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Agenda-Slide
1 2 3 4 5 Back to Basics Prescription writing Therapeutics (Analgesics) Therapeutics (Antibiotics) Q&A
Agenda-Slide
1 2 3 4 5 Back to Basics Prescription writing Therapeutics (Analgesics) Therapeutics (Antibiotics) Q&A
Pharmacology Basics
Indication Contra-indication Text Dose
Denition
Pharmacology Basics
Effect
Text Side
effects
Toxic effects Effects that are an exaggeration of the effect that produces the therapeutic response
Denition
Effects that are not desired and that occur with normal dose
Medication names
Chemical names
Generic names
Trade name
Ofcial name
Parenteral route
Topical
Intradermal
Intranasal
Subcutaneous (SC)
Intramuscular (IM)
Intravenous (IV)
Endotracheal (ET)
Sublingual injection
Intracardiac (IC)
Intraosseous
Inhalational
Umbilical
Vaginal
Pulpal
y Im Ver fo! In
ant ort p
No single method of drug administration is ideal for all drugs in all circumstances
Agenda-Slide
1 2 3 4 5 Back to Basics Prescription writing Therapeutics (Analgesics) Therapeutics (Antibiotics) Q&A
Agenda-Slide
1 2 3 4 5 Back to Basics Prescription writing Therapeutics (Analgesics Therapeutics (Antibiotics) Q&A
Prescription writing
Prescribing
The Dentist is legally responsible for the signed prescription
Prescription should be indelible, dated, with full name and address of the patient
Age of patient should be mentioned when under 12.
Use generic drugs when possible
Prescribing instructions
Don`t use abbreviations for the drug names. Define the quantity supplied Directions should be in English with no use of the abbreviations
Prescribing instructions
When writing the dose Quantities of one gram is wrriten (1 g) Less than 1 g is written in milligrams (500 mg) Less than l mg should be written in microgram 100 microgram (not 0.1 mg) Nanogram and microgram should not be abbreviated
Latin Abbreviations
Latin Abbreviations
# po (per os)
Latin Abbreviations
# q 3 h (quaque 3 hora)
# qd (quaque die)
Clarks Rule
Clark's Rule
Divide the childs weight (in pounds) by 150 to get the approximate fraction of the adult dose to give to the child.
Example: For a 50 pound child give 50/150 (or 1/3) of the adult dose. Therefore, if the adult dose is 30 drops taken 3 times per day, the childs dose will be 10 drops taken 3 times per day
(not 30 drops taken 1 time per day).
Agenda-Slide
1 2 3 4 5 Back to Basics Prescription writing Therapeutics (Analgesics Therapeutics (Antibiotics) Q&A
Agenda-Slide
1 2 3 4 5 Back to Basics Prescription writing Therapeutics (Analgesics) Therapeutics (Antibiotics) Q&A
Yes or No
The Dentist is the best judge of pain.
A person with pain will always have obvious signs such as moaning, abnormal vital signs, or not eating.
Addiction is common when opioid medications are prescribed.
Morphine and other strong pain relievers should be reserved for the late stages of dying.
Morphine and other opioids can easily cause lethal respiratory depression.
Pain medication should be given only after the resident develops pain. No
No
No
No
No
No
Ceiling Effect
100
75
50
25
Analgesics
Paracetamol
NSAIDS Opioids
Paracetamol
Indication Contraindication Dose
COX ?
Ibuprofen, ketorolac, diclofenac,
aspirin
COX 1 COX 2
Opioids
Action Efcacy Text Side effects
Analgesic Analgesic
Analgesic
Paracetamol Combinations
Paracetamol Paracetamol/Codeine Paracetamol / Oxycodone
or Hydrocodone More effective
Rapid and long acting pain relief than did Tramadol or Paracetamol alone Paracetamol/ Tramadol
Mild Pain Short acting (2 hours) Mild to severe pain 30 min to 5 hours
Agenda-Slide
1 2 3 4 5 Back to Basics Prescription writing Therapeutics (Analgesics) Therapeutics (Antibiotics) Q&A
Agenda-Slide
1 2 3 4 5 Back to Basics Prescription writing Therapeutics (Analgesics Therapeutics (Antibiotics) Q&A
Reminder
Broad Spectrum Narrow Spectrum Bacteriocidal Bacteriostatic Superinfection
Mechanism of Action:
1. Inhibition of Cell Wall Synthesis
2. Disruption of Cell Membrane
3. Inhibition of Protein Synthesis
4. Interference with Metabolic Processes
Infective endocarditis ; Cerebrospinal rhinorrhoea; Compound facial or skull fractures; Major oral and maxillofacial surgery (e.g. osteotomies or tumour resection); Surgery in immunocompromised or debilitated patients, or followi radiotherapy to the jaws.
Oral
Parenteral
Only when:
no oral preparation is available
Main point
Should usually be avoided, as they may cause the emergence of resistant strains.
Metronidazole
Clindamycin
Tetracycline
Conclusion
Odontogenic infections are typically polymicrobial.
Anaerobes are implicated in many periimplantitis infections, and these often respond to penicillins or metronidazole
Metronidazole is a good alternative.
Erythromycin in another alternative (short courses)
In severe cases: Tetracycline, or
Clindamycin in limited cases.
Agenda-Slide
1 2 3 4 5 Back to Basics Prescription writing Therapeutics (Analgesics Therapeutics (Antibiotics) Q&A
Agenda-Slide
1 2 3 4 5 Back to Basics Prescription writing Therapeutics (Analgesics) Therapeutics (Antibiotics) Q&A
Questions
Thank you.
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