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Chapter 15 Pharmacology and Pain control. Pharmacology is: • • • • 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 • • • • Names Assigned by the manufacturer aka Trade names Always capitalized registered trademark ® Examples • Tylenol ®, Bayer ®, Advil ® Drug Names Generic names • • • • • 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 ?