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Pharmacology Soup
for the
Dental Hygiene Soul
Paragon Hygiene Academy
November 14 & 15 2013
Ted A. Beitelschees, DDS
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Pharmacology Soup for the
Dental Hygiene Soul
Goals Consider some clinically significant adverse rxns
to the Top 50 drugs Discuss some pharm “wrinkles” to selected dental
drugs Look at some emerging trends in perio/oral health
care and how they relate to pharmacology Give you tools for next week!
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Pharmacology Soup for the Dental Hygiene Soul
Review the Top 50
DrugsHydrocodone/APAP MetFORMIN Gabapentin Warfarin Aoxicillin & Clavulanate
Potassium
Lisinopril Lipitor Ibprofen ClonazePAM Ciprofloxacin
Simvastatin Furosemide (Oral) NexIUM Lexapro Pravastatin
Levothyroxine Metoprolol PredniSONE (oral) Fluticasone TraZODone
Amoxicillin Atenolol TraMADol Cyclobenzaprine ProAir HFA
AmLODIPine Sertraline Plavix Cephalexin Lovastatin
Azithromycin Metoprolol XL Singulair Sulfamethoxazike &
Trimethoprim
Hydrochlorothiaszide and Triamterene
ALPRAZolam Zolpidem Lisinopril & Hydricholrothiazide
Crestor Carvedilol
Hydrochlorothiazide Oxycodone and APAP FLUoxetine Fexofenadine Advair Diskus
Omeprazole Citalopram LORazepam Synthroid Alendronate
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Top 50 Drugs Breakdown
10 Cardiac Drugs
5 Statins
4 Pain Control
5 Antibiotics
5 Respiratory Drugs
5 Sedative/Hyp
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Top 50 Drug Review - adverse reactions
Xerostomia
Orthostatic Hypotension
Polypharmia
Gingival Enlargement (Hyperplasia)
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Xerostomia
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Selected alcohol-free products Biotene
Oxyfresh products
Listerine Zero & Total Care
Zero
Butler GUM chlorhexidine
gluconate 0.12% rinse
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Flouride Treatment – varnish, rinse, gel,
toothpaste, tray Restorative materials – bonding agents,
composites, glass ionomer cements
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Sodium Laurel Sulfate (SLS)–free toothpastes
Arm & Hammer Advance White for SensitiveTeeth
Burt's Bees Natural Toothpaste
Biotene Sensitive
Sensodyne - Original, Iso-Active, ProNamel, Extra
Whitening, Cool Gel, Fresh Impact, Tartar Control plus
Whitening, Fresh Mint
Tom's of Maine Peppermint SLS-free Anticavity Plus
Whitening Clean and Gentle
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Orthostatic Hypotension
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Polypharmia
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Drugs that can cause Ginvigal Enlargement (Hyperplasia)
phenytoin (Dilantin) nifedipine (Procardia, Adalat) diltiazem (Cardizem) verapimil (Calan) amlodipine (Norvasc)
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Pharm wrinkles with dental drugs
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Local Anesthetics
Tricks with CVD Patients– Use 1:200,000 epi LA– Mix plain LA with LA & vaso
Still must watch total dosage!
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Local Anesthetics
Infiltration of mandibular molars with
4% articane (Septocaine) w/ 1:100,000
or 1:200,000 epi75% success on 1st molars
50% success on 2nd molars
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Refractory Perio Aces
Metronidazole (Flagyl)
Great against anaerobes
Gets into GCF
Watch alcohol
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Refractory Perio Aces
Doxycycline hyclate (Vibramycin)
Dosed once daily
4x concentration in GCF !
Watch sun worshippers
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How serious is the disease?(Not all bears are the same!)
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First-Line Antihypertensives
hydrochlorothiazide (HCTZ, Diazide)metaprolol (Tenormin)ACE Inhibitors
captopril (Capoten) and enalpril (Vasotec)
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Trouble on the HTN front
reserpine (Serpasil)guanethidine (Ismelin)
Other centrally acting (CNS) drugsMultiple drugs
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Future Trends
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Future Trends
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Future TrendsOld Dogs, New Tricks
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Reducing Vascular Inflammation
Statins– e.g. rosuvastatin (Crestor)
ACE inhibitors– e.g. ramipril (Altace)
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Future Trends
Perio Therapy will be considered
Preventive Care
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Pharmacology Soup for the
Dental Hygiene Soul
Thank You !
Ted Beitelschees, DDS
419.578.4100
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Pharmacology Soup for the
Dental Hygiene Soul
Questions ?