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Patients Can Be Such “Pills”

Patients Can Be Such “Pills”. Dan Lindenmeyer, RPh Pharmacy Mgr. - Dillons. Top 100 Drugs. 6 main categories Hypertension Antidepressants Pain meds Cholesterol Reducers Antibiotics Antacids-Acid Reducers. Name Brand vs Generic.

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Patients Can Be Such “Pills”

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  1. Patients Can Be Such “Pills” Dan Lindenmeyer, RPh Pharmacy Mgr. - Dillons

  2. Top 100 Drugs • 6 main categories • Hypertension • Antidepressants • Pain meds • Cholesterol Reducers • Antibiotics • Antacids-Acid Reducers

  3. Name Brand vs Generic • Company has exclusive rights to market drug for 17 years after a patent has been approved • Most of the time patents are obtained while trials are being run • By the time drug hits the market only 8 to 10 years are left on patent • AB rated generics must be therapeutically equal • The med must dissolve in the body at the same rate and produce equivalent levels

  4. Groups of Medications • Cardiology • Hypertension • Cholesterol reducers • Antibiotics • Diabetes • Weight Loss • Depression and Alzheimer’s • Acid Reducers-antacids • Herbal Supplements

  5. Pain Meds • Strong Narcotics • Percocet, Oxycontin, Percodan, Demerol • Mid-Level Narcotics • Lortab, Lorcet • Non-Narcotic Controlled • Darvocet

  6. Anti-inflammatory • NSAIDS • Ibuprofen, naproxen, diclofenac, etodolac, indomethacin, tramadol • COX-II Inhibitors • Celebrex • Mobic

  7. Cardiology- How it works • Anti-arrhythmics • Calcium Channel Blockers • Ace Inhibitors • Angiotensin receptor blockers • Beta blockers • Diuretics

  8. Common Heart Meds: Lanoxin---Antiarrhythmic Pacerone—Antiarrhythmic Mexilitine—Antiarrhythmic Nitroglycerin—angina agent

  9. High Blood Pressure • Pressure on arterial walls • Blood pressure meds work by blocking receptors in arterial wall and relaxing the artery • Diuretics remove fluids to decrease fluid volume of the body to lower blood pressure.

  10. Common HBP Meds: • Beta blockers • Atenolol, metoprolol, propranolol • ACE Inhibitors • Lisinopril, enalapril, benazapril • Calcium channel blockers • Amlodipine, diltiazem • Angiotensin receptor blockers • Cozaar, Hyzaar, Micardis • Diuretics • Furosemide, triamterene/HCTZ, hydrochlorothiazide

  11. Why we should or should not D/C blood thinners before most dental procedures…. • Previously d/c blood thinners 10 days before dental extraction or scaling and root planing • Rebound effect after antiplatelet interruption can result in stroke or MI • Minor surgical procedures can be carried out safely without altering antiplatelet therapy • Simple extractions <3 teeth • Additional visits for more than 3 teeth • Gingival surgery • Crowns and bridges • Scaling and surgical removal of teeth

  12. Antibiotics • Beta lactam antibiotics • Penicillins • Cephalosporins • Macrolide • Erythromycins • Zithromax • Quinolones • Levaquin • Ciprofloxacin • Sulfonamides • Tetracyclines

  13. Cholesterol Meds • Statins • No Generics • Lipitor • Zetia • Tricor • Vytorin(combo of Zetia and Simvastatin) • Generics • Mevacor-Lovastatin • Zocor-Simvastatin • Pravachol-Pravastatin • Niacin

  14. Diabetes • Injectable Insulins • Humalog--Novolog • Lantus • Humulin—N,R,U,70/30 • Increase Insulins effect • Alcohol, anabolic steroids, beta blockers, MAO inhibitors, tetracyclines, salicylates • Decrease Insulins effect • Oral contrceptives, corticosteroids, niacin, smoking, thiazide diuretics, thyroid hormones

  15. Oral Diabetic Meds • Metformin • Glyburide and glipizide • Glimepiride • Avandia • Actos

  16. Weight loss • Phentermine • Xenical---Alli • Natural Supplements

  17. Depression • How it works: Chemical in brain called serotonin is at higher cellular levels • Most antidepressants block re-uptake of serotonin to produce their effects • Very common condition

  18. Antidepressants • Tricyclic • Amitriptyline, nortryptyline, imipramine • Tetracyclic • Remeron • SSRI • Prozac, Zoloft, Lexapro, Celexa • SSRI & Norepinephrine • Effexor and Cymbalta • MAO-Inhibitors • Parnate, Nardil

  19. Acid Reducers • H2 antagonists • Zantac • Tagamet Available OTC and Rx • Axid • PPI’s • Prevacid • Protonix • Aciphex • Nexium • Prilosec –only one available as an OTC

  20. Alzheimer Meds • Namenda • Aricept

  21. Allergy Meds • Non-Sedating • Zyrtec • Allegra • Clarinex • Claritin—OTC • OTC • Benadryl • Chlorpheniramine • Clemastine

  22. Natural Therapeutics • Not regulated by FDA • No proof of effectiveness • Take at own risk • Products have been proven safe at recommended doses • Very popular alternative to getting prescriptions

  23. Questions? • Resources: • Drug information handbook for dentistry-7th Edition • Clinical pharmacology

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