PAINKILLERS: ANTIBIOTICS: ANTIFUNGALS:

Tylenol Extra Strength™ (oral - tablet): B
• 500 mg [OTC] dispense 28
• PD: Take 1 - 2 tablets q6h PRN pain
• CONTRAINDICATIONS: HEPATIC ISSUES
Ibuprofen (oral - tablet): C
• 600 mg dispense 28
• PD: Take 1 tablet with food q6h PRN pain
• CONTRAINDICATIONS: BLOOD THINNERS, KIDNEY
AND GASTRIC ISSUES, ASTHMATICS
Naproxen (oral - tablet): C
• 550 mg dispense 28
• PD: Take 1 tablet with food q12h PRN pain
• CONTRAINDICATIONS: BLOOD THINNERS, KIDNEY
AND GASTRIC ISSUES, ASTHMATICS
Orabase with Benzocaine™ (mucous
membrane - paste): B
• 20% [OTC] dispense 1 tube
• PD: Apply to affected area PRN pain
Orabase Lip Healer™ (topical - cream): B
• 5% [OTC] dispense 1 tube
• PD: Apply to affected area PRN pain
ANXIETY:
Triazolam (Halcion): X
• 0.25 mg dispense 2
• PD: Take 1 tablet at bedtime, then take 1 tablet 1 hour
before appointment
• CONTRAINDICATIONS: ALCOHOLICS, PTS ON
ANTIFUNGALS AND HIV DRUGS
STEROIDS:
Medrol Dosepack (oral - tablet): D
• 8 mg dispense 5 tablets
• PD: Take all 5 tablets 1 hour before surgery
• Prevents swelling during major surgical procedures.
Prescribe concurrently with antibiotics.
Amoxicillin (oral - tablet): B
• 875 mg dispense 14
o Pre-medication: 500mg dispense 4
• PD: Take 1 tablet q12h until finished
o Pre-medication: Take 4 tablets 1 hour before
appointment
• CONTRAINDICATIONS: KNOWN ALLERGIES,
BIRTH CONTROL MEDICATIONS
Clindamycin (oral - tablet): B
• 300 mg dispense 21
o Pre-medication: 300mg dispense 2
• PD: Take 1 tablet q8h until finished
o Pre-medication: Take 2 tablets 1 hour before
appointment
• CONTRAINDICATIONS: HEPATIC ISSUES
Azithromycin (oral - tablet): B
• 500 mg dispense 7
• PD: Take 1 tablet q24h until finished
• CONTRAINDICATIONS: SERIOUS CARDIAC
ISSUES, ARRHYTHMIAS
• Treats perio, perio abscesses, and acute oral
infections
Augmentin (oral - tablet): B
• 875/125 mg dispense 14
• PD: Take 1 tablet q12h until finished
• CONTRAINDICATIONS: KNOWN ALLERGIES,
BIRTH CONTROL MEDICATIONS
• Used to prevent infections for potential sinus exposure
Doxycycline (oral - tablet): D
• 100 mg dispense 21
• PD: Take 1 tablet a day until finished
• CONTRAINDICATIONS: LIVER AND KIDNEY
ISSUES, ANTICOAGULANTS. MAY DISCOLOR
TEETH AND CAUSE SKIN TO GRAY IN THE SUN
• Treats perio, perio abscesses, and acute oral
infections
Nystatin (oral - suspension): C
• 100,000 IU/mL dispense 350mL
• PD: Rinse with 5mL for 2 minutes for 4 - 5 times per
day for two weeks
• CONTRAINDICATIONS: HIGH CARIES RISK
• Treats oral candidiasis
Mycelex Troche (oral - lozenge): C
• 10 mg dispense 70
• PD: Dissolve in mouth 5 times daily for 7 – 14 days.
Do not chew or swallow.
• CONTRAINDICATIONS: HIGH CARIES RISK
• Treats oral candidiasis
Nystatin (topical - cream): C
• 100,000 IU/g dispense 1 tube
• PD: Apply to affected area QID for 14 days
• Treats angular chelitis
Diflucan (oral - tablet): C
• 100 mg dispense 16
• PD: Take 2 tablets on day 1, then 1 tablet at same
time per day for 14 days.
• CONTRAINDICATIONS: PTS ON PROTON PUMP
INHIBITORS OR PLAVIX
• Systemic treatment if local therapies ineffective
SALIVARY CONTROL:
Pilocarpine Hydrochloride (oral - tablet): C
• 5 mg dispense 90
• PD: Take 1 tablet every 8 hours
• CONTRAINDICATIONS: GLAUCOMA, ASTHMA,
SIGNIFICANT CARDIOVASCULAR DISEASE
• Especially indicated for Sjorgen’s syndrome and
radiation therapy patients
Propantheline (oral - tablet): C
• 15 mg dispense per number of appointments
• PD: Take 1 tablet 30 minutes before appointment
• CONTRAINDICATIONS: GLAUCOMA, HEPATIC
ISSUES
• Indicated for sialorrhea
PREVENTATIVE: NARCOTICS: PEDIATRIC DOSING:
Prevident 5000 Plus (1.1% paste): B Norco (oral - tablet): hydrocodone C PAINKILLERS:
• Dispense 1 tube • 325 mg / 5mg dispense 8
Children’s Tylenol (oral - suspension):
• PD: Brush with pea sized amount at night for 2 • PD: Take 1 tablet q6h PRN pain
• 160mg/5ml, disp 1 bottle
minutes. Expectorate, do not rinse • CONTRAINDICATIONS: PTS ON BENZOS,
• PD: Take X tsp q6h PRN pain. Do not exceed 4 doses
RESPIRATORY AND HEPATIC ISSUES
Peridex 0.12% (mouthwash): B in 24 hours
• Dispense 1 bottle Tylenol #3 (oral - tablet): codeine C
Children’s Motrin (oral - suspension):
• PD: Rinse 10ml for 30 seconds twice daily • 300 mg / 30mg dispense 8
• 100mg/5ml, disp 1 bottle
• PD: Take 1 tablet q6h PRN pain
• PD: Take X tsp q6h PRN pain. Do not exceed 4 doses
CONTRAINDICATIONS: PTS ON BENZOS,
MUSCLE RELAXANTS: •
RESPIRATORY AND HEPATIC ISSUES
in 24 hours

