Drug Dictionary for Dentistry.Pdf

Drug dictionary for dentistry Dose schedules are being continually revised and new side effects recognized. Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. For these reasons the reader is strongly urged to consult the phar- maceutical company’s printed instructions before administering any of the drugs recommended in this book. Drug dictionary for dentistry J.G. Meechan and R.A. Seymour 1 1 Great Clarendon Street, Oxford OX2 6DP Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide in Oxford New York Auckland Bangkok Buenos Aires Cape Town Chennai Dar es Salaam Delhi Hong Kong Istanbul Karachi Kolkata Kuala Lumpur Madrid Melbourne Mexico City Mumbai Nairobi São Paulo Shanghai Singapore Taipei Tokyo Toronto with an associated company in Berlin Oxford is a registered trade mark of Oxford University Press in the UK and in certain other countries Published in the United States by Oxford University Press Inc., New York © Oxford University Press, 2002 The moral rights of the authors have been asserted Database right Oxford University Press (maker) First published 2002 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means,without the prior permission in writing of Oxford University Press, or as expressly permitted by law, or under terms agreed with the appropriate reprographics rights organization. Enquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above You must not circulate this book in any other binding or cover and you must impose this same condition on any acquirer A catalogue record for this title is available from the British Library Library of Congress Cataloging in Publication Data Meechan, J. G. Drug dictionary for dentistry/J. G. Meechan, R. A. Seymour. p. cm. 1. Dental pharmacology–Dictionaries. 2. Dental therapeutics– Dictionaries. I. Seymour, R. A. II. Title. RK701.M442002 617.6'061'03–dc21 2001052052 ISBN 0 19 263274 4 10 9 8 7 6 5 4 3 2 1 Typeset by Newgen Imaging Systems (P) Ltd., Chennai, India Printed in Great Britain on acid-free paper by The Bath Press, Avon This book is dedicated to: The memory of my father (JGM) Gayle, Tom and Oliver (RAS) This page intentionally left blank Preface Drug therapy has an effect on the management of patients in dentistry. Many drugs produce oro-dental problems; in addition concurrent medication can interact with drugs which the dentist may prescribe. The aim of this dictionary is to draw together the effects of drugs on the teeth, oral and perioral structures and highlight drug interactions which impact on dental treatment. Drugs taken by out- patients which may be encountered in general dental practice and interactions with drugs contained in the Dental Practitioners Formu- lary have been included. Interactions which may occur with medication prescribed by dentists working in the hospital service have also been covered. Drugs which the dentist may prescribe have been anno- tated in greater detail to include any significant interactions that have been recorded. Drugs have been listed alphabetically by their Rec- ommended Non-proprietary Name (rINN) rather than their British Approved Name (BAN). In those cases where it is still recommended that both the BAN and rINN should appear then drugs commonly found in dental out-patients are listed under both names. It is hoped that this pocket-sized volume will act as a ready reference source for those dealing with dental patients taking medication. J.G. Meechan R.A. Seymour October, 2001 How to use this dictionary The drugs are listed in alphabetical order by their approved name in this dictionary. An alphabetical list of trade-names is provided in the Appendix in order to cross-reference to the approved name used in the dictionary. Acknowledgement The authors are pleased to acknowledge the assistance of Mrs Renata Taylor in the compilation of this dictionary. ABACAVIR • ACAMPROSATE CALCIUM 1 Abacavir (Ziagen) Description A nucleoside reverse transcriptase inhibitor. Indications Used in the management of HIV infection. Effects on oral and dental structures This drug may produce oral ulceration. Effects on patient management Sensitive handling of the underlying disease state is essential. Excel- lent preventive dentistry and regular examinations are important in patients suffering from HIV, as dental infections are best avoided. HIV will interfere with postoperative healing and antibiotic prophy- laxis prior to oral surgery may be advisable. Drug interactions None of importance in dentistry. Acamprosate calcium (Campral EC) Description An anti-dependence drug. Indications Used in the management of alcohol dependence. Effects on oral and dental structures None known. Effects on patient management A history of alcohol dependence may cause bleeding disorders and affect drug metabolism. Drug interactions None relevant. 