Applied pharmacology for the dental hygienist:
With a focus on the most commonly used drugs in dentistry, Applied Pharmacology for the Dental Hygienist, 9th Edition provides an in-depth understanding of the pharmacologic principles needed for safe and effective dental treatment and oral health care. It discusses drug properties and mechanisms of...
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| Main Author: | |
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| Format: | Book |
| Language: | English |
| Published: |
St. Louis, Missouri
Elsevier
[2024]
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| Edition: | 9th edition |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis Klappentext Inhaltsverzeichnis Klappentext |
| Summary: | With a focus on the most commonly used drugs in dentistry, Applied Pharmacology for the Dental Hygienist, 9th Edition provides an in-depth understanding of the pharmacologic principles needed for safe and effective dental treatment and oral health care. It discusses drug properties and mechanisms of action, dosages, intended effects, interactions, and adverse reactions - both for the medications a patient may already be taking and for the drugs prescribed by the dentist. Comprehensive coverage with a dental hygiene focus provides you with an in-depth understanding of the most commonly used drugs, how they work, and how they affect patients' oral health and dental treatment options. Multiple opportunities for classroom and board exam prep offers a clinical case study and review questions at the end of each chapter and practice quizzes on the companion Evolve website to help you assess your knowledge of the material. Learning features include Dental Hygiene Considerations, summary boxes and tables, and Note boxes to highlight key concepts. Key terms are bolded and in color within each chapter and defined in a handy glossary for mastering vocabulary. Engaging full-color design includes illustrations showing basic principles and internal processes, along with photographs of oral conditions and side effects. Separate drug index provides easy look-up of specific drugs and types of drugs. Quick-reference appendixes include resources such as medical terminology, medical acronyms, and information on dose calculations for children. NEW! Updated drug content throughout, including new side effects and warnings for many commonly seen drugs |
| Physical Description: | xix, 347 Seiten Illustrationen 216 x 276 mm |
| ISBN: | 9780323798631 0323798632 |
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| 520 | |a With a focus on the most commonly used drugs in dentistry, Applied Pharmacology for the Dental Hygienist, 9th Edition provides an in-depth understanding of the pharmacologic principles needed for safe and effective dental treatment and oral health care. It discusses drug properties and mechanisms of action, dosages, intended effects, interactions, and adverse reactions - both for the medications a patient may already be taking and for the drugs prescribed by the dentist. Comprehensive coverage with a dental hygiene focus provides you with an in-depth understanding of the most commonly used drugs, how they work, and how they affect patients' oral health and dental treatment options. Multiple opportunities for classroom and board exam prep offers a clinical case study and review questions at the end of each chapter and practice quizzes on the companion Evolve website to help you assess your knowledge of the material. Learning features include Dental Hygiene Considerations, summary boxes and tables, and Note boxes to highlight key concepts. Key terms are bolded and in color within each chapter and defined in a handy glossary for mastering vocabulary. Engaging full-color design includes illustrations showing basic principles and internal processes, along with photographs of oral conditions and side effects. Separate drug index provides easy look-up of specific drugs and types of drugs. Quick-reference appendixes include resources such as medical terminology, medical acronyms, and information on dose calculations for children. NEW! Updated drug content throughout, including new side effects and warnings for many commonly seen drugs | ||
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| _version_ | 1804186126199554048 |
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| adam_text | CONTENTS PART I General Principles 1 Information, Sources, Regulatory Agencies, Drug Legislation, and Prescription Writing, 2 History, 2 Role of the Dental Hygienist, 2 Medication/Health History, 2 Medication Administration, 3 Emergency Situations, 3 Appointment Scheduling, 3 Nonprescription Medication, 3 Nutritional or Herbal Supplements, 3 Sources of information, 3 Printed Resources, 3 Computer and Online Resources, 4 Drug Names, 4 Drug Substitution, 5 Federal Regulations and Regulatory Agencies, 5 Harrison Narcotic Act, 5 US Food and Drug Administration, 5 Federal Trade Commission, 5 US Drug Enforcement Administration, 5 Omnibus Budget Reconciliation Act, 5 Clinical Evaluation of a New Drug, 5 Drug Legislation, 6 History, 6 Scheduled Drugs, 6 Package Inserts, 6 Black Box Warning, 6 Labeled and Off-Label Uses, 7 Orphan Drugs, 7 Drug Recall, 7 Prescription Writing, 7 Measurement, 7 Prescriptions, 7 Role of the Dental Hygienist and Patient Adherence to Medication Therapy, 9 Dental Hygiene Considerations, 10 Academic Skills Assessment, 10 Clinical Applications, 10 2 Drug Action and Handling, 11 Characterization of Drug Action, 11 Log Dose-Effect Curve, 11 Potency, 11 Efficacy, 11 Therapeutic Index, 12 Mechanism of Action of Drugs, 12 Receptors, 13 Pharmacokinetics, 14 Passage Across Body Membranes, 14 Absorption, 14 Distribution, 15 Redistribution, 16 Metabolism (Biotransformation), 16 Clinical Pharmacokinetics, 18 Half-Life, 18 Kinetics, 18 Factors That Alter Drug Effects, 18 Routes of Administration and Dose Forms, 19 Routes ofAdministration, 19 Dosage Forms, 23 Dental
Hygiene Considerations, 23 Academic Skills Assessment, 23 Clinical Case Study, 23 3 Adverse Reactions, 24 Definitions and Classifications, 24 Clinical Manifestations of Adverse Reactions, 25 Exaggerated Effect on Target Tissues, 25 Effect on Nontarget Tissues, 25 Effect on Fetal Development (Teratogenic Effect), 25 Local Effect, 25 Drug Interactions, 25 Hypersensitivity (Allergic Reaction), 26 Idiosyncrasy, 27 Interference With Natural Defense Mechanisms, 27 Toxicologic Evaluation of Drugs, 27 Recognizing Adverse Drug Effects, 28 Dental Hygiene Considerations, 28 Academic Skills Assessment, 28 Clinical Case Study, 29 PART II Drugs Used in Dentistry 4 Autonomic Drugs, 31 Autonomic Nervous System, 31 Anatomy, 31 Parasympathetic Autonomic Nervous System, 31 Sympathetic Autonomic Nervous System, 31 Functional Organization, 32 Neurotransmitters, 32 Parasympathetic Autonomic Nervous System, 35 Cholinergic (Parasympathomimetic) Agents, 35 Anticholinergic (Parasympatholytic) Agents, 37 Nicotinic Agonists and Antagonists, 39 Sympathetic Autonomic Nervous System, 39 Sympathetic Autonomic Nervous System Receptors, 39 Adrenergic (Sympathomimetic) Agents, 40 Adrenergic Blocking Agents, 42 Neuromuscular Blocking Drugs, 42 Dental Hygiene Considerations, 43 Academic Skills Assessment, 43 Clinical Case Study, 44 xiii
XIV CONTENTS 5 Nonopioid (Nonnarcotic) Analgesics, 45 Pain, 45 Classification, 45 Salicylates, 45 Acetylsalicylic Acid, 45 Nonacetylated Salicylates, 50 Diflunisal, 50 Nonsteroidal Antiinflammatory Drugs, 50 Chemical Classification, 50 Mechanism ofAction, 50 Pharmacokinetics, 50 Pharmacologic Effects, 51 Adverse Reactions, 51 Drug Interactions, 52 Contraindications and Cautions, 52 Precautions, 52 Therapeutic Uses, 52 Specific Nonsteroidal Antiinflammatory Drugs, 53 Acetaminophen, 54 Pharmacokinetics, 54 Pharmacologic Effects, 54 Adverse Reactions, 54 Drug Interactions, 55 Uses, 55 Doses and Preparations, 55 Drugs Used to Treat Gout, 56 Colchicine, 56 Febuxostat, 56 Allopurinol, 56 Probenecid, 56 Other Drugs, 56 Drugs Used to Treat Arthritis, 56 Disease-Modifying Antirheumatic Drugs, 56 Biologic Response Modifiers, 57 Dental Hygiene Considerations, 57 Academic Skills Assessment, 57 Clinical Case Study, 57 6 Opioid (Narcotic) Analgesics and Antagonists, 58 History, 58 Classification, 58 Mechanism of Action, 58 Pharmacokinetics, 58 Pharmacologic Effects, 59 Analgesia, 59 Sedation and Euphoria, 59 Cough Suppression, 60 Gastrointestinal Effects, 60 Adverse Reactions, 60 Respiratory Depression, 60 Nausea and Emesis, 61 Constipation, 61 Miosis, 61 Urinary Retention, 61 Central Nervous System Effects, 61 Cardiovascular Effects, 61 Biliary Tract Constriction, 61 Histamine Release, 61 Pregnancy and Nursing Considerations, 61 Addiction, 61 Allergic Reactions, 62 Drug Interactions, 62 Specific Opioids, 63 Opioid Agonists, 63 Mixed Opioids, 65 Opioid Antagonists, 65 Full
Agonist/Reuptake Inhibitors, 66 Dental Use of Opioids, 66 Chronic Dental Pain and Opioid Use, 67 Patient Concerns Regarding Opioid Use, 67 Dental Hygiene Considerations, 67 Academic Skills Assessment, 67 Clinical Case Studies, 67 7 Antiinfective Agents, 68 Evolution of a Dental Infection, 68 Definitions, 69 Infection, 69 Resistance, 69 Indications for Antimicrobial Agents, 70 Therapeutic Indications, 70 Prophylactic Indications, 70 General Adverse Reactions and Disadvantages Associated With Antiinfective Agents, 70 Superinfection (Suprainfection), 70 Allergic Reactions, 70 Drug Interactions, 70 Gastrointestinal Complaints, 72 Pregnancy Considerations, 72 Dose Forms, 72 Cost, 72 Penicillin Varieties, 72 Pharmacokinetics, 72 Mechanism ofAction, 73 Spectrum, 73 Resistance, 73 Adverse Reactions, 73 Uses, 74 Specific Types ofPenicillin, 74 Cephalosporins, 75 Pharmacokinetics, 75 Spectrum, 75 Mechanism ofAction, 75 Adverse Reactions, 75 Uses, 76 Macrolides, 76 Erythromycin, 76 Azithromycin and Clarithromycin, 77 Tetracyclines, 77 Pharmacokinetics, 77 Spectrum, 77 Adverse Reactions, 77 Drug Interactions, 78 Uses, 79 Clindamycin, 79 Pharmacokinetics, 79 Spectrum, 79 Adverse Reactions, 79 Uses, 80 Metronidazole, 80 Pharmacokinetics, 80 Spectrum, 80 Adverse Reactions, 80 Drug Interactions, 80 Uses, 81
CONTENTS Rational Use of Antiinfective Agents in Dentistry, 81 Stages of Infection, 81 Failure ofAntiinfective Therapy, 81 Antimicrobial Agents for Nondental Use, 81 Vancomycin, 81 Aminoglycosides, 82 Sulfonamides, 82 Sulfamethoxazole- Trimethoprim, 83 Nitrofurantoin, 83 Quinolones (Fluoroquinolones), 83 Antituberculosis Agents, 84 Isoniazid, 84 Rifampin, 85 Pyrazinamide, 85 Ethambutol, 85 Topical Antibiotics, 85 Neomycin, Polymyxin, and Bacitracin, 85 Mupirocin, 85 Antibiotic Prophylaxis Used in Dentistry, 86 Prevention of Infective Endocarditis, 86 Prosthetic Joint Prophylaxis, 88 Noncardiac Medical Conditions, 88 Dental Hygiene Considerations, 88 Academic Skills Assessment, 88 Clinical Case Study, 89 Bibliography, 89 8 Antifungal and Antiviral Agents, 90 Antifungal Agents, 90 Nystatin, 90 Imidazoles, 90 Antiviral Agents, 92 Herpes Simplex, 92 SARS-CoV-2 virus, 93 Acquired Immunodeficiency Syndrome, 94 Chronic Hepatitis, 97 Influenza, 97 Dental Hygiene Considerations, 98 Academic Skills Assessment, 98 Clinical Case Study, 99 9 Antianxiety Agents, 100 Definitions, 100 Benzodiazepines, 101 Chemistry, 101 Pharmacokinetics, 101 Mechanism of Action, 102 Pharmacologic Effects, 102 Adverse Reactions, 102 Abuse and Tolerance, 103 Medical Uses, 104 Management of the Dental Patient Taking Benzodiazepines, 105 Barbiturates, 105 Chemistry, 106 Pharmacokinetics, 106 Mechanism ofAction, 106 Pharmacologic Effects, 106 Adverse Reactions, 106 Long-Term Use, 106 Contraindications, 106 Drug Interactions, 106 Uses, 106 xv Nonbenzodiazepine-Nonbarbiturate Sedative-Hypnotics, 107 Buspirone,
