Download Part 1 Drugs commonly prescribed by the dentist

Drugs & Dentistry I
Drugs commonly prescribed by the dentist
March 2002
1. Antimicrobial Drugs
a. Antibiotics
Drug
Amoxicillin
Indications
-Routine drug of choice in
infection.
-Prophylaxis regimen for
subacute bacterial
endocarditis
Forms
Usual dose
Cap. 250-500 mg Adult:
Sus. 125 mg/5ml 250-500 mg
250 mg/5ml q8h
Child:
20 mg/kg/day
in divided
Trade &price
-Amoxil
250 mg = 27 SR
500 mg = 53 SR
Comments
- 3% of population are
allergic to the drug
-Ultramox
500 mg = 25 SR
-Amoxidar
250 mg = 7 SR
500 mg = 13 SR
doses
-Augmentin
Children  40kg
-Infections caused by beta- Tab. 375-625 mg Adult:
375 mg = 48 SR
625 mg = 81 SR 20-40 mg/kg/day
lactamase producing
1g
375-625 mg
156 mg = 22 SR amoxicillin with 5-10mg
strains.
Sus. 156 mg/5ml q8h
-Amoclan
calvulanic acid in three
-Sever dental infections
228 mg/5ml OR
375 mg =34 SR
Co-Amoxiclav.
divided doses.
q12h -Amoclan forte
with spreading cellulites.
457 mg/5ml 1 g
“amoxicillin
625mg = 44 SR
-Megamox
with
375mg =36 SR
clavulanic acid”
625mg =43 SR
1g =75 SR
-Klavox
375mg = 44 SR
625 mg =76 SR
-Julmentin
375 mg = 40 SR
-Julmentin Forte
625 mg = 68 SR
-Routine second choice
to amoxicillin in infection or
Erythromycin
first choice if amoxicillin is
allergic .
Tab.
Cap.
Syr.
Inj
for tablet
for capsule
for syrup
for injection
Tab. 250-500 mg 250-500 mg
Sus. 200 mg/5ml q6h
200 mg/5ml
q6h
-Erythrocin
-50% of s.auruse is
250mg = 14 SR resistant
500mg = 27 SR -GI intolerance is
Sus. = 19 SR common
-Eromycin
Sus. for suspension
q8h = every 8 hours
By Dr. KHALID AL - JOHANI
KING ABDULAZIZ UNIVERSITY
SCHOOL OF DENTISTRY
Drug
Indications
Forms
Usual dose
Trade &price
Comment
Some pt. is allergic to the
Tab. 250-500 mg 250-500 mg
Clarithromycin -Mild to moderate
infection.
Sus. 125 mg/ 5ml bid
-Prophylaxis regimen for
250 mg/100ml
subacute bacterial endocarditis for pt. allergic to
amoxicillin.
-Klacid
drug.
-Caution when prescribed for
pregnant or lactating women,
hepatic, renal pt.
-It increases effects of
cyclosporine, warfarinn &
decreases the effects of
clindamycin, penicillin
&anticholingergic drugs.
500 mg
-Mild to moderate
infection.
Cap.
-Prophylaxis
regimen
for
Azithromycin
subacute bacterial endocarditis for pt. allergic to
qid
250 mg on day1, then
-Contraindicated if the pt. is
-Zithromax
250 mg qid
on days 2-5
hypersensitive to the drug or
to erythromycin.
-Caution when prescribed for
pregnant or lactating women,
amoxicillin.
hepatic, renal & cardiac pt. or
with elderly & child < 16 y.
-It decrease the effects of
clindamycin & penicillin
-Pt. instructed to take
medication at least an hour
before meal or 2 hours after
the meal.
Tetracycline
Doxycycline
-Second or third choice to
amoxicillin in routine inf. Tab. 250-500 mg
-Anaerobic bacterial
Sus. 125 mg/5ml
infections & periodontitis
associated with presence
of AA (Actinobacillus
actino-mycetemcomitans).
-ANUG
-Periodontitis associated
with presence of AA
(Actinobacillus actinomycetemcomitans).
-ANUG
-Syphilis
Tab.
100 mg
Cap.
100 mg
250-500 mg q6h -Tetracycline -Used in bone graft.
, 1 hour before 250 mg = 13 SR -Cause teeth discolora-
tion, so it is not used in
child  8y & in pregnant
women.
or 2 hours after
meals
-Some patients are
hypersensitive to the drug.
-It cause candidiasis,teeth
100 mg=26 SR
& tongue discoloration &
dry mouth.
100 mg q12h -Doxydar
-Vibramycin
-It is not prescribed for child
 8y &for pregnant women.
Drug
Indications
Forms
Alternative to amoxicillin
Clindamycin in prophylaxis regimen
for subacute bacterial
endocarditis if amoxicillin
is allergic.
