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Learn about the science and development of drugs, including their recognition, definitions, and dispensing. Explore terminology of prescriptions, guidelines for telephone orders, and the administration and routes of drugs. Understand the Controlled Substances Act, anesthesia and pain control, and injection techniques in dentistry.
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Chapter 30 Principles of Pharmacology
Pharmacology • The science or branch of medicine that conducts research and development in the use and effects of drugs
Drug • A substance used in the prevention, diagnosis, or treatment of a disease. • All drugs must be recognized and defined by the US Food, Drug and Cosmetic Act before they can be marketed to the public in the US
A drug is identified by three names • Chemical name: which is the chemical formula of a drug • Generic name: which may be used by any company; acetaminophen is an example of a generic name • Brand name, or trade name: which is controlled by business firm as a registered trademark; such as Tylenol is brand name for acetaminophen
Dispensing • Patent medicines: drugs that can be obtained without a prescription; also known as over-the-counter drugs • Ethical drugs: Prescription drugs (from a physician or dentist), supplied to patients only by a pharmacist.
Prescriptions • A written order by a physician or dentist for preparation and administration of a medicine • Persons legally authorized to prescribe medications are issued a Federal Drug Enforcement Agency (DEA) identification number. • Dental assistants cannot prescribe medications
Terminology of Prescriptions • Superscription: patient name, address, the date and symbol Rx • Inscription: name and quantity of the drug • Subscription: directions for mixing the medication • Signature: instructions for the patient on how to take the medication, when and how much
Telephone Guidelines • Narcotics cannot be ordered without a written prescription • It is illegal for a Dental assistant to “call in” a prescription • Notify the dentist if the Pharmacist calls the office • Never attempt to evaluate a patient’s reaction to a drug.
Mosby’s Drug Consult • Annual source of information supplied by drug companies • It is a bound text, as well as a electronic source
Drugs • Local-acting drug • Affects only the specific area of the body to which it is applied, such as a topical ointment • Systemic drug • Taken internally • Can affect the whole body by way of circulatory system
Administration • Four stages • Absorption • Absorbed from site of entry—speed varies, slowest is orally • Distribution • Enters bloodstream, attaches to proteins within blood, and circulates throughout the body • Metabolism • Compound is released, and drug becomes metabolized and is then excreted through liver or kidneys • Excretion • Drug leaves the body by way of kidneys, liver, breast milk or sweat
Routes • Oral—tablets, liquid • Topical—apply on surface of mucosa • Transdermal –patch that continuously releases medication • Inhalation—breathing in substance • Sublingual—medication placed under the tongue
Controlled Substances Act • Drugs that are covered under the Federal Comprehensive Drug Abuse Prevention and Control Act are divided into five schedules
Schedules • Schedule I • No current accepted medical use/high potential for abuse • Schedule II • High potential for abuse, some medical usefulness • Schedule III • Less abuse potential than Schedule I and II, and has accepted medical usefulnes • Schedule IV • Low abuse potential and have accepted medical usefulness • Schedule V • Lowest abuse potential and accepted medical usefulness/no prescription needed
Chapter 37 • Anesthesia and Pain Control
Topical Anesthesia • Provides numbing effect in an area where in injection is to take place • Ointments, liquids, sprays or patches
Local Anesthesia • Most frequently used form of pain control in dentistry • Obtained by injecting an anesthetic solution near a nerve where treatment is to take place • Each local anesthetic cartridge contains • Local anesthetic drug • Sodium choloride • Distilled water
Uses of Vasoconstrictors • Slows down the intake of an anesthetic agent and increases the duration of action • Prolongs the effect of the anesthetic agent by decreasing the blood flow in immediate area of the injection • Decreases bleeding in the injected area
Contraindications to Vasoconstrictors • May cause strain on the heart • Not recommended for patients with a history of: • Angina • Chest pain (heart related) • Recent myocardial infarction • Coronary artery bypass surgery • Untreated or severe hypertension • Congestive heart failure
Duration of Anesthetics • Know the duration (in minutes) of each of the following • Short-acting local anesthetic • Intermediate-acting local anesthetic • Long-acting local anesthetic
Injection Techniques • Infiltration Anesthesia • Usually used for Maxillary arch • Also used for secondary injection to block gingival tissues surrounding mandibular teeth • Block Anesthesia • Usually used for mandibular arch • Block nerves for the quadrant
Syringe • Know the parts of the syringe and their functions
Cartridges/Disposable Needle • Know the color-coding system • Know the parts of the cartridge • Know the parts of the needle • Know the size of the needle for dentistry • Lumen—the hollow center of the needle-how the anesthetic flows through needle • The larger the gauge number—thinner the needle • The smaller the gauge number—thicker the needle
Complications and Precautions • Know in detail • Injection into a blood vessel • Infected areas • Toxic reactions • Systemic reactions • Temporary numbness • paresthesia
Inhalation sedation • Know the chemical make-up • Advantages of Nitrous Oxide Use • Contraindications of Nitrous Oxide Use • Equipment
Intravenous sedation • Understand the uses of IV sedation • General Anesthesia • Know definition • Know in detail the four stages of anesthesia