107 Nonbenzodiazepine Receptor Hypnotics, 107 Zolpidem, 107 Zaleplon, 107 Eszopiclone, 107 Melatonin Receptor Agonist, 107 Melatonin, 108 Orexin Receptor Antagonist, 108 Centrally Acting Muscle Relaxants, 108 Pharmacologic Effects, 108 Individual Centrally Acting Muscle Relaxants, 108 Miscellaneous Agents, 108 Baclofen, 108 Tizanidine, 109 Dantrolene, 109 General Comments About Antianxiety Agents, 109 Analgesic-Sedative Combinations, 109 Special Considerations, 109 Precautions, 109 Dental Hygiene Considerations, 110 Academic Skills Assessment, 110 Clinical Case Study, 110 10 Local Anesthetics, 111 History, 111 Ideal Local Anesthetic, 111 Chemistry, 111 Mechanism of Action, 111 Action on Nerve Fibers, 111 Ionization Factors, 112 Pharmacokinetics, 112 Absorption, 112 Distribution, 114 Metabolism, 114 Excretion, 114 Pharmacologic Effects, 114 Peripheral Nerve Conduction (Blocker), 114 Antiarrhythmic, 114 Adverse Reactions, 114 Toxicity, 115 Local Effects, 115 Malignant Hyperthermia, 115 Pregnancy and Nursing Considerations, 115 Allergy, 115 Composition of Local Anesthetic Solutions, 116 Local Anesthetic Agents, 116 Amides, 116 Esters, 118 Other Local Anesthetics, 118 Vasoconstrictors, 118 Overview, 118 Drug Interactions, 120 Choice of Local Anesthetic, 120 Topical Anesthetics, 121 Amides, 122 Esters, 123 Precautions in Topical Anesthesia, 123 Doses of Local Anesthetic and Vasoconstrictor, 123 Dental Hygiene Considerations, 124 Academic Skills Assessment, 124 Clinical Case Study, 124
XVI 11 General Anesthetics, 125 History, 125 Mechanism of Action, 125 Overview, 125 Stages and Planes ofAnesthesia, 125 Adverse Reactions, 126 General Anesthetics, 126 Classification ofAnesthetic Agents, 126 Induction Anesthesia, 126 Induction and Maintenance Anesthesia, 128 Nitrous Oxide, 128 Halogenated Hydrocarbons, 130 Balanced General Anesthesia, 130 Dental Hygiene Considerations, 130 Academic Skills Assessment, 130 Clinical Case Study, 131 PART III Drugs That May Alter Dental Treatment 12 Drugs for the Treatment of Cardiovascular Diseases, 133 Dental Implications of Cardiovascular Disease, 133 Contraindications to Treatment, 133 Vasoconstrictor Limit, 134 Periodontal Disease and Cardiovascular Disease, 134 Hypertension, 134 Patient Evaluation, 135 Treatment of Hypertension, 136 Diuretic Agents, 138 Angiotensin Receptor Blockers, 140 Calcium Channel Blocking Agents, 141 Direct Renin Inhibitors, 142 ß-Adrenergic Blocking Agents, 142 aгAdrenergic Blocking Agents, 143 Central a-Adrenergic Agonists, 144 Management of the Dental Patient Taking Antihypertensive Agents, 144 Heart Failure, 144 Treatment of Heart Failure, 145 Angiotensin II Receptor Neprilysin Inhibitor, 145 IF Channel Inhibitor, 147 Cardiac Glycosides, 147 Digitalis Glycosides, 147 Antianginal Drugs, 148 Angina Pectoris, 148 Nitroglycerin-Like Compounds, 148 ß-Adrenergic Blocking Agents, 150 Calcium Channel Blocking Agents, 150 Ranolazine, 150 Angiotensin-Converting Enzyme Inhibitors, 150 Angiotensin Receptor Blockers, 150 Dental Implications, 150 Antiarrhythmic Agents, 151 Automaticity, 151 Arrhythmias, 151
Antiarrhythmic Agents, 151 Antihyperlipidemic Agents, 152 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase Inhibitors, 152 Inhibitors of Intestinal Absorption of Cholesterol, 152 Niacin, 153 Cholestyramine, 153 Fibric Acid Derivatives, 154 Fish Oils, 154 Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors, 155 Dental Implications ofElevated Cholesterol Levels, 155 Drugs That Affect Blood Coagulation, 155 Anticoagulants, 155 Parenteral Anticoagulants, 155 Low-Molecular-Weight Heparin, 155 Oral Anticoagulants, 155 Factor Xa Inhibitors, 157 Direct Thrombin Inhibitor, 157 Thienopyridines, 157 Clopidogrel, 157 Prasugrel, 158 Tieagrelor, 158 Streptokinase and Alteplase, 158 Dipyridamole, 158 Pentoxifylline, 158 Drugs That Increase Blood Clotting, 158 Hemostatic Agents (Fibrinolytic Inhibitors), 158 • Dental Hygiene Considerations, 158 Academic Skills Assessment, 158 Clinical Case Study, 159 References, 159 13 Drugs for the Treatment of Gastrointestinal Disorders, 160 Gastrointestinal Drugs, 160 Gastrointestinal Diseases, 160 Dental Implications, 161 Drugs Used to Treat Gastrointestinal Diseases, 161 Histamine2-Blocking Agents, 161 Proton Pump Inhibitors, 162 Mixed Antiinfective Therapyfor Ulcer Treatment, 162 Antacids, 162 Miscellaneous Gastrointestinal Drugs, 163 Laxatives and Antidiarrheals, 163 Agents Used to Manage Chronic Inflammatory Bowel Disease, 165 Celiac Disease, 165 Dental Hygiene Considerations, 166 Academic Skills Assessment, 166 Clinical Case Study, 166 14 Drugs for the Treatment of Seizure Disorders, 167 Epilepsy, 167 Generalized Seizures, 167 Partial (Focal)
Seizures, 168 Drug Therapy of Patients With Epilepsy, 168 General Adverse Reactions ofAntiepileptic Agents, 169 Valproate, 169 Lamotrigine, 170 Levetiracetam, 170 Oxcarbazepine, 170 Carbamazepine, 170 Phenytoin, 172 Ethosuximide, 174
CONTENTS Benzodiazepines, 174 Other Antiepileptic Agents, 174 Dental Treatment of the Patient With Epilepsy, 174 Nonseizure Uses of Antiepileptics, 174 Neurologic Pain, 174 Psychiatric Use, 174 Dental Hygiene Considerations, 174 Academic Skills Assessment, 174 Clinical Case Study, 175 15 Drugs for the Treatment of Central Nervous System Disorders, 176 Psychiatric Disorders, 176 Antipsychotic Agents, 178 Mechanism ofAction, 178 Pharmacologic Effects, 179 Drug Interactions, 180 Uses, 180 Dental Implications, 181 Antidepressant Agents, 181 Selective Serotonin Reuptake Inhibitors, 181 Serotonin-Norepinephrine Reuptake Inhibitors, 183 Tricyclic Antidepressants, 183 Monoamine Oxidase Inhibitors, 184 Other Antidepressants, 184 Suicide and Antidepressants, 184 Dental Implications, 184 Drugs for Treatment of Bipolar Disorder, 185 Lithium, 185 Antiepileptic Drugs, 185 Second-Generation Antipsychotics, 185 Dental hygiene considerations, 185 Academic skills assessment, 185 Clinical Case Study, 186 16 Adrenocorticosteroids, 187 Mechanism of Release, 187 Classification, 187 Definitions, 187 Routes of Administration, 188 Mechanism of Action, 188 Pharmacologic Effects, 188 Adverse Reactions, 188 Metabolic Changes, 188 Infections, 189 Central Nervous System Effects, 189 Peptic Ulcer, 189 Impaired Wound Healing and Osteoporosis, 189 Ophthalmic Effects, 189 Electrolyte and Fluid Balance, 189 Adrenal Crisis, 189 Dental Effects, 190 Uses, 190 Medical Uses, 190 Dental Uses, 191 Corticosteroid Products, 191 Dental Implications, 191 Adverse Reactions, 192 Steroid Supplementation, 193 Topical Use,
193 Dental Hygiene Considerations, 193 Academic Skills Assessment, 194 Clinical Case Study, 194 Reference, 194 XVII 17 Drugs for the Treatment of Respiratory Disorders and Allergic Rhinitis, 195 Respiratory Diseases, 195 Asthma, 195 Chronic Obstructive Pulmonary Disease, 196 Drugs Used to Treat Respiratory Diseases, 199 Metered-Dose Inhalers, 199 Sympathomimetic Agents, 199 Corticosteroids, 201 Leukotriene Modifiers, 201 Cromolyn, 201 Methylxanthines, 202 Muscarinic Antagonists, 202 Antiimmunoglobulin E Antibodies, 202 Interleukin-5 Antibody Antagonists, 202 Interleukin-4 Receptor Alpha Antibody Antagonist, 202 Agents Used to Manage Upper Respiratory Infections, 202 Dental Implications of the Respiratory Drugs, 203 Allergic Rhinitis, 203 Pharmacologic Effects, 204 H1 -Receptor Blocking Effects, 204 Other Effects (Unrelated to HrBlocking Effects), 204 Adverse Reactions, 204 Central Nervous System Depression, 204 Anticholinergic Effects, 204 Dental hygiene considerations, 206 Academic skills assessment, 207 Clinical Case Study, 207 Clinical Case Study, 207 18 Drugs for the Treatment of Diabetes Mellitus, 208 Pancreatic Hormones, 208 Diabetes Mellitus, 208 Types of Diabetes, 208 Dental Implications of Diabetes, 209 Systemic Complications ofDiabetes, 210 Evaluation of the Dental Patient With Diabetes, 211 Goals of Therapy, 211 Drugs Used to Manage Diabetes, 212 Insulins, 212 Antihyperglycemic Drugsfor Type 2 Diabetes, 213 Treatment of Hypoglycemia, 218 Glucagon, 218 Dental Hygiene Considerations, 218 Academic Skills Assessment, 218 Clinical Case Study, 218 Bibliography, 218 19
Drugs for the Treatment of Other Endocrine Disorders, 219 Pituitary Hormones, 219 Anterior Pituitary, 219 Posterior Pituitary, 221 Thyroid Hormones, 221 Iodine, 221 Hypothyroidism, 221 Hyperthyroidism, 221 Female Sex Hormones, 222 Estrogens, 223 Progestins, 224 Hormonal Contraceptives, 224
XVIII CONTENTS Male Sex Hormones, 225 Androgens, 225 Other Agents That Affect Sex Hormone Systems, 226 Clomiphene, 226 Leuprolide, 226 Tamoxifen, 227 Danazol, 227 Aromatase Inhibitors, 227 Dental Hygiene Considerations, 227 Academic Skills Assessment, 227 Clinical Case Study, 227 20 Antineoplastic Drugs, 229 Use of Antineoplastic Agents, 229 Mechanisms of Action, 230 Classification, 231 Adverse Drug Effects, 233 Bone Marrow Suppression, 233 Osteonecrosis, 233 Gastrointestinal Effects, 235 Dermatologic Effects, 235 Hepatotoxicity, 235 Nephrotoxicity, 235 Immunosuppression, 235 Germ Cells, 235 Oral Effects, 235 Combinations, 236 Dental Implications, 236 Dental Hygiene Considerations, 237 Academic Skills Assessment, 237 Clinical Case Study, 237 PART IV Special Situations 21 Emergency Drugs, 239 General Measures, 239 Steps Indicated, 239 Preparation for Treatment, 239 Categories of Emergencies, 240 Lost or Altered Consciousness, 240 Respiratory Emergencies, 241 Cardiovascular System Emergencies, 242 Other Emergency Situations, 242 Drug-Related Emergencies, 244 Emergency Kit for The Dental Office, 245 Drugs, 245 Equipment, 248 Dental Hygiene Considerations, 248 Academic Skills Assessment, 248 Clinical Case Study, 248 22 Pregnancy and Breastfeeding, 249 General Principles, 249 Two Main Concerns, 249 History, 249 Pregnancy, 249 Pregnancy Trimesters, 249 Teratogenicity, 250 US Food and Drug Administration Drug Use in Pregnancy and Lactation, 250 Breastfeeding, 251 Dental Drugs, 251 Local Anesthetic Agents, 251 Epinephrine, 251 Analgesics, 251 Antiinfective Agents, 254 Antianxiety
Agents, 255 Dental Hygiene Considerations, 256 Academic Skills Assessment, 256 Clinical Case Study, 257 23 Substance Use Disorders, 258 General Considerations, 258 Definitions, 258 Psychological Dependence, 259 Physical Dependence, 259 Tolerance, 259 Central Nervous System Depressants, 260 Ethyl Alcohol, 260 Nitrous Oxide, 263 Opioid Analgesics, 264 Opioid Street Drug 265 Sedative-Hypnotics, 265 Pattern ofAbuse, 265 Management ofAcute Overdose and Withdrawal, 266 Central Nervous System Stimulants, 266 Cocaine, 266 Amphetamines, 266 Caffeine, 267 Tobacco, 267 Psychedelics (Hallucinogens), 269 Lysergic Acid Diethylamide, 269 Phencyclidine, 269 Marijuana, 269 Identifying the Substance User, 270 The Impaired Dental Hygienist, 270 Dental Hygiene Considerations, 270 Academic Skills Assessment, 270 Clinical Case Study, 271 24 Natural/Herbal Products and Dietary Supplements, 272 Limited Regulation, 272 Dietary Supplement Health and Education Act, 272 Package Labeling, 273 Safety of Herbal and Nutritional Products, 273 Oral Adverse Effects, 273 Drug Interactions, 273 Standardization of Herbal Products, 275 Good Manufacturing Practice, 275 Herbal Supplements Used in Oral Health Care, 276 Acemannan, 276 Essential Oil Mouth Rinse, 276 Oil of Cloves (Eugenol), 276 Triclosan, 276 Xylitol, 276 Dental Hygiene Considerations, 277 Academic Skills Assessment, 277 Clinical Case Study, 277 25 Oral Conditions and Their Treatment, 278 Infectious Lesions, 278 Acute Necrotizing Ulcerative Gingivitis, 278 Herpes Infections, 278 Candidiasis (Moniliasis), 280 Angular Cheilitis/Cheilosis, 281 Alveolar
Osteitis, 282
