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Transcript 
Altered Sensation - Paresthesia
 Cardiovascular Drugs
Thiazide diuretics (Hydrodiuril)
Noncardioselective beta blockers (Inderal)
Noncardioselective beta blocker and alpha blocker Labetalol (Normodyne,
Trandate)
ACE inhibitors (Prinival, Zestril)
Angiotensin II antagonists (Cozaar)
Calcium channel blockers
Nitrates (Nitrostat)
Antiarrhythmic agent – (Rythmol, Norpace, Tambocor)
 Elevated Cholesterol Drugs
Cholesterol lowering agents – (Lopid), Niacin
 Electrolyte Supplement
Potassium chloride
 Neurologic Disease Drugs
Anticonvulsant – Dilantin, (Keppra), (Topamax)
Anti-Parkinson agent – (Sinemet)
Antimigraine agent - serotonin agonist (Imitrex), (Maxalt), (Amerge)
Ergot Alkaloid – (Cafergot, Wigraine)
CNS Stimulant – Modafinil (Provigil)
 Gastrointestinal Disease Drugs
Proton Pump Inhibitor – (Aciphex)
 Birth Control and Hormone Replacement Drugs
SERM (Evista)
 Allergy and Congestion Drugs
Antihistamines (Claritan)
 Diabetes Mellitus Drugs
Insulin (Humulin R)
 Osteoporosis Drugs
Calcitonin (Miacalcin Nasal Spray)
 Gout Drugs
Uric acid lowering agent (Allopurinol)

Antiglaucoma Agent
Carbonic Anhydrase Inhibitor
 Urinary Disorder Drugs
Skeletal muscle relaxant (Baclofen)
Anticholinergic – (Detrol)
1
Altered Sensation - Paresthesia
 Musculoskeletal Disease Drugs
Skeletal Muscle Relaxant – (Flexeril)
 Immunosuppressant Drugs
Cyclosporine, Tacrolimus, (Arava)
 Drug Abuse Drugs
Smoking deterrent - Nicotine
 Autoimmune Disease Drugs
COX-2 inhibitors (Celebrex)
 Infectious Disease Drugs
Cephalosporin
Tetracycline derivative
Quinolone
Nitrofurantoin
Protease inhibitor circumoral
Lamivudine
2
Altered Sensation
 Cardiovascular Drugs
Thiazide and potassium sparing diuretic – (Maxzide, Dyazide) burning tongue
Cardiac glycosides (Lanoxin) neuralgia, increased gag reflex
Cardioselective beta blockers (Tenormin) sore throat
Noncardioselective beta blocker and alpha blocker Labetalol (Normodyne,
Trandate) sore throat
Oral anticoagulants (Coumadin) salivary gland pain

Elevated Cholesterol Drugs
Cholesterol lowering agent – (Lopid) hypesthesia, Fenofibrate pain

Electrolyte Supplement
Potassium Chloride throat pain
 Antipsychotic Agent
(Seroquel) ear pain
 Neurologic Disease Drugs
Acetylcholinesterase inhibitor – (Aricept) toothache
AntiParkinson Agent – (Mirapex) hypesthesia
Anticonvulsant – (Topamax) hypoesthesia

Gastrointestinal Disease Drugs
Laxative – (Colace) sore throat

Diabetes Mellitus Drugs
Oral antidiabetic agent - Thiazolidinedione derivative neck pain

Neurologic Disease Drugs
Antimigraine - serotonin agonist (Imitrex) jaw, tongue, throat and sinus pain
 Immunosuppressant Agent
(Arava) pain

Autoimmune Disease Drugs
COX-2 inhibitors (Vioxx) hypesthesia
 Drug Abuse Drugs
Nicotine burning oral mucosa, sore throat, numbness
 Chelating Agent
Penicillamine sore throat
 Narcotic Analgesic
Fentanyl dysesthesia
3
Altered Taste
 Cardiovascular Drugs
Noncardioselective beta blocker and alpha blocker Labetalol (Normodyne,
Trandate)
Calcium channel blockers
Angiotensin II antagonists (Diovan)
Antiarrhythmic agent – (Rythmol, Tambocor)
 Respiratory Drugs
Beta 2 adrenergic agonist (Proventil, Ventalin)
Theophylline derivative (Theo-Dur)
Mast cell stabilizer (Intal, Nasalcrom)
Anticholinergic (Atrovent)
 Allergy and Congestion
Antihistamine