Usual dose
Trade &price
Cramps & diarrhea in 20%
Adult
Tab. 150-300 mg 150-450 mg q6h -Dalacin-C
Inj.
300-600
900 mg
Comment
Child
8 -25 mg/kg
of patients after oral
150 mg=21 SR
administration.
300 mg=37 SR
-Contraindicated if pt. is
in 3-4 divided
doses.
hypersensitive to the drug
-Chronic osteomyelitis.
or had developed pseudomembranous colitis.
-Flagyl
250 mg =13SR
500 mg =15SR
-Protozoal & anaerobic
Tab. 250-500 mg 250-500 mg q8h
bacterial infections.
-Nidazol
-Elyzol
Metronidazole -Refractory adult
-Flazol
peridontits.
Combined with penicillin
in serious Odontogenic
infection, especially in
compromised patients.
Cephalexin
Cefuroxime
Alternative to amoxicillin Cap. 250-500 mg Adult:
250-500 mg
in the tretment of
orofacial infections &in Syr. 125 mg/5ml q6h
Child:
the prevention of SAB
6.5-50 mg/kg/
endocarditis except if the
day in 4 doses
pt. had an immediate
anaphylactic allergic
reaction to amoxicillin.
Skin, soft tissue & bone
infections.
complain of neutropenia,
hepatic disease, active
CNS disease, or if the pt.
on warfarin .
-Contraindicated if pt. is
hypersensitive to the drug
or in the first trimester.
-Keflex
10-15% cross reaction
250mg = 29 SR sensitivity in pt. allergic
500mg = 42 SR
to penicillin
-Cefrin
Tab. 125-250 mg Adult:
-Zinnat
10-15% cross reaction
1-2tab
q12h
250 mg =87 SR sensitivity in pt. allergic to
Sus. 125 mg/5ml
Child:
500 mg =95 SR
250 mg/5ml
penicillin
125mg
1.
-Caution when the pt.
q12h
The Antibiotics may decrease the activity of oral contraceptive. So the pt. should be instructed
to use additional method of contraception during the antibiotic course.
2. If the infection not improved within 3days, change the drug and do sensitivity test.
3. Recommended antibiotics during pregnancy : Penicillin & Cephalosporine.
4. Recommended antibiotics for lactating mother : Cephalosporine & Erythromycin.
b. Antifungal
Drug
Indications
Forms
Usual dose
Adult
Miconazole
Trade &price
Daktarin
-Systemic & cutaneous Tab.
fungal infections.
200 mg
200-400 mg
qid
-Nizoral
Children 2 y
3.5-6.6 mg/kg/
day in a single
dose.
Nystatin
Oral gel
Treatment of candidal Tab.
250 mg 600-1800 mg Oral gel =17 SR Apply twice / day up to
infections
Oral gel. 25 mg/ml in 3 divided
1 month.
doses daily for
3-20 weeks
Children 1 y
20-45mg/kg/day
in 3 divided
doses.
Adult:
Ketoconazol
Comment
-Intestinal candidiasis. Suspention 100000
-Skin candidiasis.
inter. unit " iu " for
-Oral candidiasis
oral use.
Adult:
Sus. 400000600000 iu qid
Children 3
months
250000-500000
iu qid
Newborn
100000 iu qid
-Mycostatin
-Nilstat
-Nystan
-Rianest
-Mikostat
-Contraindicated in
patients with previous
hypersensitivity.
-Used cautiously in
patients with impaired
hepatic & or adrenal
reserve.
Contraindicated with pt.
has known
hypersensitivity.
-Oral use can cause
nausea, vomiting and
diarrhea.
- To prevent reinoculation
of candidal infection pt. is
instructed to dispose the
tooth brush or other
contaminated oral hygiene
devices used during
period of infection
c. Antiviral
Drug
Acyclovir
Indications
Forms
Usual dose
Trade &price
Comment
Herpes zoter:
-It is contraindicated in
Tab. 400- 800 mg 800 mg q4h for -Zovirax
patients with known
200 mg=149SR hypersensitivity to the
Cap.
200 mg 7-10
days
400 mg=697SR drug.
Cream
2g
Cream =23 SR
Chickenpox:
-Chickenpox.
-It should be used with
-Clovir
20
mg/kg
qid
-Prevention of
caution in-patient with
for 5 days
recurrence of the viral
renal impairment.
infections.
-It used in the tengling
stage in the management
of HSV before
development of the lesion
“vesicles “
-It could cause glossitis.
-Postpone dental
treatment when oral
herpetic lesions are
present.
-Viral infections of:
-Herpes zoster.
-Herpes simplex.
2. Analgesics
Drug
Indications
Forms
Usual dose
Trade &price
Comment
-Caution with hepatic
disease pt.