Flexeril (oral - tablet): B ANTIBIOTICS:

Percocet (oral - tablet): oxycodone C
• 5 mg dispense 30 tablets
• 325 mg / 5mg dispense 8 Amoxicillin (oral - suspension):
• PD: Take 1 tablet TID, Taper dosage as spasms
• PD: Take 1 tablet q6h PRN pain • 125/5ml, disp Y
decrease. Do not drive until drug potency is realized.
• CONTRAINDICATIONS: PTS ON BENZOS AND • PD: Take X tsp q8h until finished
• CONTRAINDICATIONS: HEPATIC ISSUES,
ANTI-SEIZURE MEDS, HEPATIC ISSUES • CONTRAINDICATIONS: KNOWN ALLERGIES
GLAUCOMA, RECENT MI, ARRHYTHMIAS, CHF,
HYPERTHYROIDISM
Ultram (oral - tablet): tramadol C Clindamycin (oral - suspension):
• Muscle relaxant used to alleviate discomfort for TMD
• 50 mg dispense 16 • 75/5ml, disp Y
and mandibular advancement devices.
• PD: Take 1 - 2 tablet q6h PRN pain • PD: Take X tsp q8h until finished
• CONTRAINDICATIONS: PTS ON BENZOS AND
MAGIC MOUTHWASH: ANTI-SEIZURE MEDS
PEDO REFERENCE TABLE:
• Abuse potential far lower than other narcotics
(oral - suspension): D Weight (lbs) Dose (tsp) X Disp (ml) Y
• 15cc as an oral rinse qid as directed: 24 – 35 1 105
o 100ml dexamethasone 0.5mg per 5ml elixir OTHER: 36 – 47 1.5 160
o 60ml nystatin 100,000U suspension
Sudafed (oral - tablet): B 48 – 59 2 210
o 100ml diphenhydramine 12.5mg per 5ml elixir
• 120 mg [OTC] dispense 14
o Contents of 3 capsules tetracycline 500mg 60 – 71 2.5 265
• PD: Take 1 tablet q12h until finished
• PD: Rinse 10ml for 30 seconds four times daily 72 – 95 3 315
• Decongestant used when suspecting sinus exposure
• Treats discomfort associated with oral mucositis

(oral - suspension): B Debacterol (mucous membrane - swab): C

• 50% - 30% [OTC] dispense 1 box
• 15cc as an oral rinse qid as directed:
• PD: Apply to affected area PRN pain
o 1 part viscous lidocaine 2%
• Cauterizes canker sores
o 1 part Maalox
o 1 part diphenhydramine 12.5mg per 5ml elixir
Lidex (oral - gel): C
• PD: Rinse 10ml for 30 seconds four times daily
• Dispense 1 tube
• Treats discomfort associated with oral mucositis
• PD: Apply thin layer to affected areas after each meal
and before bedtime
• Treats lichen planus. Prescribe with antifungal