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82 Cards in this Set
- Front
- Back
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What schedule of drug has high abuse potential, with no accepted medical use, and is illegal? |
Schedule 1
ex: heroin and LSD |
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What schedule drug has high abuse potential and only is filled with a written prescription, with no refills? |
Schedule 2
ex: morphine, codeine alone, amphetamines and oxycodine, vicodin |
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What schedule drug has moderate abuse potential, but may be phoned in and refilled 5 times within 6 months? |
Schedule 3
ex: Tylenol #3 |
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What schedule drug is Valium? (Diazepam?) |
Schedule IV |
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oral route and rectal route of drug administration are part of what major route of drug administration? |
Enternal
placed directly into GI tract |
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IV, IM, SQ, intradermal, inhalation, topical, and sublingual are all part of what major route of drug administration? |
Parenternal
bypasses the GI tract |
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What is the safest, least expensive and most convenient route of drug administration? |
Oral route
absorbed in small intestine |
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First-pass effect |
when orally-admininstered drugs initially pas through the hepatic portal circulation (liver) which reduces the amount of effect of drug
drugs with a high first pass effect require a large oral dose compared to if they were administered parenternally |
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What route of drug administration produces the most rapid drug response, and is best for emergencies? |
Intravascular route, IV |
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what route of drug administration provides sustained effect, with common sites of administration being the deltoid or gluteal muscles? |
Intramuscular, IM |
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What route of drug administration are local anesthesia injections and insulin injections considered? |
Subcutaneous
-used to administer protein products |
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What type of injection includes the tuberculin skin test, and is injected into epidermis? |
Intradermal |
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What route provides a rapid delivery across respiratory mucosa? |
Inhalation
ex: asthma inhalers and nitrous oxide/oxygen sedation |
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What type of drug administration is most effective on non-keratinized areas, and is contraindicated on ulcerated, burned, or abraded surfaces? |
Topica |
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What site is the most important for absorption of oral drugs? |
Small intestine |
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What does ADME stand for? |
Absorption, Distribution, Metabolism, Elimination |
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Term for the casual relationship between the drug use of a mother and congenital abnormalitis> |
Teratogenic effect |
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Term for when the effect of one drug is altered by another drug |
Drug Interaction |
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Adrenergic drugs |
effects mimic sympathetic nervous system
"fight or flight" Ventolin (albuterol,) epinephrine for anaphylactic reaction or local anesthesia, dopamine to treat shock and parkinsons |
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Adrenergic drugs should be avoided in people with: |
angina, uncontrolled hypertension, uncontrolled hyperthyroidism |
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What is the most important site for metabolism of drugs? |
Liver |
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What the most important organ for elimination of drugs? |
Kidneys
elimination terminates drug effects |
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Example drugs of Adrenergic Blocking Drugs
aka beta blockers! |
Inderal (propanolol) Tenormin (atenolol) Lopressor (metoprolol) Timoptic (timolol)-glaucoma |
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What type of drugs MIMIC the parasympathetic nervous system? |
cholinergic drugs
Examples: Pilocarpine used to increase saliva flow or to treat glaucoma
Contraindicated: pt's with asthma, ulcers, and cardiac disease |
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What type of drugs BLOCK the parasympathetic nervous system? |
Anticholinergic drugs |
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Anticholinergic drug examples: |
Atropine used to decrease saliva flow for dental procedures Scopolamie to treat motion sickness Dramamine to treat motion sickness
can cause dry mouth, constipation, blurred vision |
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Effects of using Aspirin |
Nonopoid
Analgesic, Antipyretic Anti-inflammatory Anti-Platelet (blood thinning
works by inhibition of prostaglandin synthesis |
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Adverse effects of Aspirin |