-Contraindicated if the pt.
is hypersensitive to
Acetaminophen
acetaminophen or
complain of Glucose 6Phosphate Dehydrogenase
Deficiency.
-Pain
Tab.
200-400 400 mg every -Brufen
It is contraindicated in:
400mg=12 SR -Hypersensitivity
-Fever
600 mg
4-6 hours for
600mg=20 SR -Nasal polyp
-Inflammatory diseases
mild-moderat
Ibuprofen
Ibofen
-Rheumatoid disorders Syrup 100 mg/5ml pain
-Angio-edema
-Profinal
-Gout
-Bronchospastic reactivity
600 mg=13 SR
to aspirin or other
-Sapofen
400 mg=10 SR NSAID’s.
600 mg=10 SR -Caution if the pt. on
anticoagulant.
-Taken after food
Adult:
500mg initially -Ponstan
-Avoid prescribing for
Tab. 500 mg
500 mg=13 SR dental pain in last
then 250 mg
Cap. 250 mg
-Fendol
trimester of pregnancy.
-Mild to moderate pain Syrup 50 mg/5ml every 6 hours
500 mg= 7 SR
with food
-Caution if the pt. on
Mefenamic acid
-Mafepain
children 6
500 mg= 9 SR anticoagulant.
months :
25 mg/kg daily
in divided
doses
-Mild to moderate
pain & fever
Adult
325-500 mg 0.5-l g every
4-6 hours to
Syrup 120 mg/5ml max.4gm daily
125 mg/5ml Children:
Tab.
-Panadol
-Tylenol
-Fevadol
-Dafalgan
1 year: 60-120mg -Panacetamol
1-5y 120-150mg syrup
6-12y 250-500mg -Tempra
-Mild to moderate pain Tab. 25-50-100 mg 150-200mg/
-Pain of rhematoid
Inj. 75 mg/ampoule day in 2-4
arthritis & osteoarthridivided doses.
tis.
Diclofenac Sodium -Gout & Ankylosing
spondylitis
Mild to moderate pain
Paracetamol 500 mg
with Caffeine 30 mg
& Codeine
________
Paracetamol 250 mg -Treatment of
, caffeine 50 mg headache.
&
propyphenazone
150 mg
-Adol
________
-Voltaren
50 mg =38 SR
-Olfen
50 mg =21 SR
-Rofinac
50 mg = 32 SR
-Diclogesic
50 mg = 17 SR
-Vortex
50 mg =10 SR
-Colfen
50 mg = 9 SR
-It can cause dry mouth &
stomatitis.
-Avoid prescribing for
dental pain in last trimester
of pregnancy.
2 tab. Every 4 -Solpadeine -Do not give if the pt. has
= 9 SR allergy to propyphenazone
hours to max.
-Fevadol plus -Not recommended for
8 tab. daily.
= 8 SR pregnant, breast-feeding
women & for children<12
years.
Adult: 1-2 tab
12-16y 1 tab.
Up to 3 doses /
-Saridon
day
________
= 5 SR
3. Miscellaneous
Drug
Indications
-Oral and perioral
lesions
Triamcinolone -Aphthous ulcers.
orabase
Pyralvex
-Treatment of oral
ulcers.
Lignocaine -Pain due to ulcers
Hydrochloride
“lidocaine”
Forms
Usual dose
Orabase: contains 2-4 times daily
triacilmone 0.1%
in adhesive basis
10 ml with brush
3-4 times daily
Jelly 2%
When needed
-Use is limited for 5 days
for children ,and short
=7 SR term for elderly.
-Contraindicated in the
presence of fungal, viral or
bacterial infections.
Norgine
Not recommended for
children under 12 years.
Xylocaine 5%
35 g=11 SR
Spray 80g =29 SR
Tab.
-Zymafluor
1 mg
Comment
Kenalog in
Orabase
Ointment 5%
Spray 80 g
1mg = 18 SR
Prevention of dental
caries & decrease teeth
Sodium fluoride hypersensitivity
_____________
-Adults should be
expectorate after use &
not to eat, drink or rinse
for 30 minutes.
-Child ages 6-16y should be
expectorate after use, rinse
mouth thoroughly to avoid
swallowing fluoride.
-Must ascertain fluoride
conc. In-patient’s drinking
water before prescribing.
-Relief of muscle
spasm.
Tab.
10-25 mg
-Relief of muscle
spasm.
Tab. 250-500 mg
(DSC)
Baclofen
Chlorzoxazone
Trade &price
5 mg tid×3 days
then, 10 mg tid×
3days then,
15 mg tid×3 days
then 20 mg tid×
3days then
triturated to
response, not to
exceed 80 mg/day
Adult
250-750 mg
tid-qid
Child
20 mg/kg/day in
3-4 divided doses.
