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Drugs & Dentistry IDrugs & Dentistry IDrugs commonly prescribed by the dentistDrugs commonly prescribed by the dentist
11. Antimicrobial Drugs. Antimicrobial Drugsa. a. AntibioticsAntibiotics
Drug Indications Forms Usual dose Trade &price Comments
Amoxicillin
-Routine drug of choice in
infection.
-Prophylaxis regimen for
subacute bacterial
endocarditis
Cap. 250-500 mg
Sus. 125 mg/5ml
250 mg/5ml
Adult:
250-500 mg
q8h
Child:
20 mg/kg/day
in divided
doses
-Amoxil 250 mg = 27 SR500 mg = 53 SR
-Ultramox500 mg = 25 SR
-Amoxidar 250 mg = 7 SR
500 mg = 13 SR
- 3% of population are
allergic to the drug
Co-Amoxiclav.
“amoxicillin
with
clavulanic acid”
-Infections caused by beta-
lactamase producing
strains.
-Sever dental infections
with spreading cellulites.
Tab. 375-625 mg
1g
Sus. 156 mg/5ml
228 mg/5ml
457 mg/5ml
Adult:
375-625 mg
q8h
OR
1 g q12h
-Augmentin375 mg = 48 SR625 mg = 81 SR156 mg = 22 SR
-Amoclan 375 mg =34 SR-Amoclan forte 625mg = 44 SR -Megamox 375mg =36 SR 625mg =43 SR 1g =75 SR-Klavox 375mg = 44 SR 625 mg =76 SR-Julmentin 375 mg = 40 SR-Julmentin Forte 625 mg = 68 SR
Children 40kg
20-40 mg/kg/day
amoxicillin with 5-10mg
calvulanic acid in three
divided doses.
Erythromycin
-Routine second choice
to amoxicillin in infection or
first choice if amoxicillin is
allergic .
Tab. 250-500 mg
Sus. 200 mg/5ml
250-500 mg
q6h
200 mg/5ml
q6h
-Erythrocin
250mg = 14 SR
500mg = 27 SR
Sus. = 19 SR
-Eromycin
-50% of s.auruse is
resistant
-GI intolerance is
common
Tab. for tablet Sus. for suspension Cap. for capsule q8h = every 8 hours Syr. for syrup Inj for injection
Drug Indications Forms Usual dose Trade &price Comment
Clarithromycin
-Mild to moderate
infection.
-Prophylaxis regimen for
subacute bacterial endo-
carditis for pt. allergic to
amoxicillin.
Tab. 250-500 mg
Sus. 125 mg/ 5ml
250 mg/100ml
250-500 mg
bid-Klacid
Some pt. is allergic to the
drug.
-Caution when prescribed for
pregnant or lactating women,
hepatic, renal pt.
-It increases effects of
cyclosporine, warfarinn &
decreases the effects of
clindamycin, penicillin
&anticholingergic drugs.
Azithromycin
-Mild to moderate
infection.
-Prophylaxis regimen for
subacute bacterial endo-
carditis for pt. allergic to
amoxicillin.
Cap. 250 mg
500 mg qid
on day1, then
250 mg qid
on days 2-5
-Zithromax
-Contraindicated if the pt. is
hypersensitive to the drug or
to erythromycin.
-Caution when prescribed for
pregnant or lactating women,
hepatic, renal & cardiac pt. or
with elderly & child < 16 y.
-It decrease the effects of
clindamycin & penicillin
-Pt. instructed to take
medication at least an hour
before meal or 2 hours after
the meal.
Tetracycline
-Second or third choice to
amoxicillin in routine inf.
-Anaerobic bacterial
infections & periodontitis
associated with presence
of AA (Actinobacillus
actino-mycetemcomitans).
-ANUG
Tab. 250-500 mg
Sus. 125 mg/5ml
250-500 mg q6h
, 1 hour before
or 2 hours after
meals
-Tetracycline
250 mg = 13 SR
-Used in bone graft.-Cause teeth discolora- tion, so it is not used in child 8y & in pregnant women.
Doxycycline
-Periodontitis associated
with presence of AA
(Actinobacillus actino-
mycetemcomitans).
-ANUG
-Syphilis
Tab. 100 mg
Cap. 100 mg
100 mg q12h -Doxydar-Vibramycin 100 mg=26 SR
-Some patients are hypersensitive to the drug.-It cause candidiasis,teeth & tongue discoloration & dry mouth.-It is not prescribed for child 8y &for pregnant women.
Drug Indications Forms Usual dose Trade &price Comment
Clindamycin
Alternative to amoxicillin
in prophylaxis regimen
for subacute bacterial
endocarditis if amoxicillin
is allergic.
-Chronic osteomyelitis.
Tab. 150-300 mg
Inj. 300-600
900 mg
Adult
150-450 mg q6h
Child
8 -25 mg/kg
in 3-4 divided
doses.
-Dalacin-C
150 mg=21 SR
300 mg=37 SR
Cramps & diarrhea in 20%
of patients after oral
administration.