Anti-Psychotic Agent
(Seroquel)
 Neurologic Drugs
Anticonvulsant – (Dilantin)
Anti-Parkinson agent – (Sinemet)
CNS Stimulant- (Adderall), amphetamine
Acetylcholinesterase inhibitor – (Aricept)
Anticonvulsant – (Topamax)
 Gastrointestinal Drugs
Proton pump inhibitors (Prilosec)
Laxative – (Colace) bitter taste
 Allergy and Congestion Drugs
Antihistamines (Zyrtec)
 Diabetes Mellitus Drugs
Biguanides (Glucophage)
 Osteoporosis Drugs
Biphosphonate derivatives (Fosamax)
Calcitonin (Miacalcin Nasal Spray)
 Gout Drugs
Uric acid lowering agents (Allopurinol)
 Antiglaucoma Agent
Carbonic Anhydrase Inhibitor metallic taste
4
Altered Taste
 Urinary Disorder Drugs
Skeletal muscle relaxant (Baclofen)
 Obesity Drugs
Anorexant – (Fastin)
 Neurologic Disease Drugs
Anticonvulsant – (Topamax)
 Drug Abuse Drugs
Anti-alcohol agent – (Antabuse)
Smoking deterrent – Nicotine (Nicoderm)
 Immunosuppressant Agent
(Arava)

Infectious Disease Drugs
Penicillin derivative
Chlorhexidine
5
Arthralgia - TMJ?
 Cardiovascular Drugs
Noncardioselective beta blocker (Visken)
Noncardioselective beta blocker and alpha blocker Labetalol (Normodyne,
Trandate)
Calcium channel blocker joint stiffness
Antiarrhythmic Agent (Tambocor)
 Elevated Cholesterol Drugs
Cholesterol lowering agent – (Questran), Fenofibrate
 Anti-Psychotic Agent
(Zyprexa)
 Neurologic Disease Drugs
Acetylcholinesterase inhibitor – (Aricept)
Anticonvulsant – (Keppra)
 Gastrointestinal Disease Drugs
H-2 antagonists (Zantac)
Proton pump inhibitors (Prilosec)
 Birth Control and Hormone Replacement Drugs
SERM (Evista)
 Allergy and Congestion Drugs
Antihistamine (Allegra)
 Osteoporosis Drugs
Calcitonin (Miacalcin Nasal Spray)
 Gout Drugs
Uric acid lowering agent (Allopurinol)