contraindicated with Coumadin or Warfarin, in people with gastric ulcers, and astham patients |
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Acetaminphen effects: |
nonopoid
antipyretic
NOT anti inflammatory |
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What is the drug of choice for children and for post-operative pain following periodontal treatment? |
Acetaminophen |
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Effects of Ibuprofen |
NSAID, Nonopoid
Analgesic antipyretic Anti-inflammatory |
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Adverse effects of Ibuprofen |
Interferes with clotting GI irritation
contraindicated in patients with gastric uncers
can decrease the effect of many drugs including ACE inhibitors, aspirin, beta blockers, steroids, loop diuretics, and lithium |
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Effects of Narcotics/Opioid Drugs |
Analgesic Antitussive (cough suppressant) Sedation Euphoria
can cause respiratory depression! |
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Morphine, Codeine (used in combo with acetaminophen in dentistry, demerol, dilaudid, and vicodin are examples of what type of drugs? |
Narcotics/Opioid Drugs |
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What drug is an opioid antagonist that reverses the effects of opiod drugs? |
Narcan (naloxone)
found in dental emergency kits |
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What drug is used to treat narcotic dependence and withdrawal, that suppresses the need for narcotics for 1 hour? |
Methadone |
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What is the term for "the range of activity of a drug" whether narrow or broad? |
Spectrum |
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Term for when a combination of two antibiotics produce LESS effect than either agent alone? |
Antagonism |
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What is the most commonly prescribed antibiotic in dentistry? |
Penicillin
Bactericidal- Kills bacteria |
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What is the most likely antibiotic to produce an allergic reaction? |
Penicillin allergic reaction most commonly a rash
safe for pregnant females |
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Macrolide antibiotics |
Bacteriostatic drugs- inhibits the growth or multiplication of bacteria, doesnt kill them
may be used for premed in dentistry
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amoxicillin, ampicillin, and augmentin are examples of what family of antibiotics? |
Penicillin Family |
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Erythromycin, azithromycin (zithromax) and clarithromycin (Biaxin) are examples of what family of antibiotics? |
Macrolide antibiotics |
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What antibiotic is used to treat penicillin resistant periodontal infections such as NUG, and should not be taken during pregnancy/early child hood due to tooth discoloration? |
Tetracyclines
tetracycline concentrates in gingival crevicular fluid |
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Cephalexin (Keflex) Cefaclor (Ceclor) and Cefuroxime (Ceftin) are all examples of what type of antibiotics? |
Cephalosporins
cross-allergenicity with penicillin in 10% of patients w. allergy pen |
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Antibiotics used to treat tuberculosis (4) |
1. Rifampin 2. Isoniazid 3. Pyrazinamid 4. Ethambutol RIPE-all 4 used to treat active TB
Rifampin and isoniazid only is usually used to prevent TB
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What is the first alternative for premedication if patient is allergic to amoxicillin? |
Clindamycin 600mg 1 hr prior to appt for premed
rare adverse reaction called pseudomembranous colitis |
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What is Metronidazone (Flagyl) used for? |
to treat anaerobic infections Treatmetn of periodontal infections and ANUG
dont use alcohol with metronidazole (anabuse effect) |
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Conditions Requiring Premed |
Artificial heart valves History of infective endocarditis Specific congenital heart defects unrepaired cyanotic heart disease heart defect repaired with prosthetic device Cardiac transplant with heart problems Renal dialysis shunt Ventriculoatrial hyrocephalic shunt (NOT stent!) |
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MAY require pre-med-- consult with orthopedic surgeon or physician |
Joint replacement less than 2 years ago Previous prosthetic joint infection Multiple joint replacements Immunocompromised patients (IV drug abusers, uncontrolled diabetes, patients with AIDS)
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Pre-Med regimens |
Amoxcillin 2000mg (2g) one hour prior to procedure
Clindamycin 600 mg 1 hour prior to procedure |
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Acyclovir (Zovirax) Penciclovir (Denavir) and Valacyclovir (Valtrex) are medications that can be used to treat what viral infection? |
Oral herpes |
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Zidovudine, (Retrovir, AZT) Didanosine, (Videx, ddI) and Zalcitabine (ddC) are medications that can be used to treat what disease? |
