Principles of Pharmacology: The Science of Drug Use and Effects

1. Chapter 30 Principles of Pharmacology

2. Pharmacology • The science or branch of medicine that conducts research and development in the use and effects of drugs

3. Drug • A substance used in the prevention, diagnosis, or treatment of a disease. • All drugs must be recognized and defined by the US Food, Drug and Cosmetic Act before they can be marketed to the public in the US

4. A drug is identified by three names • Chemical name: which is the chemical formula of a drug • Generic name: which may be used by any company; acetaminophen is an example of a generic name • Brand name, or trade name: which is controlled by business firm as a registered trademark; such as Tylenol is brand name for acetaminophen

5. Dispensing • Patent medicines: drugs that can be obtained without a prescription; also known as over-the-counter drugs • Ethical drugs: Prescription drugs (from a physician or dentist), supplied to patients only by a pharmacist.

6. Prescriptions • A written order by a physician or dentist for preparation and administration of a medicine • Persons legally authorized to prescribe medications are issued a Federal Drug Enforcement Agency (DEA) identification number. • Dental assistants cannot prescribe medications

7. Terminology of Prescriptions • Superscription: patient name, address, the date and symbol Rx • Inscription: name and quantity of the drug • Subscription: directions for mixing the medication • Signature: instructions for the patient on how to take the medication, when and how much

8. Telephone Guidelines • Narcotics cannot be ordered without a written prescription • It is illegal for a Dental assistant to “call in” a prescription • Notify the dentist if the Pharmacist calls the office • Never attempt to evaluate a patient’s reaction to a drug.

9. Mosby’s Drug Consult • Annual source of information supplied by drug companies • It is a bound text, as well as a electronic source

10. Drugs • Local-acting drug • Affects only the specific area of the body to which it is applied, such as a topical ointment • Systemic drug • Taken internally • Can affect the whole body by way of circulatory system

11. Administration • Four stages • Absorption • Absorbed from site of entry—speed varies, slowest is orally • Distribution • Enters bloodstream, attaches to proteins within blood, and circulates throughout the body • Metabolism • Compound is released, and drug becomes metabolized and is then excreted through liver or kidneys • Excretion • Drug leaves the body by way of kidneys, liver, breast milk or sweat

12. Routes • Oral—tablets, liquid • Topical—apply on surface of mucosa • Transdermal –patch that continuously releases medication • Inhalation—breathing in substance • Sublingual—medication placed under the tongue

13. Controlled Substances Act • Drugs that are covered under the Federal Comprehensive Drug Abuse Prevention and Control Act are divided into five schedules

14. Schedules • Schedule I • No current accepted medical use/high potential for abuse • Schedule II • High potential for abuse, some medical usefulness • Schedule III • Less abuse potential than Schedule I and II, and has accepted medical usefulnes • Schedule IV • Low abuse potential and have accepted medical usefulness • Schedule V • Lowest abuse potential and accepted medical usefulness/no prescription needed

15. Chapter 37 • Anesthesia and Pain Control

16. Topical Anesthesia • Provides numbing effect in an area where in injection is to take place • Ointments, liquids, sprays or patches

17. Local Anesthesia • Most frequently used form of pain control in dentistry • Obtained by injecting an anesthetic solution near a nerve where treatment is to take place • Each local anesthetic cartridge contains • Local anesthetic drug • Sodium choloride • Distilled water

18. Uses of Vasoconstrictors • Slows down the intake of an anesthetic agent and increases the duration of action • Prolongs the effect of the anesthetic agent by decreasing the blood flow in immediate area of the injection • Decreases bleeding in the injected area

19. Contraindications to Vasoconstrictors • May cause strain on the heart • Not recommended for patients with a history of: • Angina • Chest pain (heart related) • Recent myocardial infarction • Coronary artery bypass surgery • Untreated or severe hypertension • Congestive heart failure

20. Duration of Anesthetics • Know the duration (in minutes) of each of the following • Short-acting local anesthetic • Intermediate-acting local anesthetic • Long-acting local anesthetic

21. Injection Techniques • Infiltration Anesthesia • Usually used for Maxillary arch • Also used for secondary injection to block gingival tissues surrounding mandibular teeth • Block Anesthesia • Usually used for mandibular arch • Block nerves for the quadrant

22. Syringe • Know the parts of the syringe and their functions

23. Cartridges/Disposable Needle • Know the color-coding system • Know the parts of the cartridge • Know the parts of the needle • Know the size of the needle for dentistry • Lumen—the hollow center of the needle-how the anesthetic flows through needle • The larger the gauge number—thinner the needle • The smaller the gauge number—thicker the needle

24. Complications and Precautions • Know in detail • Injection into a blood vessel • Infected areas • Toxic reactions • Systemic reactions • Temporary numbness • paresthesia

25. Inhalation sedation • Know the chemical make-up • Advantages of Nitrous Oxide Use • Contraindications of Nitrous Oxide Use • Equipment

26. Intravenous sedation • Understand the uses of IV sedation • General Anesthesia • Know definition • Know in detail the four stages of anesthesia

27. Happy Testing