Table of Contents
Preface xi
Contributors xiii
1 Introduction to pharmacology 1
I. Definition of terms 1
II. Pharmacokinetics 3
III. Pharmacodynamics 6
2 The prescription and drug names 9
I. Parts of a prescription 9
II. Generic substitution 10
III. Controlled drugs 11
IV. Principles of prescription writing 13
V. How to avoid prescription errors 19
3 Drug dosing 23
I. Basic principles of drug dosing 23
II. Pediatric patient 26
a. Penicillin VK oral suspension 27
b. How is the dose calculated if the child could swallow tablets? 27
Penicillin VK tablets 27
c. If amoxicillin were to be prescribed 28
Amoxicillin oral suspension 28
Amoxicillin chewable tablets 28
Amoxicillin capsules 29
d. Azithromycin 30
Oral suspension 30
Azithromycin tablets 30
e. Clindamycin 30
Clindamycin oral solution 30
Clindamycin capsules 30
III. Pregnant and nursing patients 31
IV. Elderly patient 35
V. Renal-impaired patient 35
VI. Hepatic-impaired patient 37
4 Formulary sections 41
I. Antimicrobials, systemic 41
a. General considerations 41
b. Antibiotics 45
Beta-lactam antibiotics 45
Cephalosporins 48
Erythromycins 49
Lincomycins 52
Metronidazole 53
Tetracyclines 54
Fluoroquinolones 56
c. Specific instructions for taking antibiotics 58
II. Antimicrobials, local 59
a. Chlorhexidine gluconate 59
b. Other mouthrinses and periodontal health products 63
III. Controlled-release drug delivery 64
IV. Antivirals/antifungal agents 65
a. Antiviral agents 65
b. Antifungal agents 68
V. Prescribing for pain control 72
a. General considerations 72
b. Aspirin 72
c. Nonsteroidal anti-inflammatory drugs (NSAIDs) 74
d. Acetaminophen 80
e. Narcotic (opioid) analgesics 83
f. Management plan for acute dental pain 90
VI. Moderate sedation 94
a. Benzodiazepines 95
b. Other agents 96
VII. Glucocorticosteroids 97
a. Topical glucocorticosteroids 97
b. Other nonsteroidal topical agents used in the management of oral lesions 100
c. Systemic corticosteroids 100
5 How to manage potential drug interactions 105
I. Introduction to drug interactions 105
II. Antibiotic-drug interactions in dentistry 110
III. Analgesic-drug interactions in dentistry 116
IV. Sympathomimetic agents and drug interactions in dentistry 119
V. Anti-anxiety drug interactions in dentistry 122
6 Evidence-based theory for drug prescribing 125
I. General considerations 125
II. Prescribing for inflammatory periodontal diseases and periodontal surgical procedures 127
a. Gingivitis 127
b. Chronic periodontitis 127
c. Ulcerative periodontal diseases 129
d. Refractory and recurrent periodontitis 130
e. Aggressive periodontitis 131
f. Periodontal therapy 132
Periodontal flap surgery: pocket reduction 132
Bone/bone substitutes grafting procedures 133
Periodontal regenerative surgery: Guided tissue regeneration (GTR) 134
III. Prescribing for dental implant surgery 135
a. Prescribing for sinus floor elevation surgery 136
IV. Prescribing for oral surgery 139
V. Prescribing for odontogenic infections 139
a. Prescribing for endodontic abscess 140
b. Prescribing for periodontal abscess 145
7 Management of the medically compromised dental patient 149
I. American Heart Association (AHA) guidelines for antibiotic prophylaxis 149
a. Prevention of infective endocarditis: Antibiotic prophylaxis for the dental patient 149
II. Antibiotic prophylaxis for total joint replacement 152
III. Cardiovascular diseases 155
a. Hypertension 155
b. Angina and other ischemic cardiac conditions 162
c. Congestive heart failure 163
d. Patient on low-dose aspirin and other antiplatelet drugs 163
e. Anticoagulated patient (patient taking warfarin or heparin) 168
f. Low-molecular-weight heparins (LMWHs) 171
g. Myocardial infarction 171
h. Cardiac arrhythmias 172
i. Valvular heart disease 172
IV. Pregnant and postpartum patient 174
V. Adrenal suppression and thyroid disease 175
VI. Asthma 176
VII. Diabetes mellitus 178
VIII. Psychiatric/neurological disorders 180
IX. Organ transplant 181
X. Liver disease 186
XI. Chronic kidney disease 187
XII. Recreational and illicit drugs 189
XIII. Bisphosphonates 191
XIV. Tuberculosis 197
XV. Bariatric surgery 198
XVI. Pheochromocytoma 200
8 Herbal and natural remedies 205
I. Herbal–drug interactions 205
II. Implications in dentistry 206
Appendix 1 209
Smoking cessation therapy 209
Appendix 2 215
Oral manifestation of drugs 215
Appendix 3 219
American Heart Association antibiotic prophylaxis guidelines 219
Appendix 4 221
List of tables 221
Appendix 5 223
Pharmacology pearls in dental practice 223
Appendix 6 225
Dental drug formulary 225
Analgesics 225
Non-narcotics 225
Narcotics 225
Antibiotics 225
Penicillins 225
Erythromycins 225
Lincomycins 226
Tetracyclines 226
Fluoroquinolones 226
Others 226
Topical antimicrobials 226
Antifungal agents 226
Antiviral agents 226
Index 227