HIV/AIDS
drugs effect bleeding gingiva and oral ulcers |
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Regimen for use of Nystatin for candidiasis |
5 ml QID (4 times per day) for 2 weeks
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What is the best way to reduce the risk of system toxicity with local anesthetic injections? |
Aspiration |
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Nerves affected with local anesthetic in order: |
1. autonomic 2. temperature 3. pain 4. touch/pressure 5. Vibration 6. Motor (last)
function regained in reverse order |
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Where are amides metabolized? |
in Liver |
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Where are esters metabolized? |
In blood plasma
relatively high allergy potential |
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Lidocaine maximum recommended dose (MRD) |
3mg/pound, up to a maximum of 500mg |
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Duration of local anesthetic agents in order from longest duration to shortest: |
1. Bupivicaine (marcaine)-longest 2. Articaine (septocaine) 3. lidocaine (xylocaine) 4. prilocaine (citanest) 5. Mepivicaine (carbocaine) |
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Antianxiety drugs used in dentistry which include diazepam (valium) lorazepam (ativan) and alprazolam (xanax) are part of what group of drugs? |
Benzodiazepines |
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Contraindications for nitrous oxide use: |
COPD Upper respiratory tract infection or stuffy nose Pregnancy (especially first trimester) Emotional or behavior instability Communication barriers Abuse potential |
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Prozac (fluoxetine) and Zoloft (sertraline) are examples of what class of antidepressents? |
Serotonin Reuptake Inhibitors (SRIs)
cause cause CNS stimulation and xerostomia |
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What NSAID is contraindicated in a patient taking Lithium to treat a bipolar disorder? |
Motrin |
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Anti convulsant med that causes gingival hyperplasia in 50% of patients |
Dilantin (Phenytoin) |
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Phenobarbital |
used to treat epilepsy
Carbamazepine (Tegretol)- used to treat partial seizures, may also be used to treat trigeminal neuralgia in dentistry |
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What is the most common side effect to Insulin administration in diabetics? |
Hypoglycemia |
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Oral Hypoglycemic drugs |
Metformin (glucophage) Glyburide (Micronase, Diabeta) |
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What analgesic should be avoided in asthma patients? |
Aspirin (20% of asthmatics are allergic to aspirin) |
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Asthma Medications |
Ventolin (albuterol)-adrenergic drug, bronchodilator (opens air passages) inhaler
Corticosteroids- flovent, azmacort, pulmicort -not used for immediate relief |
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3 types of drugs that cause gingival hyperplasia? |
1. dilantin (phenytoin) 2. procardia (nifedipine) and other CCBs 3. Cyclosporin |
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3 drugs that cause gingival bleeding? |
1. Coumadin (warfarin) 2. Plavix (clopidogrel) 3. Aspirin |
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3 main drugs to cause Xerostomia? |
1. Diuretics to treat hypertension 2. Calcium channel blockers to treat hypertension 3. antihistamines |
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Digitalis and Lanoxin (digoxin) are medications to treat what type of heart condition? |
Congestive heart failure |
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Antihyperlipidemic drugs are used to treat? |
High cholesterol
"statins" atorvastatin, lovastatinm simvastatin, rosuvastatin |
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4 families of drugs to treat hypertension? |
1. diuretics 2. beta adrengergic blocking agents 3. calcium channel blockers 4. ACE inhibitors |
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Diuretics: |
thiazide diuretics include hydrochlorothiazide
loop diuretics include Lasix (furosemide)
xerostomia and orthostatic hypotension side effects |
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Beta-adrenergic blockers |
-olol
decreases cardiac output propanolol, atenolol, metoprolol |
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Calcium Channel Blockers |
causes systemic vasodilation to reduce BP **side effects gingival enlargement & xerostomia
Nefedipine (procardia, adalat) Verapamil (calan, isoptin) Amoldipine (Norvasc) Diltiazem (cardizem) |
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ACE Inhibitors |
-PRIL medications block production of angiotension II, causing vasodilation
Enalapril (vasotec) Lisinopril ( zestril, prinivil) |
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Metronidazole hydrochloride |
antibiotic-can be used for GI disorders Side effect: **Disulfiram-like reaction to alcohol (bad taste) |
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EpiPen dosage |
.3 mg |
