Chapter 15Chapter 15Pharmacology and Pain Pharmacology and Pain control.control.

Pharmacology is:Pharmacology is:• the study of all drugsthe study of all drugs• their propertiestheir properties• how they react with each other how they react with each other • actions of the drugs within the bodyactions of the drugs within the body

PharmacologyPharmacology

DrugDrug• any substance that can change any substance that can change

processes within the body.processes within the body. MedicinesMedicines

• drugs that are used to treat diseases.drugs that are used to treat diseases. Side effectsSide effects

• when drugs cause unwanted results.when drugs cause unwanted results.

PharmacologyPharmacology

Drug interactionDrug interaction• when one drug changes the effect of when one drug changes the effect of

another drug by increasing or decreasing another drug by increasing or decreasing the intended result.the intended result.

• Physicians Desk Reference aka (PDR)Physicians Desk Reference aka (PDR)– printed annuallyprinted annually– lists dosages, indications, contraindications.lists dosages, indications, contraindications.

AddictionAddiction• a person is a person is physically physically dependant on a drug.dependant on a drug.

PharmacologyPharmacology

ToleranceTolerance• ability to tolerate the influence of a drug.ability to tolerate the influence of a drug.• With a high tolerance, more of a drug With a high tolerance, more of a drug

would be needed to produce the same would be needed to produce the same effect.effect.

Psychologically dependentPsychologically dependent• emotional need to take a drugemotional need to take a drug• habit forminghabit forming• cravingcraving

PharmacologyPharmacology

WithdrawalWithdrawal• occurs when addict stops taking the drugoccurs when addict stops taking the drug• symptomssymptoms

– nervousness, nervousness, – stomach cramps, stomach cramps, – diarrhea, diarrhea, – shakes,shakes,– depression, depression, – and even deathand even death

PrescriptionsPrescriptions

Drug Enforcement AgencyDrug Enforcement Agency• aka DEAaka DEA

– federal agencyfederal agency– Must have a DEA # to prescribe medsMust have a DEA # to prescribe meds– monitor prescriptionsmonitor prescriptions– investigate abuse of prescriptionsinvestigate abuse of prescriptions

PrescriptionsPrescriptions

Who can prescribeWho can prescribe• dentistsdentists• physicians / doctorsphysicians / doctors• psychiatristpsychiatrist• some physician assistantssome physician assistants

– depends on state laws and medicationdepends on state laws and medication

• some registered nursessome registered nurses– depends on state laws and medicationdepends on state laws and medication

PrescriptionsPrescriptions

Parts of a prescription / RXParts of a prescription / RX• HeadingHeading

– Doc’s name, address, phone numberDoc’s name, address, phone number

• SuperscriptionSuperscription– Name of patient, Name of patient, – their addresstheir address– date of birth (DOB)date of birth (DOB)– date writtendate written

PrescriptionsPrescriptions

• Body (inscription)Body (inscription)– name of drugname of drug– dosagedosage– number dispensednumber dispensed– and directionsand directions

• ClosingClosing– Doc’s signatureDoc’s signature– refillsrefills– Brand name or generic OKBrand name or generic OK

Drug NamesDrug Names

Brand NamesBrand Names• Assigned by the manufacturerAssigned by the manufacturer• aka Trade namesaka Trade names• Always capitalized Always capitalized • registered trademark ®registered trademark ®

ExamplesExamples• Tylenol ®, Bayer ®, Advil ®Tylenol ®, Bayer ®, Advil ®

Drug NamesDrug Names

Generic namesGeneric names• not capitalizednot capitalized• less expensive than brand namesless expensive than brand names• unprotected, any business can use unprotected, any business can use

themthem• refer to chemical composition of drugrefer to chemical composition of drug• examples:examples:

– acetaminophen, aspirin, ibuprofenacetaminophen, aspirin, ibuprofen

Drugs used in dentistryDrugs used in dentistry

AnalgesicsAnalgesics• pain medicationpain medication• most are narcotics (habit forming)most are narcotics (habit forming)• some are non-narcoticsome are non-narcotic

AntibioticsAntibiotics• prevent or fight infectionsprevent or fight infections

– penicillin, amoxicillin, erythromycin, penicillin, amoxicillin, erythromycin, – tetracycline (will discolor developing teeth)tetracycline (will discolor developing teeth)