Lioresal
25 mg =121 SR
Parafon
500 mg=19 SR
-Some pt. has
hypersensitivity to the
medicament.
-It may cause dry mouth
-The medicament has a
sedative effect.
-Combination of the
drug with aspirin or
NSAIDs will improve
the response.
4. Mouthwashes
Mouthwash
Chlorhexidine
Mouth wash
Indications
-Antibacterial mouth
rinse
-Denture stomatitis
-Oral hygiene and
plaque inhibition.
Forms
-Oral rinse 0.2%
Usual dose
Trade &price
Comment
- Contraindicated if pt. has
Corsodyl
Swish 15ml
=12 SR hypersensitivity
undiluted oral
-Pt. instructed not to eat,
rinse around
drink or rinse mouth with
in mouth for
water after use for several
one minute,
hours.
then expectorate
-It my cause taste changes.
-Do not swallow the
medication.
2 times daily
-Perform scaling before starting
rinse.
-It causes staining of teeth &
esthetic restorations.
Hexetidine
-Oral hygine
Mouth wash or
gargle 0.1%
15ml undiluted Oraldene
= 7 SR
2-3times daily
________
-Do not swallow the
medication
Treatment &prevention -Cleanser: skin7.5% 10ml undiluted -Betadine
=15 SR -Avoid contact with eyes.
of microbial infections “30 m1-118 ml” for up 30 sec.
-Contraindicated in pt. with
-Foam 7.5% 170 g up to 4 times -Poviderim
Povidone-lodine
hypersensitivity to iodine .
daily
-Cautions with pregnancy &
breast feeding.
Orasept
Ingredients:
Benzoic acid,
Thymol, Menthol,
Methyl salicylate
& Eucalyptol
Colgate - Plax
Ingredients:
Swish 15 ml
-Prevention &
-Mouthwash 250 ml undiluted oral Orasept
250ml =10 SR
reduction of gingivitis.
rinse around
in mouth for
-General oral hygiene
one minute,
then expectorate
& bad breath.
2 times daily
-Fight plaque
-Fight caries
250-500 ml
-Treatment of halitosis
-Not recommended for
child < 6 years.
250 ml=14 SR
500 ml=22 SR
Triclosan 0.03 %
Sodium fluoride
0.025 %
Sensodyne
15ml undiluted -Classic /red
for one minute -Soft mint /
green
2 times daily
________
-Anti plaque
-Relieves minor mouth 250 ml
irritation
-Not recommended for
15ml undiluted
for 30 seconds 250 ml=16 SR child<6 years.
-Not recommended if the pt.
2 times daily
-Helps in the removal
of tar.
-Fight tobacco odor.
-Fight plaque
-Fight caries
15ml undiluted 400 ml=13 SR child < 6 years.
for 30 seconds
2 times daily
sensitive to cytylpyridinium.
-Used after brushing.
-Not recommended for
Pearl drops
Smokers 1+1
Oral-B
400 ml
Fight plaque & cavities 300 ml
15ml undiluted
for 30 seconds 300 ml=16 SR
2 times daily
-Not recommended for
child < 6 years.
KING ABDULAZIZ UNIVERSITY
SCHOOL OF DENTISTRY
Drugs & Dentistry II
Most common drugs prescribed by the dentist:
Forms
Drug
Capsule
Amoxicillin
250-500 mg
Usual Dose
Trade Names
-Amoxil
Adult:
250-500 mg q8h
-Ultramox
Suspension 125 mg/5ml
Child:
250 mg/5ml 20 mg/kg/day
-Amoxidar
in divided doses
Tablet
Co-Amoxiclav.
“Amoxicillin with
Clavulanic Acid"
375-625 mg Adult: 375-625 mg q8h
or
1g
q12h
1g
Suspension 156 mg/5ml
228 mg/5ml
Acetaminophen
-Amoclan Forte
20-40 mg/kg/day amoxicillin
-Megamox
Capsule
250-500 mg Adult:
Syrup
125 mg/5ml Child:
Tablet
Adult: 0.5-l gm every 4-6
325-500 mg hours to max.4 gm daily
Syrup
Tablet
Syrup
-Klavox
-Julmentin
250-500 mg q6h -Keflex
6.5-50 mg/kg/day -Cefrin
in 4 doses
-Adol
-Panadol
-Tylenol
120 mg/5ml Child:
-Fevadol
60-120 mg/day -Dafalgan
125 mg/5ml 1 year
1 -5 y
120-150 mg/day -Panacetamol syrup
6 -12 y 250-500 mg/day -Tempra
200 – 400 mg 400 mg every 4-6 hours
-Brufen
& 600 mg
Ibuprofen
-Amoclan
Children  40kg
with 5-10 mg calvulanic acid
457 mg/5ml in three divided doses.