CONTENTS Immune Reactions, 282 Recurrent Aphthous Stomatitis, 282 Lichen Planus, 283 Miscellaneous Oral Conditions, 283 Geographic Tongue, 283 Burning Mouth or Tongue Syndrome, 283 Inflammation, 284 Pericoronitis, 284 Post-Irradiation Caries, 284 Root Sensitivity, 284 Actinic Lip Changes, 284 Stomatitis, 284 Drug-Induced Oral Side Effects, 284 Xerostomia, 284 Sialorrhea, 284 Hypersensitivity Reactions, 285 Oral Lesions That Resemble Autoimmune-Type Reactions, 285 Stains, 287 Gingival Enlargement, 287 Osteonecrosis of the Jaw, 287 Agents Commonly Used to Treat Oral Lesions, 287 Corticosteroids, 287 Palliative Treatment, 288 Dental Hygiene Considerations, 288 Academic Skills Assessment, 288 Clinical Case Study, 288 xix 26 Hygiene-Related Oral Disorders, 289 Dental Caries, 289 Prevention, 289 Gingivitis, 295 Prevention, 295 Tooth Hypersensitivity, 296 Pathophysiology, 296 Treatment, 296 Dental Hygiene Considerations, 297 Patient Education for Caries and Gingivitis, 297 Patient Education for Tooth Hypersensitivity, 298 Patient Self-Care, 298 Academic Skills Assessment, 298 Clinical Case Study, 298 Reference, 298 Bibliography, 298 Appendix A: Medical Acronyms, 299 Appendix B: Medical Terminology, 302 Appendix C: What If..., 304 Appendix D: Oral Manifestations: Xerostomia and Taste Changes, 309 Appendix E: Children s Dose Calculations, 312 Glossary, 313 Drug Index, 321 Subject Index, 335
g’h HYGIENIST ELENA BABLENIS HAVELES With a focus on the most commonly used drugs in dentistry, this comprehensive resource dental treatment and oral health care. It discusses drug properties and mechanisms of action, dosages, intended effects, interactions, and adverse reactions-both for the medications • Clinical case studies and review questions within chapters plus quizzes online offer
СШ^Ш’Г® PART I General Principles 1 Information, Sources, Regulatory Agencies, Drug Legislation, and Prescription Writing, 2 History, 2 Role of the Dental Hygienist, 2 Medication/Health History, 2 Medication Administration, 3 Emergency Situations, 3 Appointment Scheduling, 3 Nonprescription Medication, 3 Nutritional or Herbal Supplements, 3 Sources of information, 3 Printed Resources, 3 Computer and Online Resources, 4 Drug Names, 4 Drug Substitution, 5 Federal Regulations and Regulatory Agencies, 5 Harrison Narcotic Act, 5 US Food and Drug Administration, 5 Federal Trade Commission, 5 US Drug Enforcement Administration, 5 Omnibus Budget Reconciliation Act, 5 Clinical Evaluation of a New Drug, 5 Drug Legislation, 6 History, 6 Scheduled Drugs, 6 Package Inserts, 6 Black Box Warning, 6 Labeled and Off-Label Uses, 7 Orphan Drugs, 7 Drug Recall, 7 Prescription Writing, 7 Measurement, 7 Prescriptions, 7 Role of the Dental Hygienist and Patient Adherence to Medication Therapy, 9 Dental Hygiene Considerations, 10 Academic Skills Assessment, 10 Clinical Applications, 10 2 Drug Action and Handling, 11 Characterization of Drug Action, 11 Log Dose-Effect Curve, 11 Potency, II Efficacy, 11 Therapeutic Index, 12 Mechanism of Action of Drugs, 12 Receptors, 13 Pharmacokinetics, 14 Passage Across Body Membranes, 14 Absorption, 14 Distribution, 15 Redistribution, 16 Metabolism (Biotransformation), 16 Clinical Pharmacokinetics, 18 Half-Life, 18 Kinetics, 18 Factors That Alter Drug Effects, 18 Routes of Administration and Dose Forms, 19 Routes of Administration, 19 Dosage Forms, 23 Dental
Hygiene Considerations, 23 Academic Skills Assessment, 23 Clinical Case Study, 23 3 Adverse Reactions, 24 Definitions and Classifications, 24 Clinical Manifestations of Adverse Reactions, 25 Exaggerated Effect on Target Tissues, 25 Effect on Nontarget Tissues, 25 Effect on Fetal Development (Teratogenic Effect), 25 Local Effect, 25 Drug Interactions, 25 Hypersensitivity (Allergic Reaction), 26 Idiosyncrasy, 27 Interference With Natural Defense Mechanisms, 27 Toxicologic Evaluation of Drugs, 27 Recognizing Adverse Drug Effects, 28 Dental Hygiene Considerations, 28 Academic Skills Assessment, 28 Clinical Case Study, 29 PART II Drugs Used in Dentistry 4 Autonomic Drugs, 31 Autonomic Nervous System, 31 Anatomy, 31 Parasympathetic Autonomic Nervous System, 31 Sympathetic Autonomic Nervous System, 31 Functional Organization, 32 Neurotransmitters, 32 Parasympathetic Autonomic Nervous System, 35 Cholinergic (Parasympathomimetic) Agents, 35 Anticholinergic (Parasympatholytic) Agents, 37 Nicotinic Agonists and Antagonists, 39 Sympathetic Autonomic Nervous System, 39 Sympathetic Autonomic Nervous System Receptors, 39 Adrenergic (Sympathomimetic) Agents, 40 Adrenergic Blocking Agents, 42 Neuromuscular Blocking Drugs, 42 Dental Hygiene Considerations, 43 Academic Skills Assessment, 43 Clinical Case Study, 44 xiii
CONTENTS 5 Nonopioid (Nonnarcotic) Analgesics, 45 Pain, 45 Classification, 45 Salicylates, 45 Acetylsalicylic Acid, 45 Nonacetylated Salicylates, 50 Diflunisal, 50 Nonsteroidal Antiinflammatory Drugs, 50 Chemical Classification, 50 Mechanism of Action, 50 Pharmacokinetics, 50 Pharmacologic Effects, 51 Adverse Reactions, 51 Drug Interactions, 52 Contraindications and Cautions, 52 Precautions, 52 Therapeutic Uses, 52 Specific Nonsteroidal Antiinflammatory Drugs, 53 Acetaminophen, 54 Pharmacokinetics, 54 Pharmacologic Effects, 54 Adverse Reactions, 54 Drug Interactions, 55 Uses, 55 Doses and Preparations, 55 Drugs Used to Treat Gout, 56 Colchicine, 56 Febuxostat, 56 Allopurinol, 56 Probenecid, 56 Other Drugs, 56 Drugs Used to Treat Arthritis, 56 Disease-Modifying Antirheumatic Drugs, 56 Biologic Response Modifiers, 57 Dental Hygiene Considerations, 57 Academic Skills Assessment, 57 Clinical Case Study, 57 6 Opioid (Narcotic) Analgesics and Antagonists, 58 History, 58 Classification, 58 Mechanism of Action, 58 Pharmacokinetics, 58 Pharmacologic Effects, 59 Analgesia, 59 Sedation and Euphoria, 59 Cough Suppression, 60 Gastrointestinal Effects, 60 Adverse Reactions, 60 Respiratory Depression, 60 Nausea and Emesis, 61 Constipation, 61 Miosis, 61 Urinary Retention, 61 Central Nervous System Effects, 61 Cardiovascular Effects, 61 Biliary Tract Constriction, 61 Histamine Release, 61 Pregnancy and Nursing Considerations, 61 Addiction, 61 Allergic Reactions, 62 Drug Interactions, 62 Specific Opioids, 63 Opioid Agonists, 63 Mixed Opioids, 65 Opioid Antagonists, 65 Full Agonist/Reuptake
Inhibitors, 66 Dental Use of Opioids, 66 Chronic Dental Pain and Opioid Use, 67 Patient Concerns Regarding Opioid Use, 67 Dental Hygiene Considerations, 67 Academic Skills Assessment, 67 Clinical Case Studies, 67 7 Antiinfective Agents, 68 Evolution of a Dental Infection, 68 Definitions, 69 Infection, 69 Resistance, 69 Indications for Antimicrobial Agents, 70 Therapeutic Indications, 70 Prophylactic Indications, 70 General Adverse Reactions and Disadvantages Associated With Antiinfective Agents, 70 Superinfection (Suprainfection), 70 Allergic Reactions, 70 Drug Interactions, 70 Gastrointestinal Complaints, 72 Pregnancy Considerations, 72 Dose Forms, 72 Cost, 72 Penicillin Varieties, 72 Pharmacokinetics, 72 Mechanism of Action, 73 Spectrum, 73 Resistance, 73 Adverse Reactions, 73 Uses, 74 Specific Types of Penicillin, 74 Cephalosporins, 75 Pharmacokinetics, 75 Spectrum, 75 Mechanism ofAction, 75 Adverse Reactions, 75 Uses, 76 Macrolides, 76 Erythromycin, 76 Azithromycin and Clarithromycin, 77 Tetracyclines, 77 Pharmacokinetics, 77 Spectrum, 77 Adverse Reactions, 77 Drug Interactions, 78 Uses, 79 Clindamycin, 79 Pharmacokinetics, 79 Spectrum, 79 Adverse Reactions, 79 Uses, 80 Metronidazole, 80 Pharmacokinetics, 80 Spectrum, 80 Adverse Reactions, 80 Drug Interactions, 80 Uses, 81
CONTENTS Rational Use of Antiinfective Agents in Dentistry, 81 Stages of Infection, 81 Failure ofAntiinfective Therapy, 81 Antimicrobial Agents for Nondental Use, 81 Vancomycin, 81 Aminoglycosides, 82 Sulfonamides, 82 Sidfamethoxazole-Trimethoprim, 83 Nitrofurantoin, 83 Quinolones (Fluoroquinolones), 83 Antituberculosis Agents, 84 Isoniazid, 84 Rifampin, 85 Pyrazinamide, 85 Ethambutol, 85 Topical Antibiotics, 85 Neomycin, Polymyxin, and Bacitracin, 85 Mupirocin, 85 Antibiotic Prophylaxis Used in Dentistry, 86 Prevention of Infective Endocarditis, 86 Prosthetic Joint Prophylaxis, 88 Noncardiac Medical Conditions, 88 Dental Hygiene Considerations, 88 Academic Skills Assessment, 88 Clinical Case Study, 89 Bibliography, 89 8 Antifungal and Antiviral Agents, 90 Antifungal Agents, 90 Nystatin, 90 Imidazoles, 90 Antiviral Agents, 92 Herpes Simplex, 92 SARS-CoV-2 virus, 93 Acquired Immunodeficiency Syndrome, 94 Chronic Hepatitis, 97 Influenza, 97 Dental Hygiene Considerations, 98 Academic Skills Assessment, 98 Clinical Case Study, 99 9 Antianxiety Agents, 100 Definitions, 100 Benzodiazepines, 101 Chemistry, 101 Pharmacokinetics, 101 Mechanism of Action, 102 Pharmacologic Effects, 102 Adverse Reactions, 102 Abuse and Tolerance, 103 Medical Uses, 104 Management of the Dental Patient Taking Benzodiazepines, 105 Barbiturates, 105 Chemistry, 106 Pharmacokinetics, 106 Mechanism ofAction, 106 Pharmacologic Effects, 106 Adverse Reactions, 106 Long-Term Use, 106 Contraindications, 106 Drug Interactions, 106 Uses, 106 Nonbenzodiazepine-Nonbarbiturate Sedative-Hypnotics, 107 Buspirone, 107
Nonbenzodiazepine Receptor Hypnotics, 107 Zolpidem, 107 Zaleplon, 107 Eszopiclone, 107 Melatonin Receptor Agonist, 107 Melatonin, 108 Orexin Receptor Antagonist, 108 Centrally Acting Muscle Relaxants, 108 Pharmacologic Effects, 108 Individual Centrally Acting Muscle Relaxants, 108 Miscellaneous Agents, 108 Baclofen, 108 Tizanidine, 109 Dantrolene, 109 General Comments About Antianxiety Agents, 109 Analgesic-Sedative Combinations, 109 Special Considerations, 109 Precautions, 109 Dental Hygiene Considerations, 110 Academic Skills Assessment, 110 Clinical Case Study, 110 10 Local Anesthetics, 111 History, 111 Ideal Local Anesthetic, 111 Chemistry, 111 Mechanism of Action, 111 Action on Nerve Fibers, 111 Ionization Factors, 112 Pharmacokinetics, 112 Absorption, 112 Distribution, 114 Metabolism, 114 Excretion, 114 Pharmacologic Effects, 114 Peripheral Nerve Conduction (Blocker), 114 Antiarrhythmic, 114 Adverse Reactions, 114 Toxicity, 115 Local Effects, 115 Malignant Hyperthermia, 115 Pregnancy and Nursing Considerations, 115 Allergy, 115 Composition of Local Anesthetic Solutions, 116 Local Anesthetic Agents, 116 Amides, 116 Esters, 118 Other Local Anesthetics, 118 Vasoconstrictors, 118 Overview, 118 Drug Interactions, 120 Choice of Local Anesthetic, 120 Topical Anesthetics, 121 Amides, 122 Esters, 123 Precautions in Topical Anesthesia, 123 Doses of Local Anesthetic and Vasoconstrictor, 123 Dental Hygiene Considerations, 124 Academic Skills Assessment, 124 Clinical Case Study, 124
CONTENTS 11 General Anesthetics, 125 History, 125 Mechanism of Action, 125 Overview, 125 Stages and Planes of Anesthesia, 125 Adverse Reactions, 126 General Anesthetics, 126 Classification of Anesthetic Agents, 126 Induction Anesthesia, 126 Induction and Maintenance Anesthesia, 128 Nitrous Oxide, 128 Halogenated Hydrocarbons, 130 Balanced General Anesthesia, 130 Dental Hygiene Considerations, 130 Academic Skills Assessment, 130 Clinical Case Study, 131 PART 111 Drugs That May Alter Dental Treatment 12 Drugs for the Treatment of Cardiovascular Diseases, 133 Dental Implications of Cardiovascular Disease, 133 Contraindications to Treatment, 133 Vasoconstrictor Limit, 134 Periodontal Disease and Cardiovascular Disease, 134 Hypertension, 134 Patient Evaluation, 135 Treatment of Hypertension, 136 Diuretic Agents, 138 Angiotensin Receptor Blockers, 140 Calcium Channel Blocking Agents, 141 Direct Renin Inhibitors, 142 ß-Adrenergic Blocking Agents, 142 ct^Adrenergic Blocking Agents, 143 Central a-Adrenergic Agonists, 144 Management of the Dental Patient Taking Antihypertensive Agents, 144 Heart Failure, 144 Treatment of Heart Failure, 145 Angiotensin II Receptor Neprilysin Inhibitor, 145 IF Channel Inhibitor, 147 Cardiac Glycosides, 147 Digitalis Glycosides, 147 Antianginal Drugs, 148 Angina Pectoris, 148 Nitroglycerin-Like Compounds, 148 ß-Adrenergic Blocking Agents, 150 Calcium Channel Blocking Agents, 150 Ranolazine, 150 Angiotensin-Converting Enzyme Inhibitors, 150 Angiotensin Receptor Blockers, 150 Dental Implications, 150 Antiarrhythmic Agents, 151 Automaticity, 151
