Chapter 15 Pharmacology and Pain control. b Pharmacology is: the study of all drugsthe study of all drugs their propertiestheir properties how they react with each otherhow they react with each other actions of the drugs within the bodyactions of the drugs within the body

Pharmacology b Drug any substance that can change processes within the body.any substance that can change processes within the body. b Medicines drugs that are used to treat diseases.drugs that are used to treat diseases. b Side effects when drugs cause unwanted results.when drugs cause unwanted results.

Pharmacology b Drug interaction when one drug changes the effect of another drug by increasing or decreasing the intended result.when one drug changes the effect of another drug by increasing or decreasing the intended result. Physicians Desk Reference aka (PDR)Physicians Desk Reference aka (PDR) –printed annually –lists dosages, indications, contraindications. b Addiction a person is physically dependant on a drug.a person is physically dependant on a drug.

Pharmacology b Tolerance ability to tolerate the influence of a drug.ability to tolerate the influence of a drug. With a high tolerance, more of a drug would be needed to produce the same effect.With a high tolerance, more of a drug would be needed to produce the same effect. b Psychologically dependent emotional need to take a drugemotional need to take a drug habit forminghabit forming cravingcraving

Pharmacology b Withdrawal occurs when addict stops taking the drugoccurs when addict stops taking the drug symptomssymptoms –nervousness, –stomach cramps, –diarrhea, –shakes, –depression, –and even death

Prescriptions b Drug Enforcement Agency aka DEAaka DEA –federal agency –Must have a DEA # to prescribe meds –monitor prescriptions –investigate abuse of prescriptions

Prescriptions b Who can prescribe dentistsdentists physicians / doctorsphysicians / doctors psychiatristpsychiatrist some physician assistantssome physician assistants –depends on state laws and medication some registered nursessome registered nurses –depends on state laws and medication

Prescriptions b Parts of a prescription / RX HeadingHeading –Doc’s name, address, phone number SuperscriptionSuperscription –Name of patient, –their address –date of birth (DOB) –date written

Prescriptions Body (inscription)Body (inscription) –name of drug –dosage –number dispensed –and directions ClosingClosing –Doc’s signature –refills –Brand name or generic OK

Drug Names b Brand Names Assigned by the manufacturerAssigned by the manufacturer aka Trade namesaka Trade names Always capitalizedAlways capitalized registered trademark ®registered trademark ® b Examples Tylenol ®, Bayer ®, Advil ®Tylenol ®, Bayer ®, Advil ®

Drug Names b Generic names not capitalizednot capitalized less expensive than brand namesless expensive than brand names unprotected, any business can use themunprotected, any business can use them refer to chemical composition of drugrefer to chemical composition of drug examples:examples: –acetaminophen, aspirin, ibuprofen

Drugs used in dentistry b Analgesics pain medicationpain medication most are narcotics (habit forming)most are narcotics (habit forming) some are non-narcoticsome are non-narcotic b Antibiotics prevent or fight infectionsprevent or fight infections –penicillin, amoxicillin, erythromycin, –tetracycline (will discolor developing teeth)

Drugs used in dentistry b Prophylactic Antibiotic aka Pre-medaka Pre-med –rheumatic fever –joint replacement –heart murmur –heart valve replacement Prevents bacterial endocarditisPrevents bacterial endocarditis –inflammation of the inside layer of the heart

Drugs used in dentistry b Tranquilizers Sedative effectSedative effect relieves anxiety /reduces tensionrelieves anxiety /reduces tension ExamplesExamples –Nitrous oxide (N 2 O), Valium b Atropine inhibits flow of saliva for 4-6 hoursinhibits flow of saliva for 4-6 hours

Drug Terminology b Stimulant speeds up the bodies activityspeeds up the bodies activity –tobacco, caffeine, cocaine, amphetamines b Depressant slows down the bodies processslows down the bodies process –alcohol, marijuana –narcotics are addictive depressants that relieve pain. –Morphine, codine, heroin

Drug Terminology b Sedative depresses brain activitydepresses brain activity –reduces stress / anxiety –tranquilizers, barbiturates, nitrous oxide b Hallucinogen see and hear things / images that do not exist.see and hear things / images that do not exist. –LSD, mushrooms, PCP

Schedule of drugs b Groups drugs according to uses and potential for abuse. Schedule ISchedule I –high abuse rate, –no medical acceptance –heroin, PCP, LSD Schedule IISchedule II –High abuse rate,medical acceptance –morphine, amphetamines, barbiturates,

Schedule of drugs Schedule IIISchedule III –Lower abuse rate, medical acceptance –stimulants, depressants, Tylenol III Schedule IVSchedule IV –low abuse rate, medical acceptance –anti-anxiety, sedatives Schedule V (OTC)Schedule V (OTC) –very low abuse rate –anti-diarrhea, cough medication, eye drops

Routes of administration b How to get drugs in or ‘on board’ the body. Orally / by mouthOrally / by mouth –tablets, pills, liquids Topical / applied to skin or mucosaTopical / applied to skin or mucosa –ointment, gel, cream Sublingual / under the tongueSublingual / under the tongue –Nitroglycerin pill or spray, vitamins

Routes of administration Inhalation / breathing inInhalation / breathing in –gas (N 2 0), aerosol spray Intravenous / inject in veinIntravenous / inject in vein –almost immediate drug response Intramuscular / inject in muscleIntramuscular / inject in muscle –long lasting rectalrectal –suppositories

Routes of administration SubcutaneousSubcutaneous –injected under skin, above the muscle IntradermalIntradermal –injected under the top layer of skin TransdermalTransdermal –medication, –birth control, –stop smoking patch –worn for extended periods of time

Closing b It is very important to always check a patients medical history at every visit. b If they are taking medications or drugs, make sure to inform the dentist. b If in doubt, ask. b Any questions ?