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Applied Pharmacology Donald A. Falace, D.M.D. Oral Diagnosis and Oral Medicine Presented by Dr. Lynn Theiss Drug History • What drugs, pills, medications is the patient taking, or supposed to be taking? – – – – Patient provided info Look at med labels Call patient at home Call pharmacist • For what purpose are the drugs being taken? • Are these drugs consistent with medical history? Pitfalls • Patients may only tell you about drugs they think you need to know about as a dentist (“What does that have to do with my teeth?) • Patients won’t remember what drugs they are taking • Patients won’t remember why they are taking a drug • Patients will forget to tell you about a drug that they take infrequently (e.g nitroglycerine) • Patients will provide you with a phonetic spelling or pronunciation of the drug (e.g. “Sele-Brix” for Celebrex) Drug Nomenclature • Generic Name – The official name of the chemical compound; public domain – Example: diazepam, fluoxetine, ciprofloxacin – Get used to using the generic name, rather than the brand name • Brand or Trade Name – The commercial name under which the drug is marketed by the manufacturer; copyrighted – Example: Valium, Prozac, Cipro – May be different brand names for the same generic product Prescription Drug Work Sheet • Separate form filled out for each prescription drug the patient is taking • Type/category of drug • Purpose of drug • Mechanism of action • Drug interactions – – – – Epinephrine Analgesics Antimicrobials Sedatives • Oral manifestations • Side effects Sources of Drug Information • Drug Information Handbook for Dentistry • Mosby’s Dental Drug Reference • Physician’s Desk Reference (“PDR”) – OTC drugs – Nutritional supplements – Herbal medications • Drug Information for the Health Care Provider (“the Bible”) • Websites (online or downloaded to PDA) – ePocrates – Micromedex • Pharmacology and Therapeutics for Dentistry Drug Information Handbook Series (Lexicomp) • Portable, convenient size • Relatively inexpensive (~ $38) • Alphabetical listing of drugs, both generic and brand name • Therapeutic index • Numerous helpful appendicies Mosby’s Dental Drug Reference • Portable, convenient size • Relatively inexpensive(~$39); convenient • Alphabetical listing of drugs, both generic and brand name Physician’s Desk Reference (PDR) • Very accessible, easily obtained • Moderately priced (~$85) • Drug companies pay to have their products included • Package inserts • Pictorial section • Therapeutic index Drug Information for the Health Care Professional (USP DI) • Published by the USP organization • Exhaustive, authoritative • Expert advisory panel; distributed for review and comment • Expensive (~$165) • Wealth of information • “The Bible” Web-Based Data Bases • ePocrates.com ; downloadable to PDA (Free - $50) • Clinical Pharmacology 2000 ~$130; Free at UKMC; (http://cpip.gsm.com) Drug References Exercises • Searching by brand name is most common • Will be referred to information on the generic formulation • Format differs with each reference source Inderal (Propanolol) • • • • Type/category of drug Purpose of drug Mechanism of action Drug interactions – – – – Epinephrine Analgesics Antimicrobials Sedatives • Oral manifestations • Side effects PDR- Inderal Index Pictorial PDR; Text Drug Information-Inderal Index Brand Name Citation Drug Information; Text Drug Work Sheet: Inderal Rheumatrex (Methotrexate) • • • • Type/category of drug Purpose of drug Mechanism of action Drug interactions – – – – Epinephrine Analgesics Antimicrobials Sedatives • Oral manifestations • Side effects PDR-Rheumatrex Index Pictorial PDR; Text Drug Information-Rheumatrex Index Brand Name Citation Drug Information; Text Drug Work Sheet: Rheumatrex The End