Arrhythmias, 151 Antiarrhythmic Agents, 151 Antihyperlipidemic Agents, 152 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase Inhibitors, 152 Inhibitors of Intestinal Absorption of Cholesterol, 152 Niacin, 153 Cholestyramine, 153 Fibric Acid Derivatives, 154 Fish Oils, 154 Proprotein Convertase Subtilisin/Kexin Type Inhibitors, 155 Dental Implications of Elevated Cholesterol Levels, 155 Drugs That Affect Blood Coagulation, 155 Anticoagulants, 155 Parenteral Anticoagulants, 155 Low-Molecular-Weight Heparin, 155 Oral Anticoagulants, 155 Factor Xa Inhibitors, 157 Direct Thrombin Inhibitor, 157 Thienopyridines, 157 Clopidogrel, 157 Prasugrel, 158 Ticagrelor, 158 Streptokinase and Alteplase, 158 Dipyridamole, 158 Pentoxifylline, 158 Drugs That Increase Blood Clotting, 158 Hemostatic Agents (Fibrinolytic Inhibitors), Dental Hygiene Considerations, 158 Academic Skills Assessment, 158 Clinical Case Study, 159 References, 159 13 Drugs for the Treatment of Gastrointestinal Disorders, 160 Gastrointestinal Drugs, 160 Gastrointestinal Diseases, 160 Dental Implications, 161 Drugs Used to Treat Gastrointestinal Diseases, 161 Histamine2-Blocking Agents, 161 Proton Pump Inhibitors, 162 Mixed Antiinfective Therapy for Ulcer Treatment, 162 Antacids, 162 Miscellaneous Gastrointestinal Drugs, 163 Laxatives and Antidiarrheals, 163 Agents Used to Manage Chronic Inflammatory Bowel Disease, 165 Celiac Disease, 165 Dental Hygiene Considerations, 166 Academic Skills Assessment, 166 Clinical Case Study, 166 14 Drugs for the Treatment of Seizure Disorders, 167 Epilepsy, 167 Generalized Seizures, 167
Partial (Focal) Seizures, 168 Drug Therapy of Patients With Epilepsy, 168 General Adverse Reactions ofAntiepileptic Agents, 169 Valproate, 169 Lamotrigine, 170 Levetiracetam, 170 Oxcarbazepine, 170 Carbamazepine, 170 Phenytoin, 172 Ethosuximide, 174
CONTENTS Benzodiazepines, 174 Other Antiepileptic Agents, 174 Dental Treatment of the Patient With Epilepsy, 174 Nonseizure Uses of Antiepileptics, 174 Neurologic Pain, 174 Psychiatric Use, 174 Dental Hygiene Considerations, 174 Academic Skills Assessment, 174 Clinical Case Study, 175 15 Drugs for the Treatment of Central Nervous System Disorders, 176 Psychiatric Disorders, 176 Antipsychotic Agents, 178 Mechanism of Action, 178 Pharmacologic Effects, 179 Drug Interactions, 180 Uses, 180 Dental Implications, 181 Antidepressant Agents, 181 Selective Serotonin Reuptake Inhibitors, 181 Serotonin-Norepinephrine Reuptake Inhibitors, 183 Tricyclic Antidepressants, 183 Monoamine Oxidase Inhibitors, 184 Other Antidepressants, 184 Suicide and Antidepressants, 184 Dental Implications, 184 Drugs for Treatment of Bipolar Disorder, 185 Lithium, 185 Antiepileptic Drugs, 185 Second-Generation Antipsychotics, 185 Dental hygiene considerations, 185 Academic skills assessment, 185 Clinical Case Study, 186 16 Adrenocorticosteroids, 187 Mechanism of Release, 187 Classification, 187 Definitions, 187 Routes of Administration, 188 Mechanism of Action, 188 Pharmacologic Effects, 188 Adverse Reactions, 188 Metabolic Changes, 188 Infections, 189 Central Nervous System Effects, 189 Peptic Ulcer, 189 Impaired Wound Healing and Osteoporosis, 189 Ophthalmic Effects, 189 Electrolyte and Fluid Balance, 189 Adrenal Crisis, 189 Dental Effects, 190 Uses, 190 Medical Uses, 190 Dental Uses, 191 Corticosteroid Products, 191 Dental Implications, 191 Adverse Reactions, 192 Steroid Supplementation, 193 Topical Use,
193 Dental Hygiene Considerations, 193 Academic Skills Assessment, 194 Clinical Case Study, 194 Reference, 194 17 Drugs for the Treatment of Respiratory Disorders and Allergic Rhinitis, 195 Respiratory Diseases, 195 Asthma, 195 Chronic Obstructive Pulmonary Disease, 196 Drugs Used to Treat Respiratory Diseases, 199 Metered-Dose Inhalers, 199 Sympathomimetic Agents, 199 Corticosteroids, 201 Leukotriene Modifiers, 201 Cromolyn, 201 Methylxanthines, 202 Muscarinic Antagonists, 202 Antiimmunoglobulin E Antibodies, 202 Interleukin-5 Antibody Antagonists, 202 Interleukin-4 Receptor Alpha Antibody Antagonist, 202 Agents Used to Manage Upper Respiratory Infections, 202 Dental Implications of the Respiratory Drugs, 203 Allergic Rhinitis, 203 Pharmacologic Effects, 204 Η,-Receptor Blocking Effects, 204 Other Effects (Unrelated to H t-Blockmg Effects), 204 Adverse Reactions, 204 Central Nervous System Depression, 204 Anticholinergic Effects, 204 Dental hygiene considerations, 206 Academic skills assessment, 207 Clinical Case Study, 207 Clinical Case Study, 207 18 Drugs for the Treatment of Diabetes Mellitus, 208 Pancreatic Hormones, 208 Diabetes Mellitus, 208 Types of Diabetes, 208 Dental Implications of Diabetes, 209 Systemic Complications of Diabetes, 210 Evaluation of the Dental Patient With Diabetes, 211 Goals of Therapy, 211 Drugs Used to Manage Diabetes, 212 Insulins, 212 Antihyperglycemic Drugs for Type 2 Diabetes, 213 Treatment of Hypoglycemia, 218 Glucagon, 218 Dental Hygiene Considerations, 218 Academic Skills Assessment, 218 Clinical Case Study, 218 Bibliography, 218 19
Drugs for the Treatment of Other Endocrine Disorders, 219 Pituitary Hormones, 219 Anterior Pituitary, 219 Posterior Pituitary, 221 Thyroid Hormones, 221 Iodine, 221 Hypothyroidism, 221 Hyperthyroidism, 221 Female Sex Hormones, 222 Estrogens, 223 Progestins, 224 Hormonal Contraceptives, 224
CONTENTS Male Sex Hormones, 225 Androgens, 225 Other Agents That Affect Sex Hormone Systems, 226 Clomiphene, 226 Leuprolide, 226 Tamoxifen, 227 Danazol, 227 Aromatase Inhibitors, 227 Dental Hygiene Considerations, 227 Academic Skills Assessment, 227 Clinical Case Study, 227 20 Antineoplastic Drugs, 229 Use of Antineoplastic Agents, 229 Mechanisms of Action, 230 Classification, 231 Adverse Drug Effects, 233 Bone Marrow Suppression, 233 Osteonecrosis, 233 Gastrointestinal Effects, 235 Dermatologic Effects, 235 Hepatotoxicity, 235 Nephrotoxicity, 235 Immunosuppression, 235 Germ Cells, 235 Oral Effects, 235 Combinations, 236 Dental Implications, 236 Dental Hygiene Considerations, 237 Academic Skills Assessment, 237 Clinical Case Study, 237 PART IV Special Situations 21 Emergency Drugs, 239 General Measures, 239 Steps Indicated, 239 Preparation for Treatment, 239 Categories of Emergencies, 240 Lost or Altered Consciousness, 240 Respiratory Emergencies, 241 Cardiovascular System Emergencies, 242 Other Emergency Situations, 242 Drug-Related Emergencies, 244 Emergency Kit for The Dental Office, 245 Drugs, 245 Equipment, 248 Dental Hygiene Considerations, 248 Academic Skills Assessment, 248 Clinical Case Study, 248 22 Pregnancy and Breastfeeding, 249 General Principles, 249 Two Main Concerns, 249 History, 249 Pregnancy, 249 Pregnancy Trimesters, 249 Teratogenicity, 250 US Food and Drug Administration Drug Use in Pregnancy and Lactation, 250 Breastfeeding, 251 Dental Drugs, 251 Local Anesthetic Agents, 251 Epinephrine, 251 Analgesics, 251 Antiinfective Agents, 254 Antianxiety Agents,
255 Dental Hygiene Considerations, 256 Academic Skills Assessment, 256 Clinical Case Study, 257 23 Substance Use Disorders, 258 General Considerations, 258 Definitions, 258 Psychological Dependence, 259 Physical Dependence, 259 Tolerance, 259 Central Nervous System Depressants, 260 Ethyl Alcohol, 260 Nitrous Oxide, 263 Opioid Analgesics, 264 Opioid Street Drug, 265 Sedative-Hypnotics, 265 Pattern of Abuse, 265 Management ofAcute Overdose and Withdrawal, 266 Central Nervous System Stimulants, 266 Cocaine, 266 Amphetamines, 266 Caffeine, 267 Tobacco, 267 Psychedelics (Hallucinogens), 269 Lysergic Acid Diethylamide, 269 Phencyclidine, 269 Marijuana, 269 Identifying the Substance User, 270 The Impaired Dental Hygienist, 270 Dental Hygiene Considerations, 270 Academic Skills Assessment, 270 Clinical Case Study, 271 24 Natural/Herbal Products and Dietary Supplements, д Limited Regulation, 272 Dietary Supplement Health and Education Ad,. Package Labeling, 273 Safety of Herbal and Nutritional Products, 273 Oral Adverse Effects, 273 Drug Interactions, 273 Standardization of Herbal Products, 275 Good Manufacturing Practice, 275 Herbal Supplements Used in Oral Health Care, 2: Acemannan, 276 Essential Oil Mouth Rinse, 276 Oil of Cloves (Eugenol), 276 Triclosan, 276 Xylitol, 276 Dental Hygiene Considerations, 277 Academic Skills Assessment, 277 Clinical Case Study, 277 25 Oral Conditions and Their Treatment, 278 Infectious Lesions, 278 Acute Necrotizing Ulcerative Gingivitis, 278 Herpes Infections, 278 Candidiasis (Moniliasis), 280 Angular Cheilitis/Cheilosis, 281 Alveolar Osteitis,
282
CONTENTS Immune Reactions, 282 Recurrent Aphthous Stomatitis, 282 Lichen Planus, 283 Miscellaneous Oral Conditions, 283 Geographic Tongue, 283 Burning Mouth or Tongue Syndrome, 283 Inflammation, 284 Pericoronitis, 284 Post-Irradiation Caries, 284 Root Sensitivity, 284 Actinic Lip Changes, 284 Stomatitis, 284 Drug-Induced Oral Side Effects, 284 Xerostomia, 284 Sialorrhea, 284 Hypersensitivity Reactions, 285 Oral Lesions That Resemble Autoimmune-Type Reactions, 285 Stains, 287 Gingival Enlargement, 287 Osteonecrosis of the Jaw, 287 Agents Commonly Used to Treat Oral Lesions, 287 Corticosteroids, 287 Palliative Treatment, 288 Dental Hygiene Considerations, 288 Academic Skills Assessment, 288 Clinical Case Study, 288 26 Hygiene-Related Oral Disorders, 289 Dental Caries, 289 Prevention, 289 Gingivitis, 295 Prevention, 295 Tooth Hypersensitivity, 296 Pathophysiology, 296 Treatment, 296 Dental Hygiene Considerations, 297 Patient Education for Caries and Gingivitis, 297 Patient Education for Tooth Hypersensitivity, 298 Patient Self-Care, 298 Academic Skills Assessment, 298 Clinical Case Study, 298 Reference, 298 Bibliography, 298 Appendix A: Medical Acronyms, 299 Appendix B: Medical Terminology, 302 Appendix C: What If304 Appendix D: Oral Manifestations: Xerostomia and Taste Changes, 309 Appendix E: Children s Dose Calculations, 312 Glossary, 313 Drug Index, 321 Subject Index, 335
APPLIED EDITION PHARMACOLOGY fortheDENTAL HYGIENIST ELENA BABLENIS HAVELES Build the pharmacology foundation needed for a successful dental hygiene career! With a focus on the most commonly used drugs in dentistry, this comprehensive resource provides an in-depth understanding of the pharmacologic principles behind safe and effective dental treatment and oral health care. It discusses drug properties and mechanisms of action, dosages, intended effects, interactions, and adverse reactions-both for the medications a patient may already be taking and for the drugs prescribed by the dentist. • NEW! Updated drug content throughout, including new side effects and warnings for many commonly seen drugs. / • Clinical case studies and review guestions within chapters plus guizzes online offer multiple opportunities for application and test preparation. • Learning features include Dental Hygiene Considerations, summary boxes and tables, and Note boxes to highlight key concepts. • Key terms are bolded and in color within each chapter and defined in a handy glossary for mastering vocabulary. • Engaging full-color design includes illustrations showing basic principles and internal processes, along with photographs of oral conditions and side effects. • Separate drug index provides easy look-up of spécifie drugs and types of drugs. • Quick-reference appendices include resources such as medical terminology, medical acronyms, and information on dose calculations for children.