2 ACARBOSE • ACEBUTOLOL Acarbose (Glucobay) Description An inhibitor of intestinal alpha glucosidases. Indications Diabetes mellitus inadequately controlled by diet or by diet and oral hypoglycaemic agents. Effects on oral and dental structures None reported. Effects on patient management Hypoglycaemia can be a problem in patients taking acarbose, especially if they are also on insulin. Before commencing dental treatment, it is important to check that patients have had their normal food intake. If there is any doubt, give the patient a glucose drink. As with any diabetic patient try and treat in the first half of the morning and ensure that patients can eat after dental treatment. If a patient on acarbose requires a general anaesthetic then refer to hospital. Drug interactions Systemic corticosteroids antagonize the hypoglycaemic actions of acarbose. If these drugs are required, then consult the patient’s phy- sician before prescribing. Acebutolol (Sectral) Description A beta-adrenoceptor blocking drug. Also combined with a diuretic, hydrochlorothiazide (Secadrex). Indications Hypertension. Effects on oral and dental structures Xerostomia and lichenoid eruptions can be produced. Effects on patient management Xerostomia will make the dentate patient more susceptible to dental caries (especially root caries) and will cause problems with denture retention. Postural hypotension may occur, and patients may feel dizzy when the dental chair is returned to the upright position after they have been treated in the supine position. Drug interactions NSAIDs such as ibuprofen may antagonize hypotensive action of acebutolol; possible interaction between epinephrine and acebutolol which may cause a slight increase in blood pressure. Do not exceed ACECLOFENAC • ACEMETACIN 3 more than 3 cartridges of epinephrine containing local anaesthetic solution per adult patient. Aceclofenac (Preservex) Description A peripherally acting, non-steroidal anti-inflammatory analgesic. Indications Pain and inflammation associated with musculoskeletal disorders, e.g. rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. Effects on oral and dental structures Patients on long-term NSAIDs such as aceclofenac may be afforded some degree of protection against periodontal breakdown. This arises from the drug’s inhibitory action on prostaglandin synthesis. The latter is an important inflammatory mediator in the pathogenesis of periodontal breakdown. Effects on patient management Rare unwanted effects of aceclofenac include angioedema and thrombocytopenia. If the platelet count is low (:100,000) then the socket should be packed and sutured. Persistent bleeding may require a platelet transfusion. The latter may cause an increased bleeding tendency following any dental surgical procedure. Drug interactions Ibuprofen, aspirin and diflunisal should be avoided in patients taking aceclofenac due to an increase in unwanted effects, especially gastrointestinal ulceration, renal and liver damage. Systemic corticosteroids also increase the risk of peptic ulceration and gastrointestinal bleeding. Acemetacin (Emflex) Description A peripherally acting, non-steroidal anti-inflammatory analgesic. Indications Pain and inflammation associated with musculoskeletal disorders, e.g. rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. Postoperative analgesia. Effects on oral and dental structures Patients on long-term NSAIDs such as acemetacin may be afforded some degree of protection against periodontal breakdown. This arises from the drug’s inhibitory action on prostaglandin synthesis. The latter is an important inflammatory mediator in the pathogenesis of 4 ACETAZOLAMIDE periodontal breakdown. Acemetacin has also been implicated for inducing oral lichenoid eruptions and oral ulceration. The drug does have a higher incidence of bone marrow suppression when compared to other NSAIDs. This can cause agranulocytosis, leucopenia, aplastic anaemia, and/or thrombocytopenia. Such depression of bone marrow function will affect the oral mucosa (high risk of ulceration), the periodontal tissue (high risk of gingival bleeding and periodontal breakdown) and healing after any dental surgical procedure. Effects on patient management The risk of thrombocytopenia will cause an increased bleeding tendency following dental surgical procedures. If the platelet count is low (:100,000)

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