Antiglaucoma Agent
Prostaglandin Agent
 Urinary Disease Drugs
Anticholinergic (Detrol)
 Cancer Drugs
RBC formation stimulant (Epogen)
Antineoplastic agent – Methotrexate
 Immunosuppressant Agent
(Imuran)
(Arava)
 Autoimmune Disease Drugs
COX-2 inhibitors (Celebrex)
6
Arthralgia - TMJ?
 Chelating Agent
Penicillamine
 Infectious Disease Drugs
Nitrofurantoin
Lamivudine
 Vitamin A Derivative
(Accutane)
7
Myalgia - TMJ?
 Cardiovascular Drugs
Beta blocker and thiazide diuretic (Inderide) noncardioselective
Angiotensin II antagonist (Avapro)
Calcium channel blockers
Antiarrhythmic agent (Tambocor)
 Elevated Cholesterol Drugs
Cholesterol lowering agent – (Questran), Fenofibrate
 Respiratory Drugs
Beta 2 adrenergic agonist
Leukotriene receptor antagonist (Accolate)
 Neurologic Disease Drugs
Anticonvulsant – Neurontin, (Topamax)
Antimigraine agent -serotonin agonist (Imitrex)
Acetylcholinesterase inhibitor – (Aricept)
Ergot Alkaloid –(Cafergot, Wigraine)
 Thyroid Disease Drugs
Thyroid hormone (Synthroid)
 Gastrointestinal Disease Drugs
Proton pump inhibitors (Prevacid)
Antiemetic – (Marinol)
Antacid, Calcium Product – (Tums)
 Birth Control and Hormone Replacement Drugs
SERM (Evista)
 Allergy and Congestion Drugs
Antihistamines (Tavist)
 Osteoporosis Drugs
]
Biphosphonate derivatives (Fosamax)
 Antiglaucoma Agent
Prostaglandin Analogue
 Cancer Drugs
Immune Globulin
 Immunosuppressant Agent
Cyclosporine, (Imuran), Cyclosporine, (Arava)
 Obesity Drugs
Anorexant –(Fastin)
8
Myalgia - TMJ?
 Autoimmune Disease Drugs
COX-2 inhibitors (Celebrex)
 Infectious Disease Drugs
Lamivudine
 Vitamin A Derivative
(Accutane)
 Non-Narcotic Analgesic
NSAID – Cox-2 Inhibitor
9
Tinnitus - TMJ?
 Cardiovascular Drugs
Noncardioselective beta blocker and alpha blocker Labetalol (Normodyne,
Trandate)
Alpha 1 peripheral blocker (Hytrin)
Angiotensin II antagonist (Cozaar)
Antiarrhythmic agent – (Rythmol, Tambocor)
Antiplatelet agent – (Ticlid)
 Elevated Cholesterol Drugs
Cholesterol lowering agent – (Questran)
 Neurologic Disease Drugs
Anticonvulsant – (Tegretol), barbiturates
Acetylcholinesterase inhibitor – (Aricept)
 Gastrointestinal Disease Drugs
Proton pump inhibitors (Prilosec)
Anti-emetic – (Marinol)
 Allergy and Congestion Drugs
Antihistamines (Benadryl)
 Diabetes Mellitus Drugs
Sulfonylurea (Diabinese)

Antiglaucoma Agent
Carbonic Anhydrase Inhibitor
 Urinary Disorder Drugs
Skeletal muscle relaxant (Baclofen)
 Autoimmune Disease Drugs
Antimalarial agent – (Plaquenil)
COX-2 inhibitors (Vioxx)
 Chelating Agent
Penicillamine
 Infectious Disease Drugs
Penicillin derivative
Macrolide antibiotic
Quinolone
 Non-Narcotic Analgesic
NSAIDs
10
Tinnitus - TMJ?
 Narcotic Analgesic
Hydrocodone, Codeine, Oxycodone
(Demerol)
Propoxyphene
 Narcotic Analgesic
Pentazocine
11
Headache
Every Drug Except:
 Cardiovascular Drugs
Noncardioselective beta blockers (Corgard)
Oral anticoagulant (Coumadin)
Antiplatelet agents (Persantine)
 Psychological Disorder Drugs
Tetracycline antidepressant (Remeron)
 Neurologic Disease Drugs
Anticonvulsant – (Neurontin), (Topamax)
 Birth Control and Hormone Replacement Drugs
Progestogen (Provera)
 Diabetes Mellitus Drugs
Biguanides (Glucophage)
Meglitinide (Prandin)
 Cancer Drugs
Antiandrogen –(Proscar, Propecia)
 Obesity Drugs
Anorexant –(Fastin)
 Chelating Agent
Penicillamine
 Infectious Disease Drugs
Penicillin derivative
Chlorhexidine
Trimethoprim and Sulfmethoxazole
 Non-Narcotic Analgesic
Acetaminophen
12
Dry Mouth
 Cardiovascular Drugs
Thiazide diuretics (Zaroxolyn)
Potassium sparing diuretics (Aldactone)
Beta blockers (Coreg) is noncardioselective, (Tenormin) is cardioselective
Noncardioselective beta blocker and alpha blocker Labetalol (Normodyne,
Trandate)
Alpha 1 peripheral blockers (Hytrin)
Central acting alpha 2 agonists (Catapres)
ACE inhibitors (Vasotec)
Calcium channel blockers
Nitrates (Imdur)
Antiarrhythmic agents – (Rythmol, Norpace, Tambocor)
 Elevated Cholesterol Drugs
Cholesterol lowering agent - Niacin
 Respiratory Disease Drugs
Beta 2 adrenergic agonists
Theophylline derivatives (Theo-Dur)
Corticosteroids (Flonase, Flovent)
Mast cell stabilizers (Intal, Nasalcrom)
 Anti-Psychotic Agent
(Zyprexa, Seroquel)
Clozapine (Cloazril, Leponex)
 Neurologic Disease Drugs
Anticonvulsant – (Tegretol, Neurontin, Felbatol, Topamax)
AntiParkinson agent – (Sinemet, Permax, Mirapex, Eldepryl)
AntiParkinson & anticholinergic – (Cogentin)
Acetylcholinesterase inhibitor- (Aricept)
Ergot Alkaloid – (Cafergot, Wigraine)
CNS Stimulant – Modafinil (Provigil)
 Gastrointestinal Disease Drugs
Proton pump inhibitors (Prevacid)
GI anticholinergic (Bentyl, Antispas)
Antiemetic –(Reglan, Marinol)
Antidiarrheal – (Lomotil)
 Allergy and Congestion Drugs
Antihistamines (Antivert)
Decongestants (Sudafed, Actifed Tabs, Afrin Tabs, Triaminic)
13
Dry Mouth
 Diabetes Mellitus Drugs
Insulin (Novolin R)
 Osteoporosis Drugs
Calcitonin (Miacalcin Nasal Spray)
 Antiglaucoma Agent
Carbonic Anhydrase Inhibitor
Alpha 2 Adrenergic Agonist
 Impotence Drugs
(Viagra)
 Urinary Disorder Drugs
Antispasmodic agents (Ditropan, Detrol)
Anticholinergics (Pro-Banthine)
Skeletal muscle relaxants (Baclofen)
 Musculoskeletal Disease Drugs
Skeletal Muscle relaxants (Flexeril, Norflex)
 Obesity Drugs
Anorexant –(Fastin)
 Autoimmune Disease Drugs
COX-2 inhibitors (Celebrex)
 Immunosuppressant Agent
(Arava)
 Infectious Disease Drugs
Penicillin derivative
Quinolone
 Vitamin A Derivative
(Accutane)
 Non-Narcotic Analgesic
Propionic acid derivative NSAIDs
(Dolobid) NSAID
(Feldene) NSAID
 Non-Narcotic Analgesic?
(Ultram)
14
Dry Mouth
 Narcotic Analgesic
Hydrocodone, Codeine, Oxycodone
(Demerol)
Fentanyl
Propoxyphene
Pentazocine
15
Salivation