Cephalexin
-Augmentin
for mild to moderate pain -Ibofen
100 mg/5ml
-Profinal
-Sapofen
Tablet
Diclofenac
Sodium
25-50-100 mg 150-200 mg/day
Injection 75 mg/ampoule in 2-4 divided doses.
-Voltaren
-Olfen
-Rofinac
-Diclogesic
-Vortex
-Colfen
5.
The Antibiotics may decrease the activity of oral contraceptive pills, so the pt. should be instructed
to use additional method of contraception during the antibiotic course.
6. If the infection not improved within 3days, change the drug and do sensitivity test.
7. Recommended antibiotics during pregnancy: Penicillin & Cephalosporine.
8. Recommended antibiotics for lactating mother : Cephalosporine & Erythromycin.
By Dr. KHALID AL-JOHANI
Drugs & Dentistry III
Common drugs purchased from pharmacies in Jeddah city
Drugs listed here are the ones commonly purchased from pharmacies in Jeddah city. Trade names,
indications and dental considerations, which related to the drug & the disease, are included in an
informative and concise form. For more information you are advised to refer to the product
information insert. (Antimicrobial, analgesics & mouthwashes are included in D & D I )
Cardiovascular System
Drug
Trade Names
Indications
Considerations
Calcium channel blockers
-Adalat-Retard -Prophylaxis &treatment of
Nifedipine
-It cause gingival hyperplasia and dry
-Adalat.
angina.
mouth
-Cardiopine. -Hypertention.
-Raynaud’s disease.
-Atrial fibrillation & flutter. - It cause gingival enlargement, dry
-Arrhythmias.
mouth (rare)&Stevens-Johnson syndrom
-Isoptin .
Verapamil
-Angina &hypertension.
-Calan.
-Congestive heart failure.
-Tachycardia .
-Lanoxin
Treatment of congestive heart
failure,atrial fibrillation & or
Digoxin
flutter and supra-ventricular
- It could cause sensitive gag reflux.
tachycardia.
Diuretiecs
Spironolactone
Centrally acting
antihypertensive
Methyldopa
-Aldactone.
-Spiroctan.
-Noractone.
-Aldomet
-Mild to moderate essential
hypertension.
-Congestive heart failure.
ACE Inhibitors
Captopril
-Primary aldosteronism.
Hypertension, Hypokalaemia
-Edema in liver cirrhosis.
-Nephrotic syndrom.
-Congestive heart failure.
-Hirutism associated with
polycystic ovary syndrom .
-Menstrual irregularities.
-Moderate to sever hypertention.
-Hypertensive crisis.
-Toxemia of pregnancy.
-Capoten
-It may cause dry mouth & lichenoid
drug reaction .
- It could cause dry mouth, bleeding &
lichenoid reaction.
-It causes adrenal suppression &candidal
infection.
-It could cause dry mouth, glossitis,
oral ulceration , Stevens –Johnson
syndrome,bleeding , lichenoid drug
reaction .
By Dr. Khalid Al - Johani
King Abdulaziz University
School of Dentistry
Cardiovascular System
Drug
Indications
Trade Names
Considerations
Antiarrhythmics
Amiodarone
-Cordarone
-Arrhythmia.
-It could cause dry mouth & burning
Glyceryl Trinitrate
Nitroglycerin
- It may cause dry mouth.
NitrodermTTS10 -Treatment and prophylaxis
-Angised
of angina pectoris.
-Glyceryl
-Trinitrate
-CHF associated with acute
sensation.
-Ensure that patient’s drug is easily
available if angina occurs.
MI.
-Nitroderm
-Tridil
Drug
Antiplatelets
Acetylsalicylic acid
Trade Names
-Asprin
-Rivo
-Aspav
-Aspico
Oral anticoagulants
Warfarin Sodium
-Coumadin
Indications
-Fever & minor pain
-Rheumatic arthritis
-Transient Ischemic Attack
-MI risk reduction
-Rheumatic fever
-Prophylaxis of thromboembolism .
-MI & bypass surgery.
-Prophylaxis & treatment of
venous thrombosis &
pulmonary embolism.
-Decrease risk of cerebral
embolism &TIA.
Considerations
-Aspirin inhibits platelet aggregation.
-Produce gastric ulcer in long term
therapy
-Exacerbates bronchoconstriction in
asthmatic pt.
-High doses should be avoided in
pregnancy
-Try to avoid IM injection.
-Ask for INR before any dental sugary.
-Prothrombin Time should be not more
than twice the normal value.
-Vit. K is the antagonist of warfarin
action ’10 mg will reverse the action in
24 hours ’
Respiratory System
Drug
Trade Names
Antihistamines
.