Drugs used in dentistryDrugs used in dentistry

Prophylactic AntibioticProphylactic Antibiotic• aka Pre-medaka Pre-med

– rheumatic feverrheumatic fever– joint replacementjoint replacement– heart murmurheart murmur– heart valve replacementheart valve replacement

• Prevents bacterial endocarditisPrevents bacterial endocarditis– inflammation of the inside layer of the inflammation of the inside layer of the

heartheart

Drugs used in dentistryDrugs used in dentistry

TranquilizersTranquilizers• Sedative effectSedative effect• relieves anxiety /reduces tensionrelieves anxiety /reduces tension• ExamplesExamples

– Nitrous oxide (NNitrous oxide (N22O), ValiumO), Valium

AtropineAtropine• inhibits flow of saliva for 4-6 hoursinhibits flow of saliva for 4-6 hours

Drug TerminologyDrug Terminology

StimulantStimulant• speeds up the bodies activityspeeds up the bodies activity

– tobacco, caffeine, cocaine, amphetaminestobacco, caffeine, cocaine, amphetamines

DepressantDepressant• slows down the bodies processslows down the bodies process

– alcohol, marijuanaalcohol, marijuana– narcotics are addictive depressants that narcotics are addictive depressants that

relieve pain.relieve pain.– Morphine, codine, heroinMorphine, codine, heroin

Drug TerminologyDrug Terminology

SedativeSedative• depresses brain activitydepresses brain activity

– reduces stress / anxietyreduces stress / anxiety– tranquilizers, barbiturates, nitrous oxidetranquilizers, barbiturates, nitrous oxide

HallucinogenHallucinogen• see and hear things / images that do see and hear things / images that do

not exist.not exist.– LSD, mushrooms, PCPLSD, mushrooms, PCP

Schedule of drugsSchedule of drugs

Groups drugs according to uses and Groups drugs according to uses and potential for abuse.potential for abuse.• Schedule ISchedule I

– high abuse rate, high abuse rate, – no medical acceptanceno medical acceptance– heroin, PCP, LSDheroin, PCP, LSD

• Schedule IISchedule II– High abuse rate,medical acceptanceHigh abuse rate,medical acceptance– morphine, amphetamines, barbiturates,morphine, amphetamines, barbiturates,

Schedule of drugsSchedule of drugs

• Schedule IIISchedule III– Lower abuse rate, medical acceptanceLower abuse rate, medical acceptance– stimulants, depressants, Tylenol IIIstimulants, depressants, Tylenol III

• Schedule IVSchedule IV– low abuse rate, medical acceptancelow abuse rate, medical acceptance– anti-anxiety, sedativesanti-anxiety, sedatives

• Schedule V (OTC)Schedule V (OTC)– very low abuse ratevery low abuse rate– anti-diarrhea, cough medication, eye dropsanti-diarrhea, cough medication, eye drops

Routes of administrationRoutes of administration

How to get drugs in or ‘on board’ How to get drugs in or ‘on board’ the body.the body.• Orally / by mouthOrally / by mouth

– tablets, pills, liquidstablets, pills, liquids

• Topical / applied to skin or mucosaTopical / applied to skin or mucosa– ointment, gel, creamointment, gel, cream

• Sublingual / under the tongueSublingual / under the tongue– Nitroglycerin pill or spray, vitaminsNitroglycerin pill or spray, vitamins

Routes of administrationRoutes of administration

• Inhalation / breathing inInhalation / breathing in– gas (Ngas (N220), aerosol spray0), aerosol spray

• Intravenous / inject in veinIntravenous / inject in vein– almost immediate drug responsealmost immediate drug response

• Intramuscular / inject in muscleIntramuscular / inject in muscle– long lastinglong lasting

• rectal rectal – suppositoriessuppositories

Routes of administrationRoutes of administration

• SubcutaneousSubcutaneous– injected under skin, above the muscleinjected under skin, above the muscle

• IntradermalIntradermal– injected under the top layer of skininjected under the top layer of skin

• TransdermalTransdermal– medication, medication, – birth control, birth control, – stop smoking patchstop smoking patch– worn for extended periods of timeworn for extended periods of time

ClosingClosing

It is very important to always check It is very important to always check a patients medical history at every a patients medical history at every visit.visit.

If they are taking medications or If they are taking medications or drugs, make sure to inform the drugs, make sure to inform the dentist.dentist.

If in doubt, ask.If in doubt, ask. Any questions ? Any questions ?