Neurologic Disease Drugs
AntiParkinson, anticholinergic (Cogentin) increased salivation
Cholinergic – (Mestinon)

Allergy and Congestion Drugs
Antihistamines (Claritan) increased thickness of secretions

Antiglaucoma Agent
Cholinergic Agent excessive salivation
 Antipsychotic Agent
Clozapine (Cloazril, Leponex)
16
Gingival Reactions - Hyperplasia
 Cardiovascular Drugs
Calcium channel blockers
 Neurologic Disease Drugs
Anticonvulsants – (Dilantin, Felbatol, Topamax)
 Birth Control and Hormone Replacement Drugs
Progestogen
 Immunosuppressant Agent
Cyclosporine
17
Gingival Reactions - Gingivitis
 Neurologic Disease Drugs
Anticonvulsants – Neurontin, (Keppra), (Topamax)
Acetylcholinesterase inhibitor – (Aricept)
CNS Stimulant – Modafinil (Provigil)
 Gastrointestinal Disease
Proton Pump Inhibitor – (Aciphex)
 Birth Control and Hormone Replacement Drugs
Estrogen (Premarin)
 Immunosuppressant Agent
(Arava)
 Cancer Drugs
Antineoplastic agents - Methotrexate
18
Gingival Reactions - Bleeding
 Cardiovascular Drugs
Potassium sparing diuretics (Dyrenium)
Oral anticoagulant – (Coumadin) (may be overdose)
Antiplatelet agent – (Persantine)
 Neurologic Disease Drugs
Anticonvulsant – (Felbatol)
 Birth Control and Hormone Replacement Drugs
Estrogen (Estrace)
Progestogen
 Infectious Disease Drugs
Tetracycline derivative
 Vitamin A Derivative
(Accutane)
 Non-Narcotic Analgesic
NSAID (Feldene)
19
Fever
 Cardiovascular Drugs
Noncardioselective beta blocker and alpha blocker Labetalol (Normodyne,
Trandate)
Oral anticoagulant (Coumadin)
 Respiratory Drugs
Leukotriene Receptor Antagonist (Singulair)
 Neurologic Disease Drugs
Anticonvulsants - Dilantin, Barbiturates
AntiParkinson, anticholinergic – Cogentin
CNS Stimulant – Modafinil (Provigil)
 Thyroid Disease Drugs
Thyroid hormone (Euthroid, Thyrolar)
 Gastrointestinal Disease Drugs
H-2 antagonists (Tagamet)
Proton pump inhibitors (Prilosec)
Anti-inflammatory agent – Sulfasalazine
GI anticholinergic (Librax)
 Birth Control and Hormone Replacement Drugs
Progestogen
 Gout Drugs
Uric acid lowering agent (Allopurinol)
 Antiglaucoma Agent
Carbonic Anhydrase Inhibitor
 Urinary Disorder Drugs
Antispasmodic agent (Urispas)
Anticholinergic (Pro-Banthine)

