Dental Hygiene Pharmacology

Most common Rx written by dentist

antibiotic and analgesics

Therapeutic Catagories

antibiotic

analgesics

fluoride

antifungal

corticosteriods

Prescription

An order written by a practitioner of medicine for pharmacy supplies. Pt name with certain drug, specified quanity prepared by practitioners directions.

What drugs can a dental hygienest legally prescribe

None

What are the role of a dental hygienist in Rx writing

document any OTC meds taking

write Rx out per dentist intructions

call in Rx per dentist instructions

B.I.D

2 times a day

T.I.D

3 times a day

Q.I.D

4 times a day

PRN

as needed

Q

every

H.S.

at bedtime

P.O.

by mouth

STAT

immediately

Law devides controlled substances into schedules/classes according to

abuse

requirement to prescribe controlled drugs

DEA #

Schedule I

LSD, heroin, cocaine- can not be prescribed

Schedule II

Demerol, Morphine, Percocet, Percodan, Tylox- Can be called into pharmacy

Schedule III

Tylenol #2, Tylenol #3, Tylenol #4, Lortab, Vicodin- Can be called into pharmacy

Schedule IV

Valium, Halcion, Xanex- Can not be called into pharmacy

Schedule V

Robitussin AC, Can not be called into pharmacy

Legend Drugs

Controlled drug must have DEA#, a monitored drug

Schedule II-V

Legend Drugs

IV Administration

Most effective way to administer drugs

Topical Administration

Least effective way to administer drugs

IV

Intravenus

IM

Intramuscular

Oral, Sublingual, rectal, Intranasal

variable onset, moderate control

Oral, Sublingual, rectal,intranasal

by mouth, under tongue, in nose, up rectum

Topical

Skin

Topical

slow, poor control

IV

fast onset with good control

IM

variable onset poor control

Adverse Effects

less severe effects to medication

Adverse Effects of meds

nausea,vomitting, diarrhea, extension of pharmalogical effects

Toxic effects

More severe

Toxic effects

failure due to over medicated

Allergy

Medicine mediated by immune system

Allergic Hypersensitivity

Anaphylaxis reaction- immediate, generalized, life threatening to drug exposure

Most common drugs people are allergic to

Penicillian

Sulpha

Aspirin

Local Anesthetic

ASAS

Aspirin

TX for allergic hypersensitivity

Epinephirine

Oxygen

Antihistamines

Basic Life Support

Lidocaine dose for 70 Kg Male

300 Mg

Mepivicaine dose for 70 Kg Male

300 Mg

Bupivicaine dose for 70 Kg Male

90 Mg

Max dose of vasopressor allowable for 70 Kg Male-2% Xylocaine

8-9 Carpules

1:100,000 epi

36 Mg of Xylocaine and 0.018 Mg of epi

Vasoconstrictor in local anesthetic

cuts off flow of potassium and sodium to stay localized

Bactericidal agents

Penicillian, Ampicillian, Amoxicillian,Clindamycin High dose

Cacteriostatic

Tetracycline, Erythromycin, Clindamycin low dose

Immunocompromised patients may be at risk for

fungal overgrowth

Fungal overgrowth may be due to

Oral antibiotics given to patient that may be immunocompromised

TX fungal overgrowth in immunocompromised pts with

Nystatin

Narrow range of drugs act against which organisms

Gram positive and gram negative

Broad range of drugs act against which organisms

wide variety including gram postitive and gram negative

Acquired Resistance

When previous organism previously sensitive is no longer sensitive

Drug of choice to treat ANUG

Metronidazole

Drug of choice to treat abcess

Pen VK

Drug of choice to treat juvenile periodontitis

Tetracycline

Drug of choice to treat adult periodontitis

Tetracyline

Drug used to treat or prevent infection for: soft tissue abcess, cellulitis, post surgical periocontitis

Pen Vk

Drugs used to treat Osteomyelitis

Pen VK

If you have an aerobic mixed infection insenstitive to penicillin you treat it with

Amoxicillian

If you have an anaerobic mixed infection insensitive to penicillin you treat it with

Clindamycin

Adult prophylaxis premedication

Amoxicillian 2 grams 1 hour prior to dental appt.or 2 hours post op with liquid

Adult prophylaxis premedication allergy to PCN

Ampicillin 2 grams 1 hour prior to dental appt. or 2 hours post op with liquid

Drug interaction between antibiotic and birth control pills

decreased effectiveness

Drug interaction between antibiotic and warfarin/coumadin

antibiotic changes bacterial GI Flora which is required to provide Vitamin K to host pt.

May have intensified warfarin/coumadin reaction

General Anesthesia

Controlled state of unconsciousness produced by pharmalogical methods partial or complete loss of protective reflexes, including inability to independently maintain airway

Deep sedation

Controlled state of depressed consciousness produced by pharmalogical and non pharmalogical methods. Partial loss of protective reflexes, inability to respond purposefully to verbal command and inability to maintain airway

General Anesthesia vs. Deep Sedation

DS depressed consciousness GA unconsciousness.

DS produced by pharmalogical and non-pharmalogical methods. GA produced by pharmalogical methods only.

General Anesthesia vs. Deep Sedation

GA partial or complete loss of reflexes & inability to maintain airway. DS partial and inability to respond purposefully to verbal command or maintain airway

IV Sedation

Immediate onset

IV Sedation

monitor pt with pulse oximetry, auto BP cuff