk, and sweat

Question 30

Drugs Commonly Prescribed in Dentistry

Answer 30

1. Analgesics - pain relievers -non-opiod -opiod 2. Antibiotics - for bacterial infection 3. Antifungal agents - fpr oral thrush, yeast infection 4. Antiviral agents 5. Antianxiety agents Many patients who will be seen in the dental office will be taking prescription and/or over-the-counter drugs prescribed by their personal doctor because of a medical disease It is important to have background knowledge of the drugs that your patients are taking and how they affect your patient’s total health as well as how they could interfere with their dental care

Question 31

Drugs Commonly Prescribed in Medicine

Answer 31

1. Cardiovascular drugs statins, diuretics, anticoagulants (for blood clots - stops blood from clotting), antiplatelets, beta-blockers, vasodilators, calcium channel blockers, ACE inhibitors 2. Respiratory drugs anti-inflammatories, bronchodilators (inhaler for asthma) 3. Gastrointestinal drugs acid reflux, anti-diarrheal, ulcerative colitis/crohn drugs 4. Neurologic drugs anticonvulsant, antimyasthenic, antiparkinsonism, antispastic 5. Psychoactive drugs antianxiety, antidepressant, antimanic/bipolar, antipsychotic 6. Endocrine/hormonal drugs thyroxin

Question 32

Prescriptions

Answer 32

A written order provided by a physician or dentist for the preparation and administration of a medicine by the pharmacist - Only a professional who is legally authorized to prescribe medications may write a prescription - A professional who is authorized to prescribe medications is issued a federal DEA identification number

Question 33

Prescription Terminology

Answer 33

Rx: Derived frrom the Latin word "recipe" meaning "take" Inscription: The drug name, strength, and dose Superscription: Prescriber's information for identifictation Signature: Information to be on the label such as the patient's use instructions DEA #: The Federal Drug Enforcement Agency requires all practicitioners who prescribe controlled substances to register. The practictioner's DEA number must be included in the prescription.

Question 34

Prescription Safeguards

Answer 34

-Keep prescription pads locked -Write prescription so they cannot be altered -Keep duplicates in patient chart -Dentist should never presign a prescription -Date all prescriptions

Question 35

Storage

Answer 35

1. Read the Material Safety Data Sheet (MSDS) or product information sheets that accompanies the drug 2. Comply with legislation surrounding drug stroage 3. Adhere to practice protocols that monitor for expired and recalled drugs 4. Follow legislation for drug disposal 5. Ensure all products are labeled accurately