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CONTENTS PART I General Principles 1 Information, Sources, Regulatory Agencies, Drug Legislation, and Prescription Writing, 2 History, 2 Role of the Dental Hygienist, 2 Medication/Health History, 2 Medication Administration, 3 Emergency Situations, 3 Appointment Scheduling, 3 Nonprescription Medication, 3 Nutritional or Herbal Supplements, 3 Sources of information, 3 Printed Resources, 3 Computer and Online Resources, 4 Drug Names, 4 Drug Substitution, 5 Federal Regulations and Regulatory Agencies, 5 Harrison Narcotic Act, 5 US Food and Drug Administration, 5 Federal Trade Commission, 5 US Drug Enforcement Administration, 5 Omnibus Budget Reconciliation Act, 5 Clinical Evaluation of a New Drug, 5 Drug Legislation, 6 History, 6 Scheduled Drugs, 6 Package Inserts, 6 Black Box Warning, 6 Labeled and Off-Label Uses, 7 Orphan Drugs, 7 Drug Recall, 7 Prescription Writing, 7 Measurement, 7 Prescriptions, 7 Role of the Dental Hygienist and Patient Adherence to Medication Therapy, 9 Dental Hygiene Considerations, 10 Academic Skills Assessment, 10 Clinical Applications, 10 2 Drug Action and Handling, 11 Characterization of Drug Action, 11 Log Dose-Effect Curve, 11 Potency, 11 Efficacy, 11 Therapeutic Index, 12 Mechanism of Action of Drugs, 12 Receptors, 13 Pharmacokinetics, 14 Passage Across Body Membranes, 14 Absorption, 14 Distribution, 15 Redistribution, 16 Metabolism (Biotransformation), 16 Clinical Pharmacokinetics, 18 Half-Life, 18 Kinetics, 18 Factors That Alter Drug Effects, 18 Routes of Administration and Dose Forms, 19 Routes ofAdministration, 19 Dosage Forms, 23 Dental
Hygiene Considerations, 23 Academic Skills Assessment, 23 Clinical Case Study, 23 3 Adverse Reactions, 24 Definitions and Classifications, 24 Clinical Manifestations of Adverse Reactions, 25 Exaggerated Effect on Target Tissues, 25 Effect on Nontarget Tissues, 25 Effect on Fetal Development (Teratogenic Effect), 25 Local Effect, 25 Drug Interactions, 25 Hypersensitivity (Allergic Reaction), 26 Idiosyncrasy, 27 Interference With Natural Defense Mechanisms, 27 Toxicologic Evaluation of Drugs, 27 Recognizing Adverse Drug Effects, 28 Dental Hygiene Considerations, 28 Academic Skills Assessment, 28 Clinical Case Study, 29 PART II Drugs Used in Dentistry 4 Autonomic Drugs, 31 Autonomic Nervous System, 31 Anatomy, 31 Parasympathetic Autonomic Nervous System, 31 Sympathetic Autonomic Nervous System, 31 Functional Organization, 32 Neurotransmitters, 32 Parasympathetic Autonomic Nervous System, 35 Cholinergic (Parasympathomimetic) Agents, 35 Anticholinergic (Parasympatholytic) Agents, 37 Nicotinic Agonists and Antagonists, 39 Sympathetic Autonomic Nervous System, 39 Sympathetic Autonomic Nervous System Receptors, 39 Adrenergic (Sympathomimetic) Agents, 40 Adrenergic Blocking Agents, 42 Neuromuscular Blocking Drugs, 42 Dental Hygiene Considerations, 43 Academic Skills Assessment, 43 Clinical Case Study, 44 xiii
XIV CONTENTS 5 Nonopioid (Nonnarcotic) Analgesics, 45 Pain, 45 Classification, 45 Salicylates, 45 Acetylsalicylic Acid, 45 Nonacetylated Salicylates, 50 Diflunisal, 50 Nonsteroidal Antiinflammatory Drugs, 50 Chemical Classification, 50 Mechanism ofAction, 50 Pharmacokinetics, 50 Pharmacologic Effects, 51 Adverse Reactions, 51 Drug Interactions, 52 Contraindications and Cautions, 52 Precautions, 52 Therapeutic Uses, 52 Specific Nonsteroidal Antiinflammatory Drugs, 53 Acetaminophen, 54 Pharmacokinetics, 54 Pharmacologic Effects, 54 Adverse Reactions, 54 Drug Interactions, 55 Uses, 55 Doses and Preparations, 55 Drugs Used to Treat Gout, 56 Colchicine, 56 Febuxostat, 56 Allopurinol, 56 Probenecid, 56 Other Drugs, 56 Drugs Used to Treat Arthritis, 56 Disease-Modifying Antirheumatic Drugs, 56 Biologic Response Modifiers, 57 Dental Hygiene Considerations, 57 Academic Skills Assessment, 57 Clinical Case Study, 57 6 Opioid (Narcotic) Analgesics and Antagonists, 58 History, 58 Classification, 58 Mechanism of Action, 58 Pharmacokinetics, 58 Pharmacologic Effects, 59 Analgesia, 59 Sedation and Euphoria, 59 Cough Suppression, 60 Gastrointestinal Effects, 60 Adverse Reactions, 60 Respiratory Depression, 60 Nausea and Emesis, 61 Constipation, 61 Miosis, 61 Urinary Retention, 61 Central Nervous System Effects, 61 Cardiovascular Effects, 61 Biliary Tract Constriction, 61 Histamine Release, 61 Pregnancy and Nursing Considerations, 61 Addiction, 61 Allergic Reactions, 62 Drug Interactions, 62 Specific Opioids, 63 Opioid Agonists, 63 Mixed Opioids, 65 Opioid Antagonists, 65 Full
Agonist/Reuptake Inhibitors, 66 Dental Use of Opioids, 66 Chronic Dental Pain and Opioid Use, 67 Patient Concerns Regarding Opioid Use, 67 Dental Hygiene Considerations, 67 Academic Skills Assessment, 67 Clinical Case Studies, 67 7 Antiinfective Agents, 68 Evolution of a Dental Infection, 68 Definitions, 69 Infection, 69 Resistance, 69 Indications for Antimicrobial Agents, 70 Therapeutic Indications, 70 Prophylactic Indications, 70 General Adverse Reactions and Disadvantages Associated With Antiinfective Agents, 70 Superinfection (Suprainfection), 70 Allergic Reactions, 70 Drug Interactions, 70 Gastrointestinal Complaints, 72 Pregnancy Considerations, 72 Dose Forms, 72 Cost, 72 Penicillin Varieties, 72 Pharmacokinetics, 72 Mechanism ofAction, 73 Spectrum, 73 Resistance, 73 Adverse Reactions, 73 Uses, 74 Specific Types ofPenicillin, 74 Cephalosporins, 75 Pharmacokinetics, 75 Spectrum, 75 Mechanism ofAction, 75 Adverse Reactions, 75 Uses, 76 Macrolides, 76 Erythromycin, 76 Azithromycin and Clarithromycin, 77 Tetracyclines, 77 Pharmacokinetics, 77 Spectrum, 77 Adverse Reactions, 77 Drug Interactions, 78 Uses, 79 Clindamycin, 79 Pharmacokinetics, 79 Spectrum, 79 Adverse Reactions, 79 Uses, 80 Metronidazole, 80 Pharmacokinetics, 80 Spectrum, 80 Adverse Reactions, 80 Drug Interactions, 80 Uses, 81
CONTENTS Rational Use of Antiinfective Agents in Dentistry, 81 Stages of Infection, 81 Failure ofAntiinfective Therapy, 81 Antimicrobial Agents for Nondental Use, 81 Vancomycin, 81 Aminoglycosides, 82 Sulfonamides, 82 Sulfamethoxazole- Trimethoprim, 83 Nitrofurantoin, 83 Quinolones (Fluoroquinolones), 83 Antituberculosis Agents, 84 Isoniazid, 84 Rifampin, 85 Pyrazinamide, 85 Ethambutol, 85 Topical Antibiotics, 85 Neomycin, Polymyxin, and Bacitracin, 85 Mupirocin, 85 Antibiotic Prophylaxis Used in Dentistry, 86 Prevention of Infective Endocarditis, 86 Prosthetic Joint Prophylaxis, 88 Noncardiac Medical Conditions, 88 Dental Hygiene Considerations, 88 Academic Skills Assessment, 88 Clinical Case Study, 89 Bibliography, 89 8 Antifungal and Antiviral Agents, 90 Antifungal Agents, 90 Nystatin, 90 Imidazoles, 90 Antiviral Agents, 92 Herpes Simplex, 92 SARS-CoV-2 virus, 93 Acquired Immunodeficiency Syndrome, 94 Chronic Hepatitis, 97 Influenza, 97 Dental Hygiene Considerations, 98 Academic Skills Assessment, 98 Clinical Case Study, 99 9 Antianxiety Agents, 100 Definitions, 100 Benzodiazepines, 101 Chemistry, 101 Pharmacokinetics, 101 Mechanism of Action, 102 Pharmacologic Effects, 102 Adverse Reactions, 102 Abuse and Tolerance, 103 Medical Uses, 104 Management of the Dental Patient Taking Benzodiazepines, 105 Barbiturates, 105 Chemistry, 106 Pharmacokinetics, 106 Mechanism ofAction, 106 Pharmacologic Effects, 106 Adverse Reactions, 106 Long-Term Use, 106 Contraindications, 106 Drug Interactions, 106 Uses, 106 xv Nonbenzodiazepine-Nonbarbiturate Sedative-Hypnotics, 107 Buspirone,
107 Nonbenzodiazepine Receptor Hypnotics, 107 Zolpidem, 107 Zaleplon, 107 Eszopiclone, 107 Melatonin Receptor Agonist, 107 Melatonin, 108 Orexin Receptor Antagonist, 108 Centrally Acting Muscle Relaxants, 108 Pharmacologic Effects, 108 Individual Centrally Acting Muscle Relaxants, 108 Miscellaneous Agents, 108 Baclofen, 108 Tizanidine, 109 Dantrolene, 109 General Comments About Antianxiety Agents, 109 Analgesic-Sedative Combinations, 109 Special Considerations, 109 Precautions, 109 Dental Hygiene Considerations, 110 Academic Skills Assessment, 110 Clinical Case Study, 110 10 Local Anesthetics, 111 History, 111 Ideal Local Anesthetic, 111 Chemistry, 111 Mechanism of Action, 111 Action on Nerve Fibers, 111 Ionization Factors, 112 Pharmacokinetics, 112 Absorption, 112 Distribution, 114 Metabolism, 114 Excretion, 114 Pharmacologic Effects, 114 Peripheral Nerve Conduction (Blocker), 114 Antiarrhythmic, 114 Adverse Reactions, 114 Toxicity, 115 Local Effects, 115 Malignant Hyperthermia, 115 Pregnancy and Nursing Considerations, 115 Allergy, 115 Composition of Local Anesthetic Solutions, 116 Local Anesthetic Agents, 116 Amides, 116 Esters, 118 Other Local Anesthetics, 118 Vasoconstrictors, 118 Overview, 118 Drug Interactions, 120 Choice of Local Anesthetic, 120 Topical Anesthetics, 121 Amides, 122 Esters, 123 Precautions in Topical Anesthesia, 123 Doses of Local Anesthetic and Vasoconstrictor, 123 Dental Hygiene Considerations, 124 Academic Skills Assessment, 124 Clinical Case Study, 124
XVI 11 General Anesthetics, 125 History, 125 Mechanism of Action, 125 Overview, 125 Stages and Planes ofAnesthesia, 125 Adverse Reactions, 126 General Anesthetics, 126 Classification ofAnesthetic Agents, 126 Induction Anesthesia, 126 Induction and Maintenance Anesthesia, 128 Nitrous Oxide, 128 Halogenated Hydrocarbons, 130 Balanced General Anesthesia, 130 Dental Hygiene Considerations, 130 Academic Skills Assessment, 130 Clinical Case Study, 131 PART III Drugs That May Alter Dental Treatment 12 Drugs for the Treatment of Cardiovascular Diseases, 133 Dental Implications of Cardiovascular Disease, 133 Contraindications to Treatment, 133 Vasoconstrictor Limit, 134 Periodontal Disease and Cardiovascular Disease, 134 Hypertension, 134 Patient Evaluation, 135 Treatment of Hypertension, 136 Diuretic Agents, 138 Angiotensin Receptor Blockers, 140 Calcium Channel Blocking Agents, 141 Direct Renin Inhibitors, 142 ß-Adrenergic Blocking Agents, 142 aгAdrenergic Blocking Agents, 143 Central a-Adrenergic Agonists, 144 Management of the Dental Patient Taking Antihypertensive Agents, 144 Heart Failure, 144 Treatment of Heart Failure, 145 Angiotensin II Receptor Neprilysin Inhibitor, 145 IF Channel Inhibitor, 147 Cardiac Glycosides, 147 Digitalis Glycosides, 147 Antianginal Drugs, 148 Angina Pectoris, 148 Nitroglycerin-Like Compounds, 148 ß-Adrenergic Blocking Agents, 150 Calcium Channel Blocking Agents, 150 Ranolazine, 150 Angiotensin-Converting Enzyme Inhibitors, 150 Angiotensin Receptor Blockers, 150 Dental Implications, 150 Antiarrhythmic Agents, 151 Automaticity, 151 Arrhythmias, 151
Antiarrhythmic Agents, 151 Antihyperlipidemic Agents, 152 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase Inhibitors, 152 Inhibitors of Intestinal Absorption of Cholesterol, 152 Niacin, 153 Cholestyramine, 153 Fibric Acid Derivatives, 154 Fish Oils, 154 Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors, 155 Dental Implications ofElevated Cholesterol Levels, 155 Drugs That Affect Blood Coagulation, 155 Anticoagulants, 155 Parenteral Anticoagulants, 155 Low-Molecular-Weight Heparin, 155 Oral Anticoagulants, 155 Factor Xa Inhibitors, 157 Direct Thrombin Inhibitor, 157 Thienopyridines, 157 Clopidogrel, 157 Prasugrel, 158 Tieagrelor, 158 Streptokinase and Alteplase, 158 Dipyridamole, 158 Pentoxifylline, 158 Drugs That Increase Blood Clotting, 158 Hemostatic Agents (Fibrinolytic Inhibitors), 158 • Dental Hygiene Considerations, 158 Academic Skills Assessment, 158 Clinical Case Study, 159 References, 159 13 Drugs for the Treatment of Gastrointestinal Disorders, 160 Gastrointestinal Drugs, 160 Gastrointestinal Diseases, 160 Dental Implications, 161 Drugs Used to Treat Gastrointestinal Diseases, 161 Histamine2-Blocking Agents, 161 Proton Pump Inhibitors, 162 Mixed Antiinfective Therapyfor Ulcer Treatment, 162 Antacids, 162 Miscellaneous Gastrointestinal Drugs, 163 Laxatives and Antidiarrheals, 163 Agents Used to Manage Chronic Inflammatory Bowel Disease, 165 Celiac Disease, 165 Dental Hygiene Considerations, 166 Academic Skills Assessment, 166 Clinical Case Study, 166 14 Drugs for the Treatment of Seizure Disorders, 167 Epilepsy, 167 Generalized Seizures, 167 Partial (Focal)