Musculoskeletal Disease
Skeletal Muscle Relaxant – (Soma, Flexiril)

Cancer Drugs
Antineoplastic agent - Methotrexate, Mercaptopurine drug fever
Immune Globulin
 Immunosuppressant Agents
(Imuran, Prograf, CellCept)
 Chelating Agent
Penicillamine
20
Fever
 Anti-Psychotic Agent
Clozapine (Cloazril, Leponex)
 Infectious Disease Drugs
Cephalosporin
Tetracycline derivative
Nitrofurantoin
Trimethoprim and Sulfmethoxazole
Lamivudine
Ganciclovir
21
Chills
 Neurologic Disease
AntiParkinson Agent – (Permax)
CNS Stimulant – Modafinil (Provigil)
 Gastrointestinal Disease Drugs
Anti-inflammatory agent - Sulfasalazine
 Osteoporosis Drugs
Calcitonin (Miacalcin Nasal Spray)
 Gout Drugs
Uric acid lowering agent (Allopurinol)
 Cancer Drugs
Antineoplastic agent - Methotrexate
Immune Globulin
 Autoimmune Disease Drugs
COX-2 inhibitors (Vioxx)

Chelating Agent
Penicillamine
 Infectious Disease Drugs
Cephalosporin
Nitrofurantoin
Lamivudine
22
Blood Dyscrasias
 Cardiovascular Drugs
Thiazide diuretics (Hygroton, Thalitone)
Loop diuretics (Lasix)
Potassium sparing diuretics (Dyrenium)
Noncardioselective beta blocker (Inderal)
Noncardioselective beta blocker and alpha blocker Labetalol (Normodyne,
Trandate)
Central acting alpha 2 agonist (Catapres)
Direct acting vasodilator (Apresoline)
ACE inhibitor (Lotensin)
Antiarrhythmic agent – (Rythmol, Norpace, Tambocor)
Oral anticoagulant (Coumadin)
Antiplatelet agent – (Ticlid)
 Elevated Cholesterol Drugs
Cholesterol lowering agent – (Lopid)
 Respiratory Disease Drugs
Corticosteroids (Azmacort)
 Antipsychotic Agent
Clozapine (Cloazril, Leponex)
(Seroquel)
 Neurologic Disease Drugs
Anticonvulsants – (Tegretol, Dilantin, Neurontin, Felbatol, Topamax),
Barbiturates
Anti-Parkinson agent – (Sinemet)
Acetylcholinesterase inhibitor – (Aricept)
CNS Stimulant – Modafinil (Provigil)
 Gastrointestinal Disease Drugs
H-2 antagonists (Axid)
Anti-inflammatory agent – Sulfasalazine, (Asacol)
Antiemetic – (Reglan)
 Birth Control and Hormone Replacement Drugs
Androgen (Estratest)
 Allergy and Congestion Drugs
Acetaminophen (Tylenol)
 Diabetes Mellitus Drugs
Sulfonylureas (Amaryl)
Biguanides (Glucophage)
23
Blood Dyscrasias
 Gout Drugs
Uric acid lowering agent (Allopurinol)

Antiglaucoma Agent
Carbonic Anhydrase Inhibitor
 Urinary Disease Drugs
Urinary Analgesics – (Pyridium)

