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Pharmacology for Dentistry

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This page intentionally left blank Copyright © 2007, New Age International (P) Ltd., Publishers Published by New Age International (P) Ltd., Publishers All rights reserved. No part of this ebook may be reproduced in any form, by photostat, microfilm, xerography, or any other means, or incorporated into any information retrieval system, electronic or mechanical, without the written permission of the publisher. All inquiries should be emailed to [email protected] ISBN (13) : 978-81-224-2556-7 PUBLISHING FOR ONE WORLD NEW AGE INTERNATIONAL (P) LIMITED, PUBLISHERS 4835/24, Ansari Road, Daryaganj, New Delhi - 110002 Visit us at www.newagepublishers.com This page intentionally left blank PrefacePreface Pharmacology has undergone major intellectual changes in the recent years and has become increasingly important to all medical, dental and other health professionals. The graduate students of dentistry may have to handle medical emergency during various dental procedures on the dental chair. Besides this, dentists have to look into various drug associated interactions. The broad goal of teaching pharmacology to undergraduate students is to inculcate rational and scientific basis of therapeutics keeping in view the dental curriculum and profession. A sincere attempt has been made to present a complete text for undergraduate students of dentistry as per the new syllabus requirement (Dental Council of India, BDS course regulation, 2006). The book is divided into thirteen sections, initial sections cover the general and autonomic pharmacology, followed by other sections of drug acting on different body systems. A detailed section is devoted only to dental pharmacology which covers all agents used in pharmacotherapy of dental conditions. The last section covers vaccine, sera and other immunological agents and drugs used in skin disorders. The chapters have been arranged in such a way that knowledge gained from initial chapters will be helpful to students for understanding subsequent chapters. The appendix contains the list of newly approved and banned drugs in India. The classification adopted in the books provides pharmacological distinction among latest drugs with doses and routes of administration along with leading trade name(s) available in Indian market, but it should not be construed as the recommendation of those particular brands. (viii) Thanks are due to New Age International (P) Ltd., N. Delhi for their keen interest and attention in bringing out this book in its present form. Further, I am indebted to all my friends and well wishers for their support and encouragement. I would like to express my gratitude and indebtedness to all my family members for their sacrifice, affection and inspiration throughout the present work. New Delhi Surender Singh (ix) Contents Preface (vii) SECTION 1 General Principles of Pharmacology 1.1 Sources and Nature of Drug Dosage Form 3 1.2 Prescription Writing 15 1.3 Rational Use of Drugs & Drug Laws 19 1.4 Pharmacokinetics 25 (Absorption, Distribution, Metabolism and Excretion of Drugs) 1.5 Pharmacodynamics (Mode of Action of Drugs) 39 1.6 Adverse Drug Reactions 47 1.7 Drug Interactions 51 SECTION 2 Drugs Acting on CNS 2.1 General Anaesthetics 61 2.2 Sedative & Hypnotics 69 2.3 Narcotic Analgesics (Opioids) 75 2.4 Non-Narcotic Analgesics (NSAID’s) 83 (x) 2.5 Psychotropic Agents 95 2.6 Antiepileptic Agents 105 2.7 Muscle Relaxants 111 2.8 Local Anaesthetics 115 2.9 CNS Stimulants 119 2.10 Drugs Used in Parkinsonism 123 SECTION 3 Drugs Acting on ANS 3.1 Sympathomimetics (Adrenergic Agents) 131 3.2 Treatment of Shock & Vasopressor Agents 141 3.3 Sympatholytics (Antiadrenergic Agents) 145 3.4 Parasympathomimetics (Cholinergic Agents) 155 3.5 Parasympatholytics (Anticholinergic Agents) 161 SECTION 4 Drugs Acting on Cardiovascular & Urinary System 4.1 Cardiotonics (Cardiac Glycosides) 169 4.2 Antihypertensive Agents 175 4.3 Antianginal Agents 185 4.4 Antiarrhythmic Agents 189 4.5 Antihyperlipidemic Agents 195 4.6 Plasma Expanders 199 4.7 Diuretics and Antidiuretics 203 SECTION 5 Autacoids 5.1 Histamine and Antihistaminic Agents 215 5.2 Serotonin and its Antagonists 221 5.3 Prostaglandins and Leukotrienes 225 5.4 Drugs Used in Cough and Asthma 229 (xi) SECTION 6 Drugs Acting on Blood 6.1 COAGULANTS AND ANTICOAGULANTS 239 6.2 HAEMATINICS (Drugs Used in Anaemia) 247 SECTION 7 Drugs Acting on GIT 7.1 Laxatives and Antidiarrhoeal Agents 253 7.2 Emetics & Antiemetic Agents 257 7.3 Antacids and Antiulcer Agents 261 SECTION 8 Drugs Acting on Endocrine System 8.1 Anterior Pituitary Hormones 269 8.2 Antidiabetic Agents 275 8.3 Glucocorticoids & Sex Hormones 281 8.4 Thyroid Hormone & Antithyroid Agents 293 8.5 Hormonal Contraceptives 297 SECTION 9 Chemotherapy 