Seizures, 168 Drug Therapy of Patients With Epilepsy, 168 General Adverse Reactions ofAntiepileptic Agents, 169 Valproate, 169 Lamotrigine, 170 Levetiracetam, 170 Oxcarbazepine, 170 Carbamazepine, 170 Phenytoin, 172 Ethosuximide, 174
CONTENTS Benzodiazepines, 174 Other Antiepileptic Agents, 174 Dental Treatment of the Patient With Epilepsy, 174 Nonseizure Uses of Antiepileptics, 174 Neurologic Pain, 174 Psychiatric Use, 174 Dental Hygiene Considerations, 174 Academic Skills Assessment, 174 Clinical Case Study, 175 15 Drugs for the Treatment of Central Nervous System Disorders, 176 Psychiatric Disorders, 176 Antipsychotic Agents, 178 Mechanism ofAction, 178 Pharmacologic Effects, 179 Drug Interactions, 180 Uses, 180 Dental Implications, 181 Antidepressant Agents, 181 Selective Serotonin Reuptake Inhibitors, 181 Serotonin-Norepinephrine Reuptake Inhibitors, 183 Tricyclic Antidepressants, 183 Monoamine Oxidase Inhibitors, 184 Other Antidepressants, 184 Suicide and Antidepressants, 184 Dental Implications, 184 Drugs for Treatment of Bipolar Disorder, 185 Lithium, 185 Antiepileptic Drugs, 185 Second-Generation Antipsychotics, 185 Dental hygiene considerations, 185 Academic skills assessment, 185 Clinical Case Study, 186 16 Adrenocorticosteroids, 187 Mechanism of Release, 187 Classification, 187 Definitions, 187 Routes of Administration, 188 Mechanism of Action, 188 Pharmacologic Effects, 188 Adverse Reactions, 188 Metabolic Changes, 188 Infections, 189 Central Nervous System Effects, 189 Peptic Ulcer, 189 Impaired Wound Healing and Osteoporosis, 189 Ophthalmic Effects, 189 Electrolyte and Fluid Balance, 189 Adrenal Crisis, 189 Dental Effects, 190 Uses, 190 Medical Uses, 190 Dental Uses, 191 Corticosteroid Products, 191 Dental Implications, 191 Adverse Reactions, 192 Steroid Supplementation, 193 Topical Use,
193 Dental Hygiene Considerations, 193 Academic Skills Assessment, 194 Clinical Case Study, 194 Reference, 194 XVII 17 Drugs for the Treatment of Respiratory Disorders and Allergic Rhinitis, 195 Respiratory Diseases, 195 Asthma, 195 Chronic Obstructive Pulmonary Disease, 196 Drugs Used to Treat Respiratory Diseases, 199 Metered-Dose Inhalers, 199 Sympathomimetic Agents, 199 Corticosteroids, 201 Leukotriene Modifiers, 201 Cromolyn, 201 Methylxanthines, 202 Muscarinic Antagonists, 202 Antiimmunoglobulin E Antibodies, 202 Interleukin-5 Antibody Antagonists, 202 Interleukin-4 Receptor Alpha Antibody Antagonist, 202 Agents Used to Manage Upper Respiratory Infections, 202 Dental Implications of the Respiratory Drugs, 203 Allergic Rhinitis, 203 Pharmacologic Effects, 204 H1 -Receptor Blocking Effects, 204 Other Effects (Unrelated to HrBlocking Effects), 204 Adverse Reactions, 204 Central Nervous System Depression, 204 Anticholinergic Effects, 204 Dental hygiene considerations, 206 Academic skills assessment, 207 Clinical Case Study, 207 Clinical Case Study, 207 18 Drugs for the Treatment of Diabetes Mellitus, 208 Pancreatic Hormones, 208 Diabetes Mellitus, 208 Types of Diabetes, 208 Dental Implications of Diabetes, 209 Systemic Complications ofDiabetes, 210 Evaluation of the Dental Patient With Diabetes, 211 Goals of Therapy, 211 Drugs Used to Manage Diabetes, 212 Insulins, 212 Antihyperglycemic Drugsfor Type 2 Diabetes, 213 Treatment of Hypoglycemia, 218 Glucagon, 218 Dental Hygiene Considerations, 218 Academic Skills Assessment, 218 Clinical Case Study, 218 Bibliography, 218 19
Drugs for the Treatment of Other Endocrine Disorders, 219 Pituitary Hormones, 219 Anterior Pituitary, 219 Posterior Pituitary, 221 Thyroid Hormones, 221 Iodine, 221 Hypothyroidism, 221 Hyperthyroidism, 221 Female Sex Hormones, 222 Estrogens, 223 Progestins, 224 Hormonal Contraceptives, 224
XVIII CONTENTS Male Sex Hormones, 225 Androgens, 225 Other Agents That Affect Sex Hormone Systems, 226 Clomiphene, 226 Leuprolide, 226 Tamoxifen, 227 Danazol, 227 Aromatase Inhibitors, 227 Dental Hygiene Considerations, 227 Academic Skills Assessment, 227 Clinical Case Study, 227 20 Antineoplastic Drugs, 229 Use of Antineoplastic Agents, 229 Mechanisms of Action, 230 Classification, 231 Adverse Drug Effects, 233 Bone Marrow Suppression, 233 Osteonecrosis, 233 Gastrointestinal Effects, 235 Dermatologic Effects, 235 Hepatotoxicity, 235 Nephrotoxicity, 235 Immunosuppression, 235 Germ Cells, 235 Oral Effects, 235 Combinations, 236 Dental Implications, 236 Dental Hygiene Considerations, 237 Academic Skills Assessment, 237 Clinical Case Study, 237 PART IV Special Situations 21 Emergency Drugs, 239 General Measures, 239 Steps Indicated, 239 Preparation for Treatment, 239 Categories of Emergencies, 240 Lost or Altered Consciousness, 240 Respiratory Emergencies, 241 Cardiovascular System Emergencies, 242 Other Emergency Situations, 242 Drug-Related Emergencies, 244 Emergency Kit for The Dental Office, 245 Drugs, 245 Equipment, 248 Dental Hygiene Considerations, 248 Academic Skills Assessment, 248 Clinical Case Study, 248 22 Pregnancy and Breastfeeding, 249 General Principles, 249 Two Main Concerns, 249 History, 249 Pregnancy, 249 Pregnancy Trimesters, 249 Teratogenicity, 250 US Food and Drug Administration Drug Use in Pregnancy and Lactation, 250 Breastfeeding, 251 Dental Drugs, 251 Local Anesthetic Agents, 251 Epinephrine, 251 Analgesics, 251 Antiinfective Agents, 254 Antianxiety
Agents, 255 Dental Hygiene Considerations, 256 Academic Skills Assessment, 256 Clinical Case Study, 257 23 Substance Use Disorders, 258 General Considerations, 258 Definitions, 258 Psychological Dependence, 259 Physical Dependence, 259 Tolerance, 259 Central Nervous System Depressants, 260 Ethyl Alcohol, 260 Nitrous Oxide, 263 Opioid Analgesics, 264 Opioid Street Drug 265 Sedative-Hypnotics, 265 Pattern ofAbuse, 265 Management ofAcute Overdose and Withdrawal, 266 Central Nervous System Stimulants, 266 Cocaine, 266 Amphetamines, 266 Caffeine, 267 Tobacco, 267 Psychedelics (Hallucinogens), 269 Lysergic Acid Diethylamide, 269 Phencyclidine, 269 Marijuana, 269 Identifying the Substance User, 270 The Impaired Dental Hygienist, 270 Dental Hygiene Considerations, 270 Academic Skills Assessment, 270 Clinical Case Study, 271 24 Natural/Herbal Products and Dietary Supplements, 272 Limited Regulation, 272 Dietary Supplement Health and Education Act, 272 Package Labeling, 273 Safety of Herbal and Nutritional Products, 273 Oral Adverse Effects, 273 Drug Interactions, 273 Standardization of Herbal Products, 275 Good Manufacturing Practice, 275 Herbal Supplements Used in Oral Health Care, 276 Acemannan, 276 Essential Oil Mouth Rinse, 276 Oil of Cloves (Eugenol), 276 Triclosan, 276 Xylitol, 276 Dental Hygiene Considerations, 277 Academic Skills Assessment, 277 Clinical Case Study, 277 25 Oral Conditions and Their Treatment, 278 Infectious Lesions, 278 Acute Necrotizing Ulcerative Gingivitis, 278 Herpes Infections, 278 Candidiasis (Moniliasis), 280 Angular Cheilitis/Cheilosis, 281 Alveolar
Osteitis, 282
CONTENTS Immune Reactions, 282 Recurrent Aphthous Stomatitis, 282 Lichen Planus, 283 Miscellaneous Oral Conditions, 283 Geographic Tongue, 283 Burning Mouth or Tongue Syndrome, 283 Inflammation, 284 Pericoronitis, 284 Post-Irradiation Caries, 284 Root Sensitivity, 284 Actinic Lip Changes, 284 Stomatitis, 284 Drug-Induced Oral Side Effects, 284 Xerostomia, 284 Sialorrhea, 284 Hypersensitivity Reactions, 285 Oral Lesions That Resemble Autoimmune-Type Reactions, 285 Stains, 287 Gingival Enlargement, 287 Osteonecrosis of the Jaw, 287 Agents Commonly Used to Treat Oral Lesions, 287 Corticosteroids, 287 Palliative Treatment, 288 Dental Hygiene Considerations, 288 Academic Skills Assessment, 288 Clinical Case Study, 288 xix 26 Hygiene-Related Oral Disorders, 289 Dental Caries, 289 Prevention, 289 Gingivitis, 295 Prevention, 295 Tooth Hypersensitivity, 296 Pathophysiology, 296 Treatment, 296 Dental Hygiene Considerations, 297 Patient Education for Caries and Gingivitis, 297 Patient Education for Tooth Hypersensitivity, 298 Patient Self-Care, 298 Academic Skills Assessment, 298 Clinical Case Study, 298 Reference, 298 Bibliography, 298 Appendix A: Medical Acronyms, 299 Appendix B: Medical Terminology, 302 Appendix C: What If., 304 Appendix D: Oral Manifestations: Xerostomia and Taste Changes, 309 Appendix E: Children's Dose Calculations, 312 Glossary, 313 Drug Index, 321 Subject Index, 335
g’h HYGIENIST ELENA BABLENIS HAVELES With a focus on the most commonly used drugs in dentistry, this comprehensive resource dental treatment and oral health care. It discusses drug properties and mechanisms of action, dosages, intended effects, interactions, and adverse reactions-both for the medications • Clinical case studies and review questions within chapters plus quizzes online offer
СШ^Ш’Г® PART I General Principles 1 Information, Sources, Regulatory Agencies, Drug Legislation, and Prescription Writing, 2 History, 2 Role of the Dental Hygienist, 2 Medication/Health History, 2 Medication Administration, 3 Emergency Situations, 3 Appointment Scheduling, 3 Nonprescription Medication, 3 Nutritional or Herbal Supplements, 3 Sources of information, 3 Printed Resources, 3 Computer and Online Resources, 4 Drug Names, 4 Drug Substitution, 5 Federal Regulations and Regulatory Agencies, 5 Harrison Narcotic Act, 5 US Food and Drug Administration, 5 Federal Trade Commission, 5 US Drug Enforcement Administration, 5 Omnibus Budget Reconciliation Act, 5 Clinical Evaluation of a New Drug, 5 Drug Legislation, 6 History, 6 Scheduled Drugs, 6 Package Inserts, 6 Black Box Warning, 6 Labeled and Off-Label Uses, 7 Orphan Drugs, 7 Drug Recall, 7 Prescription Writing, 7 Measurement, 7 Prescriptions, 7 Role of the Dental Hygienist and Patient Adherence to Medication Therapy, 9 Dental Hygiene Considerations, 10 Academic Skills Assessment, 10 Clinical Applications, 10 2 Drug Action and Handling, 11 Characterization of Drug Action, 11 Log Dose-Effect Curve, 11 Potency, II Efficacy, 11 Therapeutic Index, 12 Mechanism of Action of Drugs, 12 Receptors, 13 Pharmacokinetics, 14 Passage Across Body Membranes, 14 Absorption, 14 Distribution, 15 Redistribution, 16 Metabolism (Biotransformation), 16 Clinical Pharmacokinetics, 18 Half-Life, 18 Kinetics, 18 Factors That Alter Drug Effects, 18 Routes of Administration and Dose Forms, 19 Routes of Administration, 19 Dosage Forms, 23 Dental
Hygiene Considerations, 23 Academic Skills Assessment, 23 Clinical Case Study, 23 3 Adverse Reactions, 24 Definitions and Classifications, 24 Clinical Manifestations of Adverse Reactions, 25 Exaggerated Effect on Target Tissues, 25 Effect on Nontarget Tissues, 25 Effect on Fetal Development (Teratogenic Effect), 25 Local Effect, 25 Drug Interactions, 25 Hypersensitivity (Allergic Reaction), 26 Idiosyncrasy, 27 Interference With Natural Defense Mechanisms, 27 Toxicologic Evaluation of Drugs, 27 Recognizing Adverse Drug Effects, 28 Dental Hygiene Considerations, 28 Academic Skills Assessment, 28 Clinical Case Study, 29 PART II Drugs Used in Dentistry 4 Autonomic Drugs, 31 Autonomic Nervous System, 31 Anatomy, 31 Parasympathetic Autonomic Nervous System, 31 Sympathetic Autonomic Nervous System, 31 Functional Organization, 32 Neurotransmitters, 32 Parasympathetic Autonomic Nervous System, 35 Cholinergic (Parasympathomimetic) Agents, 35 Anticholinergic (Parasympatholytic) Agents, 37 Nicotinic Agonists and Antagonists, 39 Sympathetic Autonomic Nervous System, 39 Sympathetic Autonomic Nervous System Receptors, 39 Adrenergic (Sympathomimetic) Agents, 40 Adrenergic Blocking Agents, 42 Neuromuscular Blocking Drugs, 42 Dental Hygiene Considerations, 43 Academic Skills Assessment, 43 Clinical Case Study, 44 xiii