Musculoskeletal Disease
Skeletal Muscle Relaxant – (Parafon Forte, Norflex, Skelaxin)
 Cancer Drugs
Antineoplastic agent - Hydroxyurea (significant), Methotrexate, Tamoxifen,
Mercaptopurine
Interferon
 Immunosuppressant Agent
(Imuran, CellCept, Prograf, Arava)
 Obesity Drugs
Anorexant (Fastin)
 Autoimmune Disease Drugs
Antimalarial agent – (Plaquenil)
COX-2 inhibitors (Celebrex)

Chelating Agent
Penicillamine
 Infectious Disease Drugs
Penicillin derivative
Clindamyacin
Tetracycline derivative
Nitrofurantoin
Trimethoprim and Sulfmethoxazole
Acyclovir
(Invirase)
(Videx)
Zidovudine
Lamivudine
Ganciclovir
 Non-Narcotic Analgesic
NSAIDs
Acetaminophen
24
Stomatitis
 Cardiovascular Drugs
Antiarrhythmic agent – (Rythmol)
Oral anticoagulant (Coumadin) ulcerative type
 Respiratory Disease Drugs
Anticholinergic (Atrovent)
 Neurologic Disease Drugs
Anticonvulsant – (Neurontin, Dilantin) oral ulcers, (Tegretol) oral and throat
ulcers
CNS Stimulant – Modafinil (Provigil) oral ulcers
 Gout Drugs
Uric acid lowering agent (Allopurinol)
 Cancer Drugs
Antineoplastic agent - Hydroxyurea, Methotrexate ulcerative type,
Mercaptopurine
 Immunosuppressant Agent
(Imuran) aphthous (Arava) oral ulcers
 Autoimmune Disease Drugs
COX-2 inhibitors (Vioxx) ulcerative type
 Infectious Disease Drugs
Penicillin derivative
Tetracycline derivative
Trimethoprim and Sulfmethoxazole
 Non-Narcotic Analgesic
NSAIDs Propionic acid derivative
(Clinoril) aphthous stomatitis
(Feldene)
 Non-Narcotic Analgesic?
(Ultram)
25
Glossitis
 Elevated Cholesterol Drugs
Cholesterol lowering agent – (Questran)
 Neurologic Disease Drugs
Anticonvulsants – (Tegretol, Neurontin)
AntiParkinson, anticholinergic agent – (Cogentin)

Gastrointestinal Disease
Proton pump inhibitor (Prevacid) mucosal atrophy (Aciphex)
 Musculoskeletal Disease Drugs
Skeletal Muscle Relaxant – (Soma)
 Cancer Drugs
Antineoplastic agent – Methotrexate, Mercaptopurine
 Anti-Psychotic Agent
Clozapine (Cloazril, Leponex)
 Infectious Disease Drugs
Penicillin derivative
Cephalosporin
Acyclovir
 Impotence Drugs
(Viagra)
 Non-Narcotic Analgesic
(Clinoril)
26
Pharyngitis
 Antipsychotic Agent
(Seroquel)
 Neurologic Disease Drugs
Anticonvulsants - (Neurontin)
CNS Stimulant – Modafinil (Provigil)
 Birth Control and Hormone Replacement Drugs
SERM (Evista)
 Diabetes Mellitus Drugs
Thiazolidinedione derivative
 Urinary Disease Drugs
Anticholinergic – (Detrol)
Alpha Adrenergic Blocking Agent – (Flomax)
 Immunosuppressant Agent
(CellCept)
 Cancer Drugs
Antineoplastic agent - Methotrexate
27
Sinusitis
 Cardiovascular Drugs
Alpha-1 peripheral blocker (Tenex)
Calcium channel blockers
 Neurologic Disease
Anticonvulsant – (Keppra), (Topamax)
 Birth Control and Hormone Replacement Drugs
SERM (Evista)