9.1 Sulfonamides, Nitrofurans and Quinolones 303 9.2 Tetracyclines, Chloramphenicol and Chemotherapy of UTI 311 9.3 Beta Lactam Antibiotics 317 9.4 Aminoglycosides Antibiotics 327 9.5 Macrolide and Polypeptide Antibiotics 331 9.6 Antiviral Agents 337 9.7 Antifungal Agents 343 9.8 Antimalarial Agents 349 9.9 Antiamoebic and other Antiprotozoal Drugs 355 9.10 Anthelmintic Agents 361 9.11 Chemotherapy of Tuberculosis 365 (xii) 9.12 Chemotherapy of Leprosy 369 9.13 Chemotherapy of Malignancy 371 SECTION 10 Vitamins and Trace Elements 10.1 Vitamins and Trace Elements 383 SECTION 11 Chelating Agents & Treatment of Poisoning 11.1 Chelating Agents & Treatment of Poisoning 395 SECTION 12 Dental Pharmacology 12.1 Antiseptics & Disinfectants 407 12.2 Astringent and Obtundents 413 12.3 Mummifying and Bleaching Agents 415 12.4 Styptics (Local Haemostatics) and Disclosing Agents 417 12.5 Dentifrices and Mouth Washes 419 12.6 Caries and Fluorides 423 12.7 Pharmacotherapy of Common Oral Conditions & Dental Emergencies 425 SECTION 13 Miscellaneous 13.1 Vaccines, Sera and Other Immunological Agents 431 13.2 Drugs Used in Skin Disorders 449 APPENDICES Appendix I : List of Recently Approved New Drugs and Combinations in India (During 1999-July 2006) 459 Appendix II : List of Banned Drugs and Fixed Dose Combinations in India (Updated till January 2007) 473 Index 477 Section 1 General Principles of Pharmacology This page intentionally left blank Sources and Nature ChapterChapter of 1.1.1 4 Drug Dosage Form INTRODUCTION Pharmacokinetics deals with the alterations of the drug by the body which Pharmacology (derived from Greek words, includes absorption, distribution, binding/ pharmacon-drug; logos-discourse in) consists storage, biotransformation and excretion of of detailed study of drugs – its source, physi- drugs. cal and chemical properties, compounding, biochemical and physiological effects, phar- Toxicology deals with the side/adverse macodynamics (its mechanism of action), effects and other poisonous effects of drugs, pharmacokinetics (absorption, distribution, since the same drug can be a poison, biotransformation and excretion), therapeu- depending on the dose. tic and other uses of drugs. Chemotherapy deals with the effects of According to WHO definition ‘Drug is drugs upon microorganisms and parasites any substance or product that is used or intended to be used to modify or explore without destroying the host cells. physiological system or pathological states Pharmacology also includes certain for the benefit of the recipient’. allied fields as: Pharmacology has some major subdivi- Pharmacy is the science of preparation, sions: compounding and dispensing of drugs. It is Pharmacodynamics is the study of the concerned with collection, identification, biochemical and physiological effects of the purification, isolation, synthesis and stan- drugs and their mechanism of action. dardization of medicinal /pharmaceutical Pharmacotherapeutics deals with the substances. use of drugs in the prevention and treatment of diseases and it utilizes or depends upon Pharmacognosy deals with the study of the information of drug obtained by the sources of drugs derived from plants and pharmacodynamic studies. animal origin. 4 Section 1/ General Principles of Pharmacology Materia-medica: This is an older term • Belladonna (Atropa belladonna): At- and deals with the source, description ropine group. (physical and chemical properties) and • Pilocarpus sp.: Pilocarpine. preparation of drugs. • Vinca (Vinca rosea): Vincristine, Pharmacopoeia is an official reference vinblastine. containing a selected drugs/medicinal • Rauwolfia serpentina (root): Reserpine. preparations with their description, tests for • Coca (Erythroxylum coca): Cocaine. their identity, purity and potency and with their average doses. A few famous pharmacopoeia ii. Glycosides are ether like organic and other reference books are the Indian structure combined with sugars, the Pharmacopoeia (IP), the British Pharmacopoeia non-sugar component called aglycone (BP); the United States Pharmacopoeia (USP); or genin. The important glycosides are: the British Pharmaceutical Codex (BPC); the • Digitalis (Digitalis purpurea, Digitalis National Formulary (NF) i.e. British National lanata): Digoxin etc. Formulary (BNF) and National Formulary (NF) • Stropanthus (Stropanthus kombe): of India. It is necessary for understanding the Stropanthin etc. each aspects of pharmacology by dentists, as • Senna (Cassia acutifolia): Sennoside etc. they have to prescribe the drug for the treatment of various dental conditions in general and iii. Oils other concurrently disease with many of the a. Fixed oils are glycerides of oleic, palmitic dental patients. The dentists should be aware and stearic acids. Mostly fixed oils are of drug interactions
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