Therapeutics in Dentistry

(General Principles)
• Iyad Abou Rabii

2012 2005 2004 2001 1998 1998 1993 1991

MSc (Medical Education) PG Certificat (Implant Dentistry) PhD(Dental Pharmacology) PG Diploma (Pharmaceutical Engeneering) PG Certificat (General Pharmacology) MRes (Master of Research) PG Diploma Oral and Max-Fac Surgery Docteur of Dental Surgery

Pharmacology Basics

• Indications

• Contra-indications

2

Pharmacology Basics

• Indications
– The reasons for administering a medication or performing a treatment

• Contra-indications
– A factor that prevents the use of a medication or treatment (eg. Allergies)

2

Pharmacology Basics
• Dose

• Mechanism of Action

3

Pharmacology Basics
• Dose
– The amount of a drug to be administered at one time

• Mechanism of Action
– How a drug works

3

Pharmacology Basics

• Effects

• Side Effects

4

Pharmacology Basics

• Effects
– The desired result of administration of a medication

• Side Effects
– Effects that are not desired and that occur in addition to the desired therapeutic effects

4

Medication Names
• Chemical Name • Generic Name • Trade Name • Official Name

6

Medication Names
• Chemical Name
– describes the drug’s chemical structure

• Generic Name
– reflects the chemical name, but in shorter form

• Trade Name
– the name the manufacturer uses to market the drug

• Official Name
– the name used in the Pharmocopoeia

6

Routes of drug administration
• Enteral tract routes • Parenteral routes

Comparison of Enteral vs. Parenteral Routes

Enteral Routes
• • • • • Oral (PO) Orogastric/nasogastric (OG/NG) Sublingual (SL) Buccal Rectal (PR)

Parenteral Routes
• • • • • • • Topical Intradermal Intranasal Subcutaneous (SC) Intramuscular (IM) Intravenous (IV) Endotracheal (ET)

• Sublingual injection • Intracardiac (IC) • Intraosseous • Inhalational • Umbilical • Vaginal • Pulpal

No single method of drug administration is ideal for all drugs in all circumstances

Drug prescriptio n
What are the essential components of a drug prescription?

Essential Components of Prescriptions
All written prescriptions should contain: 1) Patient's full name and address

2) Prescriber's full name, address, telephone number,
3) Date of issuance 4) Signature of prescriber 5) Drug name, dose, dosage form, amount 6) Directions for use 7) Refill instructions

The Medication Order (Prescription)
• • • • Medication desired Dose desired Administration route Administration rate

Before any Drug prescription
• Discuss with patient the possible consequences (god and bad) • Prescribe drugs you know • Keep updated (BNF, Vidal…others) • Dose: consider age, physiology, and pathology • Drug interactions

Prescribing
• The Dentist is legally responsible for the signed prescription • Prescription should be indelible, dated, with full name and address of the patient • Age of patient should be mentioned when under 12. • Use generic drugs when possible

Prescribing
• Don`t use abbreviations for the drug names. • Define the quantity supplied • Directions should be in English with no use of the abbreviations

Prescribing
• When writing the dose
– Quantities of one gram is wrriten (1 g) – Less than 1 g is written in milligrams (500 mg) – Less than l mg should be written in microgram 100 microgram (not 0.1 mg) – Nanogram and microgram should not be abbreviated

Clark’s Rule
Clark's Rule Divide the child’s weight (in pounds) by 150 to get the approximate fraction of the adult dose to give to the child.  Example: For a 50 pound child give 50/150 (or 1/3) of the adult dose. Therefore, if the adult dose is 30 drops taken 3 times per day, the child’s dose will be 10 drops taken 3 times per day  (not 30 drops taken 1 time per day).

Essential Components of Prescriptions
All written prescriptions should contain: 1)Patient's full name and address 2)Prescriber's full name, address, telephone number,

3)Date of issuance
4)Signature of prescriber 5)Drug name, dose, dosage form, amount 6)Directions for use 7)Refill instructions

Essential Components of Prescriptions

Latin abbreviations

Rx : abbreviation of the Latin word "recipe” x as a substitute period. # ac (ante cibum)

means "before meals"

# bid (bis in die) means

"twice a day"

Latin abbreviations

# po (per os)

means "by mouth"

# pc (post cibum) means

"after meals"

# prn (pro re nata)

means "as needed"

Latin abbreviations

# q 3 h (quaque 3 hora)

means "every 3 hours"

# qd (quaque die)

means "every day"

# qid (quater in die) means

"4 times a day"

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