CONTENTS 5 Nonopioid (Nonnarcotic) Analgesics, 45 Pain, 45 Classification, 45 Salicylates, 45 Acetylsalicylic Acid, 45 Nonacetylated Salicylates, 50 Diflunisal, 50 Nonsteroidal Antiinflammatory Drugs, 50 Chemical Classification, 50 Mechanism of Action, 50 Pharmacokinetics, 50 Pharmacologic Effects, 51 Adverse Reactions, 51 Drug Interactions, 52 Contraindications and Cautions, 52 Precautions, 52 Therapeutic Uses, 52 Specific Nonsteroidal Antiinflammatory Drugs, 53 Acetaminophen, 54 Pharmacokinetics, 54 Pharmacologic Effects, 54 Adverse Reactions, 54 Drug Interactions, 55 Uses, 55 Doses and Preparations, 55 Drugs Used to Treat Gout, 56 Colchicine, 56 Febuxostat, 56 Allopurinol, 56 Probenecid, 56 Other Drugs, 56 Drugs Used to Treat Arthritis, 56 Disease-Modifying Antirheumatic Drugs, 56 Biologic Response Modifiers, 57 Dental Hygiene Considerations, 57 Academic Skills Assessment, 57 Clinical Case Study, 57 6 Opioid (Narcotic) Analgesics and Antagonists, 58 History, 58 Classification, 58 Mechanism of Action, 58 Pharmacokinetics, 58 Pharmacologic Effects, 59 Analgesia, 59 Sedation and Euphoria, 59 Cough Suppression, 60 Gastrointestinal Effects, 60 Adverse Reactions, 60 Respiratory Depression, 60 Nausea and Emesis, 61 Constipation, 61 Miosis, 61 Urinary Retention, 61 Central Nervous System Effects, 61 Cardiovascular Effects, 61 Biliary Tract Constriction, 61 Histamine Release, 61 Pregnancy and Nursing Considerations, 61 Addiction, 61 Allergic Reactions, 62 Drug Interactions, 62 Specific Opioids, 63 Opioid Agonists, 63 Mixed Opioids, 65 Opioid Antagonists, 65 Full Agonist/Reuptake
Inhibitors, 66 Dental Use of Opioids, 66 Chronic Dental Pain and Opioid Use, 67 Patient Concerns Regarding Opioid Use, 67 Dental Hygiene Considerations, 67 Academic Skills Assessment, 67 Clinical Case Studies, 67 7 Antiinfective Agents, 68 Evolution of a Dental Infection, 68 Definitions, 69 Infection, 69 Resistance, 69 Indications for Antimicrobial Agents, 70 Therapeutic Indications, 70 Prophylactic Indications, 70 General Adverse Reactions and Disadvantages Associated With Antiinfective Agents, 70 Superinfection (Suprainfection), 70 Allergic Reactions, 70 Drug Interactions, 70 Gastrointestinal Complaints, 72 Pregnancy Considerations, 72 Dose Forms, 72 Cost, 72 Penicillin Varieties, 72 Pharmacokinetics, 72 Mechanism of Action, 73 Spectrum, 73 Resistance, 73 Adverse Reactions, 73 Uses, 74 Specific Types of Penicillin, 74 Cephalosporins, 75 Pharmacokinetics, 75 Spectrum, 75 Mechanism ofAction, 75 Adverse Reactions, 75 Uses, 76 Macrolides, 76 Erythromycin, 76 Azithromycin and Clarithromycin, 77 Tetracyclines, 77 Pharmacokinetics, 77 Spectrum, 77 Adverse Reactions, 77 Drug Interactions, 78 Uses, 79 Clindamycin, 79 Pharmacokinetics, 79 Spectrum, 79 Adverse Reactions, 79 Uses, 80 Metronidazole, 80 Pharmacokinetics, 80 Spectrum, 80 Adverse Reactions, 80 Drug Interactions, 80 Uses, 81
CONTENTS Rational Use of Antiinfective Agents in Dentistry, 81 Stages of Infection, 81 Failure ofAntiinfective Therapy, 81 Antimicrobial Agents for Nondental Use, 81 Vancomycin, 81 Aminoglycosides, 82 Sulfonamides, 82 Sidfamethoxazole-Trimethoprim, 83 Nitrofurantoin, 83 Quinolones (Fluoroquinolones), 83 Antituberculosis Agents, 84 Isoniazid, 84 Rifampin, 85 Pyrazinamide, 85 Ethambutol, 85 Topical Antibiotics, 85 Neomycin, Polymyxin, and Bacitracin, 85 Mupirocin, 85 Antibiotic Prophylaxis Used in Dentistry, 86 Prevention of Infective Endocarditis, 86 Prosthetic Joint Prophylaxis, 88 Noncardiac Medical Conditions, 88 Dental Hygiene Considerations, 88 Academic Skills Assessment, 88 Clinical Case Study, 89 Bibliography, 89 8 Antifungal and Antiviral Agents, 90 Antifungal Agents, 90 Nystatin, 90 Imidazoles, 90 Antiviral Agents, 92 Herpes Simplex, 92 SARS-CoV-2 virus, 93 Acquired Immunodeficiency Syndrome, 94 Chronic Hepatitis, 97 Influenza, 97 Dental Hygiene Considerations, 98 Academic Skills Assessment, 98 Clinical Case Study, 99 9 Antianxiety Agents, 100 Definitions, 100 Benzodiazepines, 101 Chemistry, 101 Pharmacokinetics, 101 Mechanism of Action, 102 Pharmacologic Effects, 102 Adverse Reactions, 102 Abuse and Tolerance, 103 Medical Uses, 104 Management of the Dental Patient Taking Benzodiazepines, 105 Barbiturates, 105 Chemistry, 106 Pharmacokinetics, 106 Mechanism ofAction, 106 Pharmacologic Effects, 106 Adverse Reactions, 106 Long-Term Use, 106 Contraindications, 106 Drug Interactions, 106 Uses, 106 Nonbenzodiazepine-Nonbarbiturate Sedative-Hypnotics, 107 Buspirone, 107
Nonbenzodiazepine Receptor Hypnotics, 107 Zolpidem, 107 Zaleplon, 107 Eszopiclone, 107 Melatonin Receptor Agonist, 107 Melatonin, 108 Orexin Receptor Antagonist, 108 Centrally Acting Muscle Relaxants, 108 Pharmacologic Effects, 108 Individual Centrally Acting Muscle Relaxants, 108 Miscellaneous Agents, 108 Baclofen, 108 Tizanidine, 109 Dantrolene, 109 General Comments About Antianxiety Agents, 109 Analgesic-Sedative Combinations, 109 Special Considerations, 109 Precautions, 109 Dental Hygiene Considerations, 110 Academic Skills Assessment, 110 Clinical Case Study, 110 10 Local Anesthetics, 111 History, 111 Ideal Local Anesthetic, 111 Chemistry, 111 Mechanism of Action, 111 Action on Nerve Fibers, 111 Ionization Factors, 112 Pharmacokinetics, 112 Absorption, 112 Distribution, 114 Metabolism, 114 Excretion, 114 Pharmacologic Effects, 114 Peripheral Nerve Conduction (Blocker), 114 Antiarrhythmic, 114 Adverse Reactions, 114 Toxicity, 115 Local Effects, 115 Malignant Hyperthermia, 115 Pregnancy and Nursing Considerations, 115 Allergy, 115 Composition of Local Anesthetic Solutions, 116 Local Anesthetic Agents, 116 Amides, 116 Esters, 118 Other Local Anesthetics, 118 Vasoconstrictors, 118 Overview, 118 Drug Interactions, 120 Choice of Local Anesthetic, 120 Topical Anesthetics, 121 Amides, 122 Esters, 123 Precautions in Topical Anesthesia, 123 Doses of Local Anesthetic and Vasoconstrictor, 123 Dental Hygiene Considerations, 124 Academic Skills Assessment, 124 Clinical Case Study, 124
CONTENTS 11 General Anesthetics, 125 History, 125 Mechanism of Action, 125 Overview, 125 Stages and Planes of Anesthesia, 125 Adverse Reactions, 126 General Anesthetics, 126 Classification of Anesthetic Agents, 126 Induction Anesthesia, 126 Induction and Maintenance Anesthesia, 128 Nitrous Oxide, 128 Halogenated Hydrocarbons, 130 Balanced General Anesthesia, 130 Dental Hygiene Considerations, 130 Academic Skills Assessment, 130 Clinical Case Study, 131 PART 111 Drugs That May Alter Dental Treatment 12 Drugs for the Treatment of Cardiovascular Diseases, 133 Dental Implications of Cardiovascular Disease, 133 Contraindications to Treatment, 133 Vasoconstrictor Limit, 134 Periodontal Disease and Cardiovascular Disease, 134 Hypertension, 134 Patient Evaluation, 135 Treatment of Hypertension, 136 Diuretic Agents, 138 Angiotensin Receptor Blockers, 140 Calcium Channel Blocking Agents, 141 Direct Renin Inhibitors, 142 ß-Adrenergic Blocking Agents, 142 ct^Adrenergic Blocking Agents, 143 Central a-Adrenergic Agonists, 144 Management of the Dental Patient Taking Antihypertensive Agents, 144 Heart Failure, 144 Treatment of Heart Failure, 145 Angiotensin II Receptor Neprilysin Inhibitor, 145 IF Channel Inhibitor, 147 Cardiac Glycosides, 147 Digitalis Glycosides, 147 Antianginal Drugs, 148 Angina Pectoris, 148 Nitroglycerin-Like Compounds, 148 ß-Adrenergic Blocking Agents, 150 Calcium Channel Blocking Agents, 150 Ranolazine, 150 Angiotensin-Converting Enzyme Inhibitors, 150 Angiotensin Receptor Blockers, 150 Dental Implications, 150 Antiarrhythmic Agents, 151 Automaticity, 151
Arrhythmias, 151 Antiarrhythmic Agents, 151 Antihyperlipidemic Agents, 152 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase Inhibitors, 152 Inhibitors of Intestinal Absorption of Cholesterol, 152 Niacin, 153 Cholestyramine, 153 Fibric Acid Derivatives, 154 Fish Oils, 154 Proprotein Convertase Subtilisin/Kexin Type Inhibitors, 155 Dental Implications of Elevated Cholesterol Levels, 155 Drugs That Affect Blood Coagulation, 155 Anticoagulants, 155 Parenteral Anticoagulants, 155 Low-Molecular-Weight Heparin, 155 Oral Anticoagulants, 155 Factor Xa Inhibitors, 157 Direct Thrombin Inhibitor, 157 Thienopyridines, 157 Clopidogrel, 157 Prasugrel, 158 Ticagrelor, 158 Streptokinase and Alteplase, 158 Dipyridamole, 158 Pentoxifylline, 158 Drugs That Increase Blood Clotting, 158 Hemostatic Agents (Fibrinolytic Inhibitors), Dental Hygiene Considerations, 158 Academic Skills Assessment, 158 Clinical Case Study, 159 References, 159 13 Drugs for the Treatment of Gastrointestinal Disorders, 160 Gastrointestinal Drugs, 160 Gastrointestinal Diseases, 160 Dental Implications, 161 Drugs Used to Treat Gastrointestinal Diseases, 161 Histamine2-Blocking Agents, 161 Proton Pump Inhibitors, 162 Mixed Antiinfective Therapy for Ulcer Treatment, 162 Antacids, 162 Miscellaneous Gastrointestinal Drugs, 163 Laxatives and Antidiarrheals, 163 Agents Used to Manage Chronic Inflammatory Bowel Disease, 165 Celiac Disease, 165 Dental Hygiene Considerations, 166 Academic Skills Assessment, 166 Clinical Case Study, 166 14 Drugs for the Treatment of Seizure Disorders, 167 Epilepsy, 167 Generalized Seizures, 167
Partial (Focal) Seizures, 168 Drug Therapy of Patients With Epilepsy, 168 General Adverse Reactions ofAntiepileptic Agents, 169 Valproate, 169 Lamotrigine, 170 Levetiracetam, 170 Oxcarbazepine, 170 Carbamazepine, 170 Phenytoin, 172 Ethosuximide, 174
CONTENTS Benzodiazepines, 174 Other Antiepileptic Agents, 174 Dental Treatment of the Patient With Epilepsy, 174 Nonseizure Uses of Antiepileptics, 174 Neurologic Pain, 174 Psychiatric Use, 174 Dental Hygiene Considerations, 174 Academic Skills Assessment, 174 Clinical Case Study, 175 15 Drugs for the Treatment of Central Nervous System Disorders, 176 Psychiatric Disorders, 176 Antipsychotic Agents, 178 Mechanism of Action, 178 Pharmacologic Effects, 179 Drug Interactions, 180 Uses, 180 Dental Implications, 181 Antidepressant Agents, 181 Selective Serotonin Reuptake Inhibitors, 181 Serotonin-Norepinephrine Reuptake Inhibitors, 183 Tricyclic Antidepressants, 183 Monoamine Oxidase Inhibitors, 184 Other Antidepressants, 184 Suicide and Antidepressants, 184 Dental Implications, 184 Drugs for Treatment of Bipolar Disorder, 185 Lithium, 185 Antiepileptic Drugs, 185 Second-Generation Antipsychotics, 185 Dental hygiene considerations, 185 Academic skills assessment, 185 Clinical Case Study, 186 16 Adrenocorticosteroids, 187 Mechanism of Release, 187 Classification, 187 Definitions, 187 Routes of Administration, 188 Mechanism of Action, 188 Pharmacologic Effects, 188 Adverse Reactions, 188 Metabolic Changes, 188 Infections, 189 Central Nervous System Effects, 189 Peptic Ulcer, 189 Impaired Wound Healing and Osteoporosis, 189 Ophthalmic Effects, 189 Electrolyte and Fluid Balance, 189 Adrenal Crisis, 189 Dental Effects, 190 Uses, 190 Medical Uses, 190 Dental Uses, 191 Corticosteroid Products, 191 Dental Implications, 191 Adverse Reactions, 192 Steroid Supplementation, 193 Topical Use,
193 Dental Hygiene Considerations, 193 Academic Skills Assessment, 194 Clinical Case Study, 194 Reference, 194 17 Drugs for the Treatment of Respiratory Disorders and Allergic Rhinitis, 195 Respiratory Diseases, 195 Asthma, 195 Chronic Obstructive Pulmonary Disease, 196 Drugs Used to Treat Respiratory Diseases, 199 Metered-Dose Inhalers, 199 Sympathomimetic Agents, 199 Corticosteroids, 201 Leukotriene Modifiers, 201 Cromolyn, 201 Methylxanthines, 202 Muscarinic Antagonists, 202 Antiimmunoglobulin E Antibodies, 202 Interleukin-5 Antibody Antagonists, 202 Interleukin-4 Receptor Alpha Antibody Antagonist, 202 Agents Used to Manage Upper Respiratory Infections, 202 Dental Implications of the Respiratory Drugs, 203 Allergic Rhinitis, 203 Pharmacologic Effects, 204 Η,-Receptor Blocking Effects, 204 Other Effects (Unrelated to H t-Blockmg Effects), 204 Adverse Reactions, 204 Central Nervous System Depression, 204 Anticholinergic Effects, 204 Dental hygiene considerations, 206 Academic skills assessment, 207 Clinical Case Study, 207 Clinical Case Study, 207 18 Drugs for the Treatment of Diabetes Mellitus, 208 Pancreatic Hormones, 208 Diabetes Mellitus, 208 Types of Diabetes, 208 Dental Implications of Diabetes, 209 Systemic Complications of Diabetes, 210 Evaluation of the Dental Patient With Diabetes, 211 Goals of Therapy, 211 Drugs Used to Manage Diabetes, 212 Insulins, 212 Antihyperglycemic Drugs for Type 2 Diabetes, 213 Treatment of Hypoglycemia, 218 Glucagon, 218 Dental Hygiene Considerations, 218 Academic Skills Assessment, 218 Clinical Case Study, 218 Bibliography, 218 19