Promethazine
-Phenergan
-Histaloc
-Promantine
Cough prep.
Triprolidine &
Pseudoephedrine - Actified
-Kafosed.
-Tusilar.
Dextromethorphan -Contrasal.
-Romilar.
-Simatus.
Topical Nasal
Decongestants
Xylometazoline
Hydrochloride
-Otrivine
-Nasivin
-Xylometazoline
Pseudoephedrine
-Otrinol
Hydrochloride
Indications
-Antihistaminic.
-Motion sickness.
-Sedative & hypnotic.
-Antiemetic.
-Hay fever.
- It could cause dry mouth.
-Temporary relife of nasal
congestion.
-Decongest sinus opening.
-Running nose, sneezing.
-Itching of nose or throat.
-Hay fever or other upper
respiratory allergies.
-Watery eyes due to
common cold.
- Dry or painful cough.
-Non-productive cough.
- It cause dry mouth & lichenoid reaction
-Nasal congestion due to
seasonal allergic rhinitis.
-Chronic rhinitis and
rhinitis occurring with the
common cold & respiratory
tract infection.
-Nasal congestion.
Anti T.B.
Ethambutol
-Myambutol
-Ethanbutol
-Treatment of T.B. in the
first 2 months
Rifampicin
-Rimactan
-Rifadin
-Rimactazid
-T.B “intial treatment”.
-Eradicate nasal colonisation in meningococcal
infections
Isoniazid “INH”
Considerations
-Look for oral signs of T.B.
-Avoid elective dental procedures in active
infections.
-Look for oral signs of T.B.
-Avoid elective dental procedures in active
infections.
-INH
- Treatment and prevention -Look for oral signs of T.B.
-Avoid elective dental procedures in active
-Rimifon
of T.B
infections.
-Rimactazid “INH+
Rifampicin”
Respiratory System
Drug
Anti asthmatics
Aminophylline
Trade Names
-Euphylline
-Aminomal
-Phyllocontin
Beclomethasone -Bectoide
-Viorex
Cromolyn Sodium -Intal
-Opticrom
Ketotifen Fumarate -Zaditen
Salbutamol
Theophylline
-Ventolin
-Butalin
-Quibron-T/SR
-Bronquim
Indications
-Reversible airway
obstructions.
-Status asthmaticus & left
ventricular failure.
Considerations
-It increases the action of erythromycin.
- Ensure that patient’s drug is easily
available if attach occurs.
-It causes adrenal suppression &
Chronic airway obstructions candidal infection .
-It could cause dry mouth & hoarseness.
-Pt. Instructed to gargle and rinse with water
after each dose to help in preventing
candidiasis.
- Ensure that patient’s drug is easily
available if attach occurs.
-Prophylaxis of asthma &
allergic conditions.
-Chronic bronchitis.
-Emphysema.
-Asthmatic patients.
-Frequently it cause mouth dryness &
burning mouth senseation .
- Ensure that patient’s drug is easily
available if attach occurs.
-Prophylaxis of asthma.
- Ensure that patient’s drug is easily
available if attach occurs.
-Bronchodilator for.
treatment of asthma.
-Reversible airway
obstruction.
-It may cause mouth & throat irritation.
- Ensure that patient’s drug is easily
available if attach occurs.
-Bronchial asthma.
-Chronic obstructive
pulmonary disease.
- It could cause dry mouth.
- Ensure that patient’s drug is easily
available if attach occurs.
Central Nervous System
Drug
Trade Names
Antiparkinsons
Levodopa -Carbidopa -Sinemet
Antidepresents
Amitriptyline
Clomipramine
-Tryptizol
-Saroten
-Elavil
-Anafranil
Imipramine
-Tofranil
-Imiprex
Antimigraine
Ergotamine
-Migril
-Cafergot
Sumatriptan
-Imigran
Indications
-Used in parkinsonism
Considerations
- It cause dry mouth.
-Depression.
- It cause dry mouth, stomatitis & salivary
-Analgesic for certain chronic
gland pain.
& neuropathic pain.
-Migraine prophylaxis.
-Depressive illness
- It cause dry mouth & bleeding.
-Phobic & obsessional states
-Depressive illness
-It cause dry mouth & stomatitis
-Nocturnal enuresis in
children &school phobia.
-Sever symptoms of cocaine
withdrawal.
-Treatment of vascular
headache “migraine”,
-Cluster headache.
-Treatment of migraine with - It may cause discomfort in jaw, mouth or
or without aura
tongue.
Central Nervous System
Drug
Antiepileptics
Carbamazepine
Phenytoin Sodium
Ethosuximide
Sodium Valproate
Sedative-Hypnotic
Clonazepam
Trade Names
Indications
-First line agent in treatment
of partial seizures.
-Tegretol
-Trigeminal neuralgia.
