Pharma 1

Introduction to Pharmacology

• Definition:
  • Derived from Greek roots: "pharmaco" (drug) + "-logy" (study).
  • Pharmacology is the study of drugs and their interactions with living organisms.

Required Resources

• Textbooks:
  • Applied Pharmacology for the Dental Hygienist by Elena Bablenis Haveles, 12th Edition.
  • Dental Drug Reference.

Chairside Drug References

• American Dental Association Guide to Dental Therapeutics.
• Physicians' Desk Reference.
• Herbal Medicines Reference.
• Clinical implications of drug interactions and dosages relevant in dentistry.

Pregnancy Risk Categories

• Categories A, B, C, D, and X:
  • Classifications by the FDA from least to most risky.
• Breastfeeding:
  • Medications can pass into breast milk, affecting infants.

Eight Fundamental Questions of the Pharmacologic History

1. Why is the client taking medication?
2. What are the adverse effects of this drug?
   • Consider drug toxicity, hypersensitivity, etc.
3. Are there potential drug interactions?
   • Drug interactions can lead to unexpected adverse effects.
4. Is there a dosage problem?
   • Dosage schedules may be inappropriate for children or elderly clients.
5. How is the client managing medications?
   • Compliance must be assessed.
6. Will oral side effects require intervention?
   • Examples: Xerostomia, gingival enlargement.
7. Are symptoms caused by medical conditions or drug side effects?
   • Differentiate between drug-related effects and medical issues.
8. What are the risks of treating this client?
   • Assess for potential risks during treatment.

Example Drug: Carvedilol (Coreg, Dilatrend)

• Drug Class: Alpha and beta-adrenergic blocker.
• Action: Blocks alpha-receptors and beta-receptors to reduce blood pressure.
• Uses: Essential hypertension, heart failure management.
• Interactions:
  • COX-1 inhibitors reduce antihypertensive effect.
  • Sympathomimetics decrease effectiveness of the drug.
• Adverse Effects:
  • Oral: Dry mouth, periodontitis.
  • CNS: Dizziness, headache, fatigue.
  • CVS: Bradycardia, hypotension.

Clinical Implications for Dental Treatment

• Monitoring:
  • Monitor blood pressure and vital signs during appointments.
  • Advise against elective dental treatment if BP is ≥ 180/110.
• Patient Education:
  • Recommend fluoride therapy for dry mouth and frequent plaque control.

Drug Pharmacokinetics

• Absorption: How drugs enter the body.
• Distribution: Movement of drugs to various body compartments.
• Metabolism: Conversion of drugs into forms that can be excreted by the body.
• Excretion: Can occur through kidneys, lungs, or gastrointestinal tract.

Routes of Administration

1. Enteral (oral): Slow onset, needs compliance.
2. Parenteral (injection, IV): Faster onset, used in emergencies.
3. Topical: Rare systemic side effects.
4. Inhalation: Rapid action, popular route for drug misuse.
5. Rectal: Useful if client is vomiting; however, absorption is irregular.

Patient Management in Dental Hygiene

• Managing Side Effects:
  • Monitor and manage oral side effects of medications during dental treatments.
• Documentation:
  • Maintain accurate medical histories, especially regarding medications, to understand potential implications for dental care.

Pharmacological Definitions

• Agonists: Drugs that activate receptors.
• Antagonists: Substances that block receptor actions.
• Efficacy vs. Potency:
  • Efficacy: Maximum effect of a drug.
  • Potency: Amount of drug required to produce an effect.

Summary of Interventions Based on Medications

• Determine drug actions, monitor client responses, adjust care strategies, and provide education on the implications of drug therapy on oral health.