Drugs for the Treatment of Other Endocrine Disorders, 219 Pituitary Hormones, 219 Anterior Pituitary, 219 Posterior Pituitary, 221 Thyroid Hormones, 221 Iodine, 221 Hypothyroidism, 221 Hyperthyroidism, 221 Female Sex Hormones, 222 Estrogens, 223 Progestins, 224 Hormonal Contraceptives, 224
CONTENTS Male Sex Hormones, 225 Androgens, 225 Other Agents That Affect Sex Hormone Systems, 226 Clomiphene, 226 Leuprolide, 226 Tamoxifen, 227 Danazol, 227 Aromatase Inhibitors, 227 Dental Hygiene Considerations, 227 Academic Skills Assessment, 227 Clinical Case Study, 227 20 Antineoplastic Drugs, 229 Use of Antineoplastic Agents, 229 Mechanisms of Action, 230 Classification, 231 Adverse Drug Effects, 233 Bone Marrow Suppression, 233 Osteonecrosis, 233 Gastrointestinal Effects, 235 Dermatologic Effects, 235 Hepatotoxicity, 235 Nephrotoxicity, 235 Immunosuppression, 235 Germ Cells, 235 Oral Effects, 235 Combinations, 236 Dental Implications, 236 Dental Hygiene Considerations, 237 Academic Skills Assessment, 237 Clinical Case Study, 237 PART IV Special Situations 21 Emergency Drugs, 239 General Measures, 239 Steps Indicated, 239 Preparation for Treatment, 239 Categories of Emergencies, 240 Lost or Altered Consciousness, 240 Respiratory Emergencies, 241 Cardiovascular System Emergencies, 242 Other Emergency Situations, 242 Drug-Related Emergencies, 244 Emergency Kit for The Dental Office, 245 Drugs, 245 Equipment, 248 Dental Hygiene Considerations, 248 Academic Skills Assessment, 248 Clinical Case Study, 248 22 Pregnancy and Breastfeeding, 249 General Principles, 249 Two Main Concerns, 249 History, 249 Pregnancy, 249 Pregnancy Trimesters, 249 Teratogenicity, 250 US Food and Drug Administration Drug Use in Pregnancy and Lactation, 250 Breastfeeding, 251 Dental Drugs, 251 Local Anesthetic Agents, 251 Epinephrine, 251 Analgesics, 251 Antiinfective Agents, 254 Antianxiety Agents,
255 Dental Hygiene Considerations, 256 Academic Skills Assessment, 256 Clinical Case Study, 257 23 Substance Use Disorders, 258 General Considerations, 258 Definitions, 258 Psychological Dependence, 259 Physical Dependence, 259 Tolerance, 259 Central Nervous System Depressants, 260 Ethyl Alcohol, 260 Nitrous Oxide, 263 Opioid Analgesics, 264 Opioid Street Drug, 265 Sedative-Hypnotics, 265 Pattern of Abuse, 265 Management ofAcute Overdose and Withdrawal, 266 Central Nervous System Stimulants, 266 Cocaine, 266 Amphetamines, 266 Caffeine, 267 Tobacco, 267 Psychedelics (Hallucinogens), 269 Lysergic Acid Diethylamide, 269 Phencyclidine, 269 Marijuana, 269 Identifying the Substance User, 270 The Impaired Dental Hygienist, 270 Dental Hygiene Considerations, 270 Academic Skills Assessment, 270 Clinical Case Study, 271 24 Natural/Herbal Products and Dietary Supplements, д' Limited Regulation, 272 Dietary Supplement Health and Education Ad,. Package Labeling, 273 Safety of Herbal and Nutritional Products, 273 Oral Adverse Effects, 273 Drug Interactions, 273 Standardization of Herbal Products, 275 Good Manufacturing Practice, 275 Herbal Supplements Used in Oral Health Care, 2: Acemannan, 276 Essential Oil Mouth Rinse, 276 Oil of Cloves (Eugenol), 276 Triclosan, 276 Xylitol, 276 Dental Hygiene Considerations, 277 Academic Skills Assessment, 277 Clinical Case Study, 277 25 Oral Conditions and Their Treatment, 278 Infectious Lesions, 278 Acute Necrotizing Ulcerative Gingivitis, 278 Herpes Infections, 278 Candidiasis (Moniliasis), 280 Angular Cheilitis/Cheilosis, 281 Alveolar Osteitis,
282
CONTENTS Immune Reactions, 282 Recurrent Aphthous Stomatitis, 282 Lichen Planus, 283 Miscellaneous Oral Conditions, 283 Geographic Tongue, 283 Burning Mouth or Tongue Syndrome, 283 Inflammation, 284 Pericoronitis, 284 Post-Irradiation Caries, 284 Root Sensitivity, 284 Actinic Lip Changes, 284 Stomatitis, 284 Drug-Induced Oral Side Effects, 284 Xerostomia, 284 Sialorrhea, 284 Hypersensitivity Reactions, 285 Oral Lesions That Resemble Autoimmune-Type Reactions, 285 Stains, 287 Gingival Enlargement, 287 Osteonecrosis of the Jaw, 287 Agents Commonly Used to Treat Oral Lesions, 287 Corticosteroids, 287 Palliative Treatment, 288 Dental Hygiene Considerations, 288 Academic Skills Assessment, 288 Clinical Case Study, 288 26 Hygiene-Related Oral Disorders, 289 Dental Caries, 289 Prevention, 289 Gingivitis, 295 Prevention, 295 Tooth Hypersensitivity, 296 Pathophysiology, 296 Treatment, 296 Dental Hygiene Considerations, 297 Patient Education for Caries and Gingivitis, 297 Patient Education for Tooth Hypersensitivity, 298 Patient Self-Care, 298 Academic Skills Assessment, 298 Clinical Case Study, 298 Reference, 298 Bibliography, 298 Appendix A: Medical Acronyms, 299 Appendix B: Medical Terminology, 302 Appendix C: What If304 Appendix D: Oral Manifestations: Xerostomia and Taste Changes, 309 Appendix E: Children's Dose Calculations, 312 Glossary, 313 Drug Index, 321 Subject Index, 335
APPLIED EDITION PHARMACOLOGY fortheDENTAL HYGIENIST ELENA BABLENIS HAVELES Build the pharmacology foundation needed for a successful dental hygiene career! With a focus on the most commonly used drugs in dentistry, this comprehensive resource provides an in-depth understanding of the pharmacologic principles behind safe and effective dental treatment and oral health care. It discusses drug properties and mechanisms of action, dosages, intended effects, interactions, and adverse reactions-both for the medications a patient may already be taking and for the drugs prescribed by the dentist. • NEW! Updated drug content throughout, including new side effects and warnings for many commonly seen drugs. / • Clinical case studies and review guestions within chapters plus guizzes online offer multiple opportunities for application and test preparation. • Learning features include Dental Hygiene Considerations, summary boxes and tables, and Note boxes to highlight key concepts. • Key terms are bolded and in color within each chapter and defined in a handy glossary for mastering vocabulary. • Engaging full-color design includes illustrations showing basic principles and internal processes, along with photographs of oral conditions and side effects. • Separate drug index provides easy look-up of spécifie drugs and types of drugs. • Quick-reference appendices include resources such as medical terminology, medical acronyms, and information on dose calculations for children. |
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| callnumber-subject | RK - Dentistry |
| classification_rvk | XI 2397 |
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| dewey-ones | 615 - Pharmacology and therapeutics |
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| dewey-sort | 3615 17 6246176 |
| dewey-tens | 610 - Medicine and health |
| discipline | Medizin |
| discipline_str_mv | Medizin |
| edition | 9th edition |
| format | Book |
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| spelling | Haveles, Elena Verfasser (DE-588)1230494634 aut Applied pharmacology for the dental hygienist Elena Bablenis Haveles, BS Pharmacy, PharmD, RPh 9th edition St. Louis, Missouri Elsevier [2024] xix, 347 Seiten Illustrationen 216 x 276 mm txt rdacontent n rdamedia nc rdacarrier With a focus on the most commonly used drugs in dentistry, Applied Pharmacology for the Dental Hygienist, 9th Edition provides an in-depth understanding of the pharmacologic principles needed for safe and effective dental treatment and oral health care. It discusses drug properties and mechanisms of action, dosages, intended effects, interactions, and adverse reactions - both for the medications a patient may already be taking and for the drugs prescribed by the dentist. Comprehensive coverage with a dental hygiene focus provides you with an in-depth understanding of the most commonly used drugs, how they work, and how they affect patients' oral health and dental treatment options. Multiple opportunities for classroom and board exam prep offers a clinical case study and review questions at the end of each chapter and practice quizzes on the companion Evolve website to help you assess your knowledge of the material. Learning features include Dental Hygiene Considerations, summary boxes and tables, and Note boxes to highlight key concepts. Key terms are bolded and in color within each chapter and defined in a handy glossary for mastering vocabulary. Engaging full-color design includes illustrations showing basic principles and internal processes, along with photographs of oral conditions and side effects. Separate drug index provides easy look-up of specific drugs and types of drugs. Quick-reference appendixes include resources such as medical terminology, medical acronyms, and information on dose calculations for children. NEW! Updated drug content throughout, including new side effects and warnings for many commonly seen drugs Dentistry / BIC2 Pharmacology / BIC2 Dental Hygienists Dental hygiene Dental pharmacology Dentistry Pharmacology, Clinical Pharmakologie (DE-588)4045687-0 gnd rswk-swf Zahnmedizin (DE-588)4079454-4 gnd rswk-swf Zahnmedizin (DE-588)4079454-4 s Pharmakologie (DE-588)4045687-0 s DE-604 Digitalisierung UB Regensburg - ADAM Catalogue Enrichment application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=034731857&sequence=000001&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis Digitalisierung UB Regensburg - ADAM Catalogue Enrichment application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=034731857&sequence=000003&line_number=0002&func_code=DB_RECORDS&service_type=MEDIA Klappentext Digitalisierung UB Regensburg - ADAM Catalogue Enrichment application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=034731857&sequence=000005&line_number=0003&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis Digitalisierung UB Regensburg - ADAM Catalogue Enrichment application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=034731857&sequence=000007&line_number=0004&func_code=DB_RECORDS&service_type=MEDIA Klappentext |
| spellingShingle | Haveles, Elena Applied pharmacology for the dental hygienist Dentistry / BIC2 Pharmacology / BIC2 Dental Hygienists Dental hygiene Dental pharmacology Dentistry Pharmacology, Clinical Pharmakologie (DE-588)4045687-0 gnd Zahnmedizin (DE-588)4079454-4 gnd |
| subject_GND | (DE-588)4045687-0 (DE-588)4079454-4 |
| title | Applied pharmacology for the dental hygienist |
| title_auth | Applied pharmacology for the dental hygienist |
| title_exact_search | Applied pharmacology for the dental hygienist |
| title_exact_search_txtP | Applied pharmacology for the dental hygienist |
| title_full | Applied pharmacology for the dental hygienist Elena Bablenis Haveles, BS Pharmacy, PharmD, RPh |
| title_fullStr | Applied pharmacology for the dental hygienist Elena Bablenis Haveles, BS Pharmacy, PharmD, RPh |
| title_full_unstemmed | Applied pharmacology for the dental hygienist Elena Bablenis Haveles, BS Pharmacy, PharmD, RPh |
| title_short | Applied pharmacology for the dental hygienist |
| title_sort | applied pharmacology for the dental hygienist |
| topic | Dentistry / BIC2 Pharmacology / BIC2 Dental Hygienists Dental hygiene Dental pharmacology Dentistry Pharmacology, Clinical Pharmakologie (DE-588)4045687-0 gnd Zahnmedizin (DE-588)4079454-4 gnd |
| topic_facet | Dentistry / BIC2 Pharmacology / BIC2 Dental Hygienists Dental hygiene Dental pharmacology Dentistry Pharmacology, Clinical Pharmakologie Zahnmedizin |
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