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Pharmacology Soup for the Dental Hygiene Soul

Pharmacology Soup for the Dental Hygiene Soul. Paragon Hygiene Academy November 14 & 15 2013 Ted A. Beitelschees, DDS. Pharmacology Soup for the Dental Hygiene Soul. Goals Consider some clinically significant adverse rxns to the Top 50 drugs

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Pharmacology Soup for the Dental Hygiene Soul

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  1. Pharmacology Soup for the Dental Hygiene Soul Paragon Hygiene Academy November 14 & 15 2013 Ted A. Beitelschees, DDS

  2. 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!

  3. Pharmacology Soup for the Dental Hygiene Soul Review the Top 50 Drugs

  4. Top 50 Drugs Breakdown • 10 Cardiac Drugs • 5 Statins 4 Pain Control 5 Antibiotics 5 Respiratory Drugs 5 Sedative/Hyp

  5. Top 50 Drug Review - adverse reactions Xerostomia Orthostatic Hypotension Polypharmia Gingival Enlargement (Hyperplasia)

  6. Xerostomia

  7. Selected alcohol-free products • Biotene • Oxyfresh products • Listerine Zero & Total Care Zero • Butler GUM chlorhexidine gluconate 0.12% rinse

  8. Flouride • Treatment – varnish, rinse, gel, toothpaste, tray • Restorative materials – bonding agents, composites, glass ionomer cements

  9. 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

  10. Orthostatic Hypotension

  11. Polypharmia

  12. Drugs that can cause Ginvigal Enlargement (Hyperplasia) • phenytoin (Dilantin) • nifedipine (Procardia, Adalat) • diltiazem (Cardizem) • verapimil (Calan) • amlodipine (Norvasc)

  13. Pharm wrinkles with dental drugs

  14. Local Anesthetics Tricks with CVD Patients • Use 1:200,000 epi LA • Mix plain LA with LA & vaso • Still must watch total dosage!

  15. Local Anesthetics Infiltration of mandibular molars with 4% articane (Septocaine) w/ 1:100,000 or 1:200,000 epi • 75% success on 1st molars • 50% success on 2nd molars

  16. Refractory Perio Aces Metronidazole (Flagyl) • Great against anaerobes • Gets into GCF • Watch alcohol

  17. Refractory Perio Aces Doxycycline hyclate (Vibramycin) • Dosed once daily • 4x concentration in GCF ! • Watch sun worshippers

  18. How serious is the disease?(Not all bears are the same!)

  19. First-Line Antihypertensives hydrochlorothiazide (HCTZ, Diazide) metaprolol (Tenormin) ACE Inhibitors • captopril (Capoten) and enalpril (Vasotec)

  20. Trouble on the HTN front reserpine (Serpasil) guanethidine (Ismelin) Other centrally acting (CNS) drugs Multiple drugs

  21. Future Trends

  22. Future Trends

  23. Future TrendsOld Dogs, New Tricks

  24. Reducing Vascular Inflammation • Statins • e.g. rosuvastatin (Crestor) • ACE inhibitors • e.g. ramipril (Altace)

  25. Future Trends Perio Therapy will be considered Preventive Care

  26. Pharmacology Soup for the Dental Hygiene Soul Thank You ! Ted Beitelschees, DDS drted@WestgateFamilyDental.com 419.578.4100

  27. Pharmacology Soup for the Dental Hygiene Soul Questions ?

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