Pharmacology Soup for the Dental Hygiene Soul

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Pharmacology Soup for
the
Dental Hygiene Soul
Paragon Hygiene Academy
November 14 & 15 2013
Ted A. Beitelschees, DDS
Pharmacology Soup for the
Dental Hygiene Soul
Goals




Consider some clinically significant adverse rxns
to the Top 50 drugs
Discuss some pharm “wrinkles” to selected dental
drugs
Look at some emerging trends in perio/oral health
care and how they relate to pharmacology
Give you tools for next week!
Pharmacology Soup for the Dental Hygiene Soul
Review the Top 50 Drugs
Hydrocodone/APAP
MetFORMIN
Gabapentin
Warfarin
Aoxicillin & Clavulanate Potassium
Lisinopril
Lipitor
Ibprofen
ClonazePAM
Ciprofloxacin
Simvastatin
Furosemide (Oral)
NexIUM
Lexapro
Pravastatin
Levothyroxine
Metoprolol
PredniSONE (oral)
Fluticasone
TraZODone
Amoxicillin
Atenolol
TraMADol
Cyclobenzaprine
ProAir HFA
AmLODIPine
Sertraline
Plavix
Cephalexin
Lovastatin
Azithromycin
Metoprolol XL
Singulair
Sulfamethoxazike &
Hydrochlorothiaszide and
Triamterene
ALPRAZolam
Zolpidem
Lisinopril &
Hydricholrothiazide
Crestor
Carvedilol
Hydrochlorothiazide
Oxycodone and APAP
FLUoxetine
Fexofenadine
Advair Diskus
Omeprazole
Citalopram
LORazepam
Synthroid
Alendronate
Trimethoprim
Top 50 Drugs Breakdown
10 Cardiac Drugs
5
Statins
4
Pain Control
5
Antibiotics
5
Respiratory Drugs
5
Sedative/Hyp
Top 50 Drug Review - adverse reactions
Xerostomia
Orthostatic Hypotension
Polypharmia
Gingival Enlargement (Hyperplasia)
Xerostomia
Selected alcohol-free products

Biotene

Oxyfresh products

Listerine Zero & Total Care Zero

Butler GUM chlorhexidine
gluconate 0.12% rinse

Flouride


Treatment – varnish, rinse, gel,
toothpaste, tray
Restorative materials – bonding agents,
composites, glass ionomer cements
Sodium Laurel Sulfate (SLS)–free toothpastes

Arm & Hammer Advance White for SensitiveTeeth

Burt's Bees Natural Toothpaste

Biotene Sensitive

Sensodyne - Original, Iso-Active, ProNamel, Extra Whitening, Cool
Gel, Fresh Impact, Tartar Control plus Whitening, Fresh Mint

Tom's of Maine Peppermint SLS-free Anticavity Plus Whitening
Clean and Gentle
Orthostatic Hypotension
Polypharmia
Drugs that can cause
Ginvigal Enlargement (Hyperplasia)





phenytoin (Dilantin)
nifedipine (Procardia, Adalat)
diltiazem (Cardizem)
verapimil (Calan)
amlodipine (Norvasc)
Pharm wrinkles with dental drugs
Local Anesthetics
Tricks with CVD Patients
–
–

Use 1:200,000 epi LA
Mix plain LA with LA & vaso
Still must watch total dosage!
Local Anesthetics
Infiltration of mandibular molars with
4% articane (Septocaine) w/ 1:100,000
or 1:200,000 epi
75% success on 1st molars
50% success on 2nd molars
Refractory Perio Aces
Metronidazole (Flagyl)

Great against anaerobes

Gets into GCF

Watch alcohol
Refractory Perio Aces
Doxycycline hyclate (Vibramycin)

Dosed once daily

4x concentration in GCF !

Watch sun worshippers
How serious is the disease?
(Not all bears are the same!)
First-Line Antihypertensives
hydrochlorothiazide (HCTZ, Diazide)
metaprolol (Tenormin)
ACE Inhibitors
 captopril (Capoten) and enalpril (Vasotec)
Trouble on the HTN front
reserpine (Serpasil)
guanethidine (Ismelin)
Other centrally acting (CNS) drugs
Multiple drugs
Future Trends
Future Trends
Future Trends
Old Dogs, New Tricks
Reducing Vascular Inflammation


Statins
– e.g. rosuvastatin (Crestor)
ACE inhibitors
– e.g. ramipril (Altace)
Future Trends
Perio Therapy
will be considered
Preventive Care
Pharmacology Soup for the
Dental Hygiene Soul
Thank You !
Ted Beitelschees, DDS
[email protected]
419.578.4100
Pharmacology Soup for the
Dental Hygiene Soul
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