Types of Medications, Analgesics

Flashcards about medications and analgesics in dentistry

Analgesics

Drugs that do not address the cause of pain and should only be used when the patient's pain cannot be removed, reduced, or eliminated by appropriate dental treatment.

Analgesic usage

Should be recommended as a 'course of treatment' to maintain drug blood levels above the threshold for effective pain relief.

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Drugs with anti-inflammatory and analgesic properties that act on the arachidonic acid pathway, inhibiting prostaglandin production, effective for acute pain and inflammation.

Prostaglandins

The mediator and modulator of inflammation.

NSAIDs

The side effects of this drug are dependent on total daily intake and duration of dosing and is often the drug of choice for acute dental pain.

Ibuprofen

An example of a non-selective NSAID.

Celecoxib

An example of a COX2 selective NSAID.

Ibuprofen Dose

400 mg orally, every 6-8 hours

Ibuprofen Adverse Effects

Higher dose regimens for long term use of this drug increase risk of gastrointestinal and renal problems.

Paracetamol

Drug with analgesic and antipyretic actions, that is less effective than NSAIDs for acute dental pain, but the drug of choice when NSAIDs are contraindicated.

Paracetamol Dose Range

500-1000mg, every 4-6 hours (daily maximum 4000mg)

Adverse effects of Paracetamol

Include liver disease, increased toxicity if taken with alcohol, and overdose can produce hepatotoxicity, hypoglycaemia, and acute renal tubular necrosis.

Opioids

Mode of action achieved through activation of opioid receptors inhibiting neuronal activity and subsequently pain transmission

Opioids Interactions/Precautions

MAOIs, potentiation of sedative/depressant effects if used in conjunction with other CNS depressants (sedatives, hypnotics, phenothiazines, anesthetics, and alcohol)

Opioids use

Generally used for severe pain.

Pain management

Oxycodone is preferred

The principle of the '3 Ds' for effective pain management

Diagnosis, Dental treatment, and then Drugs

Paracetamol dosage for mild to moderate acute dental pain

1000 mg orally, 4- to 6-hourly (to a maximum of 4 g in 24 hours) for the shortest duration possible.

Ibuprofen dosage for post-treatment pain in children

5 to 10 mg/kg orally, 6- to 8-hourly (to a maximum daily dose of 2400 mg)

Paracetamol dosage for post-treatment pain in children

15 mg/kg orally or rectally, 4- to 6-hourly (to a maximum daily dose of 4 g)