Principles of Pharmacology Chapter 30 Principles of Pharmacology

Pharmacology The science or branch of medicine that conducts research and development in the use and effects of drugs

Drug A substance used in the prevention, diagnosis, or treatment of a disease. All drugs must be recognized and defined by the US Food, Drug and Cosmetic Act before they can be marketed to the public in the US

A drug is identified by three names Chemical name: which is the chemical formula of a drug Generic name: which may be used by any company; acetaminophen is an example of a generic name Brand name, or trade name: which is controlled by business firm as a registered trademark; such as Tylenol is brand name for acetaminophen

Dispensing Patent medicines: drugs that can be obtained without a prescription; also known as over-the-counter drugs Ethical drugs: Prescription drugs (from a physician or dentist), supplied to patients only by a pharmacist.

Prescriptions A written order by a physician or dentist for preparation and administration of a medicine Persons legally authorized to prescribe medications are issued a Federal Drug Enforcement Agency (DEA) identification number. Dental assistants cannot prescribe medications

Terminology of Prescriptions Superscription: patient name, address, the date and symbol Rx Inscription: name and quantity of the drug Subscription: directions for mixing the medication Signature: instructions for the patient on how to take the medication, when and how much

Telephone Guidelines Narcotics cannot be ordered without a written prescription It is illegal for a Dental assistant to “call in” a prescription Notify the dentist if the Pharmacist calls the office Never attempt to evaluate a patient’s reaction to a drug.

Mosby’s Drug Consult Annual source of information supplied by drug companies It is a bound text, as well as a electronic source

Drugs Local-acting drug Systemic drug Affects only the specific area of the body to which it is applied, such as a topical ointment Systemic drug Taken internally Can affect the whole body by way of circulatory system

Administration Four stages Absorption Distribution Metabolism Absorbed from site of entry—speed varies, slowest is orally Distribution Enters bloodstream, attaches to proteins within blood, and circulates throughout the body Metabolism Compound is released, and drug becomes metabolized and is then excreted through liver or kidneys Excretion Drug leaves the body by way of kidneys, liver, breast milk or sweat

Routes Oral—tablets, liquid Topical—apply on surface of mucosa Transdermal –patch that continuously releases medication Inhalation—breathing in substance Sublingual—medication placed under the tongue

Controlled Substances Act Drugs that are covered under the Federal Comprehensive Drug Abuse Prevention and Control Act are divided into five schedules

Schedules Schedule I Schedule II Schedule III Schedule IV Schedule V No current accepted medical use/high potential for abuse Schedule II High potential for abuse, some medical usefulness Schedule III Less abuse potential than Schedule I and II, and has accepted medical usefulnes Schedule IV Low abuse potential and have accepted medical usefulness Schedule V Lowest abuse potential and accepted medical usefulness/no prescription needed

Chapter 37 Anesthesia and Pain Control

Topical Anesthesia Provides numbing effect in an area where in injection is to take place Ointments, liquids, sprays or patches

Local Anesthesia Most frequently used form of pain control in dentistry Obtained by injecting an anesthetic solution near a nerve where treatment is to take place Each local anesthetic cartridge contains Local anesthetic drug Sodium choloride Distilled water

Uses of Vasoconstrictors Slows down the intake of an anesthetic agent and increases the duration of action Prolongs the effect of the anesthetic agent by decreasing the blood flow in immediate area of the injection Decreases bleeding in the injected area

Contraindications to Vasoconstrictors May cause strain on the heart Not recommended for patients with a history of: Angina Chest pain (heart related) Recent myocardial infarction Coronary artery bypass surgery Untreated or severe hypertension Congestive heart failure

Duration of Anesthetics Know the duration (in minutes) of each of the following Short-acting local anesthetic Intermediate-acting local anesthetic Long-acting local anesthetic

Injection Techniques Infiltration Anesthesia Block Anesthesia Usually used for Maxillary arch Also used for secondary injection to block gingival tissues surrounding mandibular teeth Block Anesthesia Usually used for mandibular arch Block nerves for the quadrant

Syringe Know the parts of the syringe and their functions

Cartridges/Disposable Needle Know the color-coding system Know the parts of the cartridge Know the parts of the needle Know the size of the needle for dentistry Lumen—the hollow center of the needle-how the anesthetic flows through needle The larger the gauge number—thinner the needle The smaller the gauge number—thicker the needle

Complications and Precautions Know in detail Injection into a blood vessel Infected areas Toxic reactions Systemic reactions Temporary numbness paresthesia

Inhalation sedation Know the chemical make-up Advantages of Nitrous Oxide Use Contraindications of Nitrous Oxide Use Equipment

Intravenous sedation General Anesthesia Understand the uses of IV sedation General Anesthesia Know definition Know in detail the four stages of anesthesia

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