-Tegretol Retard -Diabetes insipidus.
-Pain syndrome.
-Schizophrenia.
-Epanutin
-Dilantin
-Zarontin
-Emeside
-Depakine
-Epilim
-Convulex
-Rivotril
Considerations
-It may cause:
-Stevens –Jonson syndrom.
-SLE-like syndrom.
- Dry mouth & glossitis.
-Anticonvulsant
-Antiarrhythmic.
-Prevention of seizures
following head truma &
neurosurgery .
-It may cause:
-Gingival hyperplasia.
-Lupus erythematosus .
-Stevens –Jonson syndrom.
-Osteamalacia.
-Absence seizures.
- Side effects : gingival bleeding
,ulceration , swelling of tongue & gingival
enlargement ( Rare) .
-Indicated when both absence
& generalized tonic-clonic
seizures are present.
-Alternative to primary
anticonvulsants in
generalized tonic –clonic
seizures.
-Status epilepticus
-May used as an antipanic
agent.
-It cause dry mouth.
-Ask about epilepsy type, seizure
frequency & the onset of the last attack.
Gastro-intestinal System
Drug
H2 receptor
antagonists
Trade Names
Ranitidine
-Zantac
-Tanidina
-Antagonin
Cimetidine
-Cimedine
-Tagamet
Antimuscarinic
Hyoscine NButylbromid.
Laxatives
Bisacodyl
-Buscopan
-Scopinal
-Spasmopan
-Butacid
-Spasmonore
-Dulcolax.
-Laxocodyle
Indications
Considerations
-Reduction of gastric aciditiy
-Benign gastric &duodenal
ulcers .
-Reflux oesophagitis
-Long term therapy lead to vit. B12
deficiency.
-Decrease absorption of diazepam &
ketoconazole.
-Short term treatment of
benign gastric& duodenal
ulcers.
-Prophylaxis of duodenal
ulcer.
Gastric hypersecretory states.
-Gastro-esophageal reflux.
-Prevention of upper GI
bleeding in ill pt.
-Decrease absorption of ketoconazole &
tetracycline.
-Increase blood levels of metronidazol &
lidocaine.
-Adjunct in gastro- intestinal -It cause dry mouth, thirst & difficulty in
disorders characterized by
swallowing.
smooth muscle spasm.
-Constipation.
-Bowel evacuation befor: Surgery, endoscopy &
radiology.
Musculoskeletal and joint
Drug
Antigout
Allopurinol
Trade Names
Indications
Considerations
-Prevention of attack of gout
-It could cause stomatitis, lichenoid
-Zyloric
-Arthritis &nephropathy
reaction & salivary gland swelling.
-No-Uric
-Prevent calcium oxalate
-Main clinical feature is arthritis that
calculi.
could affect TMJ.
-Treatment of hyperuricemia
which may occure during
treatment of tumers or
leukemia.
Nutrients, Vitamins & Blood modifiers
Drug
Trade Names
Indications
-Megalobastic anemia
due to folic acid deficiency.
-Chronic alcoholism.
-Pregnancy &lactation.
-Sprue & ileal diseases.
-Nutritional deficiency
& haemolytic aneamia.
-Prevention & treatment of
Ascorbic acid
Vitamin-c chew- scurvy.
Vit. C
able
-Urinary acidification.
-Upsa-c
-Prevention & decreasing of
-Calcefor
cold
-B-complex plus vitamin- c
B-complex vitamins -Becozym
used in conditions
B1,B6,B12
characterized by depletation
or increase demand of the
water –soluble vitamins.
Nutrients& Vitamins
Folic Acid
-Folicum
Vit. B9
-Folvite
Blood Modifiers
Ferrous Fumarate
Ferrous Sulphate
- Fersamal .
- Galfer .
Considerations
-Glossitis or atrophy of the tongue and
angular cheilitis may be a symptom of folic
acid deficiency.
- Incidence of erosion & caries has been
reported with excessive use of chewable
ascorbic acid tablets.
-Prevention and treatment of -Absorption of tetracyclines &
iron deficiency anemias
penicillamine may decrease if given
together with this drug.
-Oral manifestation of iron deficiency:
- Atrophic glossitis.
- Angular cheilitis &some times
aphthous ulceration.
-Prevention & treatment of
iron deficiency anemias
-If not diluted it may cause teeth
discoloration, so rinsing mouth is indicated
after taken the preparation .
-It may cause dysphagia.
-it may reduce the absorption of
tetracyclines & penicillamine.
-Oral manifestation of iron deficiency:
- Atrophic glossitis.
- Angular cheilitis &some times
aphthous ulceration.
