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Chapter 15
Pharmacology and Pain control.
 Pharmacology is:
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•
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the study of all drugs
their properties
how they react with each other
actions of the drugs within the body
Pharmacology
 Drug
• any substance that can change processes
within the body.
 Medicines
• drugs that are used to treat diseases.
 Side effects
• when drugs cause unwanted results.
Pharmacology
 Drug interaction
• when one drug changes the effect of another
drug by increasing or decreasing the intended
result.
• Physicians Desk Reference aka (PDR)
– printed annually
– lists dosages, indications, contraindications.
 Addiction
• a person is physically dependant on a drug.
Pharmacology
 Tolerance
• ability to tolerate the influence of a drug.
• With a high tolerance, more of a drug would be
needed to produce the same effect.
 Psychologically dependent
• emotional need to take a drug
• habit forming
• craving
Pharmacology
 Withdrawal
• occurs when addict stops taking the drug
• symptoms
– nervousness,
– stomach cramps,
– diarrhea,
– shakes,
– depression,
– and even death
Prescriptions
 Drug Enforcement Agency
• aka DEA
– federal agency
– Must have a DEA # to prescribe meds
– monitor prescriptions
– investigate abuse of prescriptions
Prescriptions
 Who can prescribe
•
•
•
•
dentists
physicians / doctors
psychiatrist
some physician assistants
– depends on state laws and medication
• some registered nurses
– depends on state laws and medication
Prescriptions
 Parts of a prescription / RX
• Heading
– Doc’s name, address, phone number
• Superscription
– Name of patient,
– their address
– date written
Prescriptions
• Body (inscription)
– name of drug
– dosage
– number dispensed
– and directions
• Closing
– Doc’s signature
– refills
– Brand name or generic OK
Drug Names
 Brand
•
•
•
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Names
Assigned by the manufacturer
aka Trade names
Always capitalized
registered trademark ®
 Examples
• Tylenol ®, Bayer ®, Advil ®
Drug Names
 Generic names
•
•
•
•
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not capitalized
less expensive than brand names
unprotected, any business can use them
refer to chemical composition of drug
examples:
– acetaminophen, aspirin, ibuprofen
Drugs used in dentistry
 Analgesics
• pain medication
• most are narcotics (habit forming)
• some are non-narcotic
 Antibiotics
• prevent or fight infections
– penicillin, amoxicillin, erythromycin,
– tetracycline (will discolor developing teeth)
Drugs used in dentistry
 Prophylactic Antibiotic
• aka Pre-med
– rheumatic fever
– joint replacement
– heart murmur
– heart valve replacement
• Prevents bacterial endocarditis
– inflammation of the inside layer of the heart
Drugs used in dentistry
 Tranquilizers
• Sedative effect
• relieves anxiety /reduces tension
• Examples
– Nitrous oxide (N2O), Valium
 Atropine
• inhibits flow of saliva for 4-6 hours
Drug Terminology
 Stimulant
• speeds up the bodies activity
– tobacco, caffeine, cocaine, amphetamines
 Depressant
• slows down the bodies process
– alcohol, marijuana
– narcotics are addictive depressants that relieve
pain.
– Morphine, codine, heroin
Drug Terminology
 Sedative
• depresses brain activity
– reduces stress / anxiety
– tranquilizers, barbiturates, nitrous oxide
 Hallucinogen
• see and hear things / images that do not exist.
– LSD, mushrooms, PCP
Schedule of drugs
 Groups drugs according to uses and
potential for abuse.
• Schedule I
– high abuse rate,
– no medical acceptance
– heroin, PCP, LSD
• Schedule II
– High abuse rate,medical acceptance
– morphine, amphetamines, barbiturates,
Schedule of drugs
• Schedule III
– Lower abuse rate, medical acceptance
– stimulants, depressants, Tylenol III
• Schedule IV
– low abuse rate, medical acceptance
– anti-anxiety, sedatives
• Schedule V (OTC)
– very low abuse rate
– anti-diarrhea, cough medication, eye drops
Routes of administration
 How to get drugs in or ‘on board’ the body.
• Orally / by mouth
– tablets, pills, liquids
• Topical / applied to skin or mucosa
– ointment, gel, cream
• Sublingual / under the tongue
– Nitroglycerin pill or spray, vitamins
Routes of administration
• Inhalation / breathing in
– gas (N20), aerosol spray
• Intravenous / inject in vein
– almost immediate drug response
• Intramuscular / inject in muscle
– long lasting
• rectal
– suppositories
Routes of administration
• Subcutaneous
– injected under skin, above the muscle
• Intradermal
– injected under the top layer of skin
• Transdermal
– medication,
– birth control,
– stop smoking patch
– worn for extended periods of time
Closing
 It is very important to always check a
patients medical history at every visit.
 If they are taking medications or drugs,
make sure to inform the dentist.
 If in doubt, ask.
 Any questions ?