1. Dan Lindenmeyer, RPh Pharmacy Mgr. - Dillons

2.  6 main categories ◦ Hypertension ◦ Antidepressants ◦ Pain meds ◦ Cholesterol Reducers ◦ Antibiotics ◦ Antacids-Acid Reducers

3.  Company has exclusive rights to market drug for 17 years after a patent has been approved ◦ Most of the time patents are obtained while trials are being run ◦ By the time drug hits the market only 8 to 10 years are left on patent  AB rated generics must be therapeutically equal ◦ The med must dissolve in the body at the same rate and produce equivalent levels

4.  Cardiology  Hypertension  Cholesterol reducers  Antibiotics  Diabetes  Weight Loss  Depression and Alzheimer’s  Acid Reducers-antacids  Herbal Supplements

5.  Strong Narcotics ◦ Percocet, Oxycontin, Percodan, Demerol  Mid-Level Narcotics ◦ Lortab, Lorcet  Non-Narcotic Controlled ◦ Darvocet

6.  NSAIDS ◦ Ibuprofen, naproxen, diclofenac, etodolac, indomethacin, tramadol  COX-II Inhibitors ◦ Celebrex ◦ Mobic

7.  Anti-arrhythmics  Calcium Channel Blockers  Ace Inhibitors  Angiotensin receptor blockers  Beta blockers  Diuretics

8. Lanoxin---Antiarrhythmic Pacerone—Antiarrhythmic Mexilitine—Antiarrhythmic Nitroglycerin—angina agent

9.  Pressure on arterial walls ◦ Blood pressure meds work by blocking receptors in arterial wall and relaxing the artery ◦ Diuretics remove fluids to decrease fluid volume of the body to lower blood pressure.

10.  Beta blockers ◦ Atenolol, metoprolol, propranolol  ACE Inhibitors ◦ Lisinopril, enalapril, benazapril  Calcium channel blockers ◦ Amlodipine, diltiazem  Angiotensin receptor blockers ◦ Cozaar, Hyzaar, Micardis  Diuretics ◦ Furosemide, triamterene/HCTZ, hydrochlorothiazide

11.  Previously d/c blood thinners 10 days before dental extraction or scaling and root planing  Rebound effect after antiplatelet interruption can result in stroke or MI  Minor surgical procedures can be carried out safely without altering antiplatelet therapy ◦ Simple extractions <3 teeth  Additional visits for more than 3 teeth ◦ Gingival surgery ◦ Crowns and bridges ◦ Scaling and surgical removal of teeth

12.  Beta lactam antibiotics ◦ Penicillins ◦ Cephalosporins  Macrolide ◦ Erythromycins ◦ Zithromax  Quinolones ◦ Levaquin ◦ Ciprofloxacin  Sulfonamides  Tetracyclines

13.  Statins ◦ No Generics  Lipitor  Zetia  Tricor  Vytorin(combo of Zetia and Simvastatin) ◦ Generics  Mevacor-Lovastatin  Zocor-Simvastatin  Pravachol-Pravastatin  Niacin

14.  Injectable Insulins ◦ Humalog--Novolog ◦ Lantus ◦ Humulin—N,R,U,70/30  Increase Insulins effect ◦ Alcohol, anabolic steroids, beta blockers, MAO inhibitors, tetracyclines, salicylates  Decrease Insulins effect ◦ Oral contrceptives, corticosteroids, niacin, smoking, thiazide diuretics, thyroid hormones

15.  Metformin  Glyburide and glipizide  Glimepiride  Avandia  Actos

16.  Phentermine  Xenical---Alli  Natural Supplements

17.  How it works: Chemical in brain called serotonin is at higher cellular levels  Most antidepressants block re-uptake of serotonin to produce their effects  Very common condition

18.  Tricyclic ◦ Amitriptyline, nortryptyline, imipramine  Tetracyclic ◦ Remeron  SSRI ◦ Prozac, Zoloft, Lexapro, Celexa  SSRI & Norepinephrine ◦ Effexor and Cymbalta  MAO-Inhibitors ◦ Parnate, Nardil

19.  H2 antagonists ◦ Zantac ◦ Tagamet Available OTC and Rx ◦ Axid  PPI’s ◦ Prevacid ◦ Protonix ◦ Aciphex ◦ Nexium ◦ Prilosec –only one available as an OTC

20.  Namenda  Aricept

21.  Non-Sedating ◦ Zyrtec ◦ Allegra ◦ Clarinex ◦ Claritin—OTC  OTC ◦ Benadryl ◦ Chlorpheniramine ◦ Clemastine

22.  Not regulated by FDA ◦ No proof of effectiveness ◦ Take at own risk ◦ Products have been proven safe at recommended doses  Very popular alternative to getting prescriptions

23.  Resources: ◦ Drug information handbook for dentistry-7 th Edition ◦ Clinical pharmacology