Diabetic Disease Drugs
Thiazolidinedione derivative
 Urinary Disease Drugs
Anticholinergic – (Detrol)
 Immunosuppressant Agent
Cyclosporine, (Arava)
 Autoimmune Disease Drugs
COX-2 inhibitors (Celebrex)
 Impotence Drugs
(Viagra)
28
Dysphagia
 Neurologic Disease Drugs
AntiParkinson, anticholinergic (Cogentin)
 Gastrointestinal Disease Drugs
GI anticholinergic (Levbid)
 Osteoporosis
Biphosphonate derivative (Fosamax)
 Urinary Disorder Drugs
Anticholinergic (Pro-Banthine)
 Impotence Drugs
(Viagra)
 Infectious Disease Drugs
Tetracycline derivative
29
Stevens-Johnson Syndrome
 Cardiovascular Drugs
Loop diuretics (Demadex)
 Neurologic Disease Drugs
Anticonvulsant – (Tegretol, Dilantin), Barbiturates
 Gastrointestinal Disease Drugs
Anti-inflammatory agent - Sulfasalazine
 Gout Drugs
Uric acid lowering agent (Allopurinol)

Antiglaucoma Agent
Carbonic Anhydrase Inhibitor
 Infectious Disease Drugs
Clindamycin
Trimethoprim and Sulfmethoxazole
Fluconazole
Nystatin
(Invirase)
 Non-Narcotic Analgesic
NSAIDs
30
Photophobia
 Cardiovascular Drugs
Cardiac Glycosides (Lanoxin)
Antiarrhythmic Agent (Tambocor)
 Neurologic Disease Drugs
AntiParkinson, anticholinergic (Cogentin)
Anticonvulsant – (Topamax)
Antimigraine agent - serotonin agonist (Imitrex) (Maxalt), (Amerge)
 Gastrointestinal Disease Drugs
GI anticholinergic (Bentyl, Antispas)
 Antiglaucoma Agent
Cholinergic Agent
Prostaglandin Analogue
Alpha 2 Adrenergic Agent
 Urologic Disease Drugs
Anticholinergics (Probanthine)
 Autoimmune Disease Drugs
Antimalarial agent – (Plaquenil)
 Infectious Disease Drugs
Quinolone
 Vitamin A Derivative
(Accutane)
31
Photosensitivity
 Cardiovascular Drugs
Thiazide diuretic (Aquatensin, Enduron)
 Cholesterol Lower Agent
Fenofibrate
 Gastrointestinal Disease
Proton Pump – (Aciphex)
 Cancer Drugs
Antineoplastic agent - Methotrexate
32
Swelling
 Cardiovascular Drugs
Noncardioselective beta blockers (Visken) facial swelling
Angiotensin II antagonist and thiazide diuretic (Hyzaar) facial swelling
ACE inhibitors (Accupril) angioedema
Oral anticoagulants (Coumadin) salivary gland swelling
Antiarrhythmic Agent (Tambocor) swelling lips, tongue, mouth

Respiratory Disease Drugs
Mast cell stabilizer (Intal, Nasalcrom) angioedema, parotid gland swelling

Neurologic Disease Drugs
Anticonvulsant –(Felbatol) buccal mucosa swelling, facial swelling
Acetylcholinesterase inhibitor – (Aricept) tongue edema

Gastrointestinal Disease Drugs
H-2 antagonist (Pepcid) angioedema
Proton Pump Inhibitor – (Aciphex) facial edema, salivary gland enlargement

Gout Drugs
Uric acid lowering agent (Allopurinol) salivary gland swelling
 Musculoskeletal Disease
Skeletal Muscle Relaxant – (Soma) swelling of lips (Flexeril) swelling of face and
lips

Chelating Agent
Penicillamine edema of face
 Immunosuppressant Agent
(Arava) enlarged salivary glands
 Infectious Disease Drugs
Nitrofurantoin Angioedema
 Non-Narcotic Analgesic
Acetic Acid derivative NSAIDs Angioedema
33
Orthostatic Hypotension
 Cardiovascular Drugs
Thiazide diuretics (Aquatensin, Enduron)
Loop diuretics (Lozol)
Noncardioselective beta blocker and alpha blocker Labetalol (Normodyne,
Trandate)
Alpha 1 peripheral blocker (Cardura)
Central acting alpha 2 agonist (Catapres)
ACE inhibitor (Monopril)
Angiotensin II antagonist (Diovan)
Nitrates (Isordil)
Antiplatelet agent – (Persantine)
 Antipsychotic Agent
(Seroquel)
 Neurologic Disease Drugs
AntiParkinson agent – (Sinemet, Permax, Eldepryl)
AntiParkinson, anticholinergic (Cogentin)
Ergot Alkaloid – (Germinal, Hydergine)
 Gastrointestinal Disease Drugs
GI anticholinergic (Librax)
Anti-Emetic – (Marinol)
 Urinary Disease Drugs
Alpha Adrenergic Blocking Agent – (Flomax)
 Musculoskeletal Disease Drugs
Skeletal Muscle Relaxant – (Soma, Flexeril)
 Narcotic Analgesic
Fentanyl
34
Discoloration
 Cardiovascular Drugs
Direct acting vasodilator (Apresoline) facial flushing