Endocrine System
Drug
Trade Names
Indications
Antidiabetes
Insulin Human Reg. -Humalin-R
-Diabetes mellitus
-Humalin-N
-Diabetes Mellitus
Insulin Human –NPH
Glibenclamide
-Daonil
-Diatab
-Euglucon
-Glynase
-Diabetic pt. may be more susceptible to
infection & have delay wound healing.
-Diabetic pt. may be more susceptible to
infection & have delay wound healing.
-Diabetes mellitus
-Diabetic pt. may be more susceptible to
infection & have delay wound healing.
-Diamicron
-Non insulin-dependent
diabetes mellitus.
-Diabetic pt. may be more susceptible to
infection & have delay wound healing.
-Glucophage
-Glucomet
-Melbin
- Non insulin-dependent
diabetes mellitus.
-Diabetic pt. may be more susceptible to
infection & have delay wound healing.
Gliclazid
Metformin
Considerations
Endocrine System
Drug
Trade Names
Corticosteroids
Prednisolone
Dexamethasone
Hydrocorisone
-Prednisolone
-Deltacortef
-Gupisone
-Precortisly
-Decadron
-Oradexo
-Cortef
-Solu-cortef
-Cortiderm
-Hydrocortone
Indications
-In general, it is indicated in
autoimmune diseases.
-Multiple sclerosis.
-Adrenocortical
insufficiency
-Adreno-genital syndrom .
-Arthritis.
-Collagen diseases.
-Rheumatic carditis.
-Nephrotic syndrom
-Skin disease.
eg.pemphigus
-Ulcerative coltitis.
-Throbocytopenia.
-Organ transplantation
-Acute asthma.
-Group of oral lesions eg.
L.P, pemphigus vulgaris,
EM &cicatrical pemphigoid
-Behcet’s disease.
-Prevention of post –
herpetic neuralgia.
-Acute exacerbation of
chronic allergic disorder
-Cerebral edema.
-Multiple sclerosis
-Antiemetic with cancer
therapy.
-Replacement therapy in
adrenal cortical
insufficiency salt-losing
forms of congenital adrenal
hyperplasia syndromes.
-Addison’s disease
Considerations
-Contraindicate in viral infections.
–It delays wound healing.
-It causes candidal infection & dry mouth.
-Symptoms of oral infection may be
masked.
-Assess need for supplemental doses for the
dental treatment.
-Prophylactic antibiotic may be indicated to
prevent infection in surgery or deep
scaling
Forms:
-Tablet:
1 mg , 5 mg
20 mg , 25 mg
-Enema 20 mg/100 ml
As prednisolone
As prednisolone
KING ABDULAZIZ UNIVERSITY
SCHOOL OF DENTISTRY
Drugs & Dentistry IV
Prophylactic Antibiotic Regimens for Bacterial
Endocarditis for Dental procedures
Situation
Agent
Regimen
Adults:
Standard general
Amoxicillin
prophylaxis
Ampicillin
medication
Cap. 250-500 mg
-Ultramox
Sus. 125 mg/5ml
Orally ,one hour before procedure -Amoxidar
250 mg/5ml
Children: 50 mg/kg
or
-Pentrexyl
250 mg/vial
within 30 min. before procedure
1 g /vial
600 mg
Children: 20 mg/kg
-Dalacin-C
Cap.
150 mg
Tab.
250-500 mg
Orally,one hour before procedure.
Adults:
2g
-Keflex
or
Children:
50 mg/kg
-Cefrin
orally, one hour before the
-Ultracef
Tab.
1g
procedure.
-Cefadrox
Cap.
500 mg
or
Azithromycin
Inj.
500 mg/vial
Cephalexin
Cefadroxil
Allergic to penicillin
2g
Children : 50 mg/kg ,IM or IV -Polycillin
Adults:
Clindamycin
Forms
-Amoxil
Adults :
Unable to take oral
2g
Trade names
Sus. 125-250mg/5ml
Adults:
500 mg
or
Children: 15 mg/kg
Clarithromycin
Orally, one hour before the
-Zithromax
Cap.
250 mg
-Klacid
Tab.
250-500 mg
Sus.
125 mg/5ml
procedure
250mg/100 ml
Clindamycin
or
Adults:
600 mg
-Dalacin-C
Inj.
Children: 20 mg/kg
300-600
900 mg
IV within 30 min. before
Allergic to penicillin &
unable to take oral
medication
procedure.
Cefazolin
Adults:
1g
Children: 25 mg/kg
-Cefamezin
-Totacef
Inj.
250-500 mg
1g
IM or IV within 30 min. before
procedure.
1. Total dose of the children must not exceed the adult dose.
2. Do not prescribe cephalosporins if the pt. has immediate-type hypersensitivity
to penicillins due to the cross reaction between the tow drugs.
3. Reference: Dental Drug Reference 1999.
By Dr. KHALID AL-JOHANI