Respiratory Disease Drugs
Beta 2 adrenergic agent facial flushing, tooth discoloration
 Osteoporosis Drugs
Calcitonin (Miacalcin Nasal Spray) facial flushing
 Musculoskeletal Disease
Skeletal Muscle Relaxant – (Soma, Parafon Forte, Flexeril, Norflex) facial
flushing
 Anemia Drugs
Iron Salt – Ferrous Sulfate (extrinsic stain on teeth with liquid form)
 Cancer Drugs
Immune Globulin facial flushing
Antineoplastic agent - Hydroxyurea facial erythema

Autoimmune Disease Drugs
Antimalarial agent – (Plaquenil) discoloration of oral mucosa

Chelating Agent
Penicillamine white spots on lips or mouth
 Infectious Disease Drugs
Penicillin derivative black hairy tongue
Tetracycline derivative tongue discoloration
Chlorhexidine staining teeth, tongue, restorations
Nitrofurantoin brown discoloration of saliva, tooth staining
 Non-Narcotic Analgesic
NSAIDs (Clinoril) white spots mouth or lips
35
Miscellaneous Reactions
 Cardiovascular Drugs
Thiazide and potassium sparing diuretic (Maxzide, Dyazide) angular cheilitis
Noncardioselective beta-blocker and alpha-blocker Labetalol (Normodyne,
Trandate) lichenoid reaction

Neurologic Disease Drugs
Anticonvulsant –(Dilantin) Lupus Erythematosus
Barbiturates Laryngospasm
Acetylcholinesterase inhibitor – (Aricept) coated tongue
Ergot Alkaloid (Germinal, Hydergine) Sublingual irritation
 Autoimmune Disease Drugs
Antimalarial agent –(Plaquenil) lichenoid lesions
COX-2 inhibitors (Vioxx) dry sockets

Respiratory Disease Drugs
Corticosteroids (Nasalide) candidiasis

Gastrointestinal Disease Drugs
Proton pump inhibitor (Prilosec) candidiasis

Diabetes Mellitus Drugs
Thiazolidinedione derivative - infection

Birth Control and Hormone Replacement Drugs
Estrogen (Estrace) dry sockets

Urinary Disease Drugs
Alpha Adrenergic Blocking Agent – (Flomax) tooth disorders
 Immunosuppressant Agent
Cyclosporine candidiasis (Arava) tooth disorders, candidiasis
 Infectious Disease Drugs
Penicillin derivative candidiasis
Macrolide antibiotic candidiasis
Clindamyacin candidiasis
Cephalosporin candidiasis, pseudomembranous colitis
Tetracycline derivative hypertrophy tongue papilla, lichenoid reaction, candidiasis,
erythema multiforme
Chlorhexidine mucosal desquamation and irritation, transient parotitis, increased
calculus formation
Quinolone candidiasis
Trimethoprim and Sulfmethoxazole pseudomembranous colitis, erythema
multiforme
36
Miscellaneous Reactions
 Vitamin A Derivative
(Accutane) cheilitis
 Non-Narcotic Analgesic
Salicylate NSAIDs increased oral bleeding
NSAID (Daypro) Erythema multiforme
 Narcotic Analgesic
Fentanyl laryngospasm
37
Bright Orange Tongue
 Cardiovascular Drugs
Thiazide and potassium sparing diuretic - Maxzide, Dyazide
 Obesity Agonist
Creamsicle!
38
Question #1
How does Aldosterone
work?
39
Question #2
What’s with all these
different neurotransmitters
and how exactly do they
work?
40
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