-Contraindicated if pt. is
hypersensitive to the drug
or had developed pseudo-
membranous colitis.
Metronidazole
-Protozoal & anaerobic
bacterial infections.
-Refractory adult
peridontits.
Combined with penicillin
in serious Odontogenic
infection, especially in
compromised patients.
Tab. 250-500 mg 250-500 mg q8h
-Flagyl250 mg =13SR500 mg =15SR
-Nidazol-Elyzol-Flazol
-Caution when the pt.
complain of neutropenia,
hepatic disease, active
CNS disease, or if the pt.
on warfarin .
-Contraindicated if pt. is
hypersensitive to the drug
or in the first trimester.
Cephalexin
Alternative to amoxicillin
in the tretment of
orofacial infections &in
the prevention of SAB
endocarditis except if the
pt. had an immediate
anaphylactic allergic
reaction to amoxicillin.
Cap. 250-500 mg
Syr. 125 mg/5ml
Adult:
250-500 mg
q6h
Child:
6.5-50 mg/kg/
day in 4 doses
-Keflex
250mg = 29 SR
500mg = 42 SR
-Cefrin
10-15% cross reaction
sensitivity in pt. allergic
to penicillin
Cefuroxime
Skin, soft tissue & bone
infections.
Tab. 125-250 mg
Sus. 125 mg/5ml
250 mg/5ml
Adult:
1-2tab q12h
Child:
125mg q12h
-Zinnat
250 mg =87 SR
500 mg =95 SR
10-15% cross reaction
sensitivity in pt. allergic
to penicillin
1. The Antibiotics may decrease the activity of oral contraceptive. So the pt. should be instructed to use additional method of contraception during the antibiotic course.
2. If the infection not improved within 3days, change the drug and do sensitivity test.3. Recommended antibiotics during pregnancy : Penicillin & Cephalosporine.4. Recommended antibiotics for lactating mother : Cephalosporine & Erythromycin.
Drug Indications Forms Usual dose Trade &price Comment
-Viral infections of: -Herpes zoster. -Herpes simplex.
Tab. 400- 800 mgCap. 200 mgCream 2 g
Herpes zoter:800 mg q4h for 7-10daysChickenpox:
-Zovirax 200 mg=149SR400 mg=697SRCream =23 SR
-It is contraindicated in patients with known hypersensitivity to the drug.
Acyclovir -Chickenpox.-Prevention of recurrence of the viral infections.
20 mg/kg qid for 5 days
-Clovir -It should be used with caution in-patient with renal impairment.-It used in the tengling stage in the management of HSV before development of the lesion “vesicles “-It could cause glossitis.-Postpone dental treatment when oral herpetic lesions are present.
b. Antifungal
Drug Indications Forms Usual dose Trade &price Comment
Miconazole
Treatment of candidal infections
Tab. 250 mg Oral gel. 25 mg/ml
Adult 600-1800 mg in 3 divided doses daily for 3-20 weeks Children 1 y 20-45mg/kg/day in 3 divided doses.
Daktarin Oral gel =17 SR
Oral gelApply twice / day up to 1 month.
Ketoconazol
-Systemic & cutaneous fungal infections.
Tab. 200 mg Adult:200-400 mgqid Children 2 y 3.5-6.6 mg/kg/ day in a single dose.
-Nizoral -Contraindicated in patients with previous hypersensitivity.-Used cautiously in patients with impaired hepatic & or adrenal reserve.
Nystatin
-Intestinal candidiasis.-Skin candidiasis.-Oral candidiasis
Suspention 100000 inter. unit " iu " for oral use.
Adult:Sus. 400000-600000 iu qid Children 3 months250000-500000 iu qidNewborn100000 iu qid
-Mycostatin -Nilstat -Nystan -Rianest -Mikostat
Contraindicated with pt. has known hypersensitivity.-Oral use can cause nausea, vomiting and diarrhea.- To prevent reinoculation of candidal infection pt. is instructed to dispose the tooth brush or other contaminated oral hygiene devices used during period of infection
c. Antiviral
2. Analgesics
Drug Indications Forms Usual dose Trade &price Comment
Acetaminophen
-Mild to moderate pain & fever
Tab. 325-500 mg
Syrup 120 mg/5ml 125 mg/5ml
Adult 0.5-l g every 4-6 hours tomax.4gm dailyChildren : 1 year: 60-120mg1-5y 120-150mg 6-12y 250-500mg
-Adol-Panadol-Tylenol-Fevadol-Dafalgan -Panacetamol syrup-Tempra
-Caution with hepatic disease pt.-Contraindicated if the pt. is hypersensitive to acetaminophen or complain of Glucose 6-Phosphate Dehydrogenase Deficiency.
Ibuprofen
-Pain-Fever -Inflammatory diseases -Rheumatoid disorders-Gout
Tab. 200-400 600 mg
Syrup 100 mg/5ml
400 mg every4-6 hours formild-moderat pain
-Brufen400mg=12 SR600mg=20 SR
-Ibofen-Profinal 600 mg=13 SR -Sapofen 400 mg=10 SR 600 mg=10 SR
It is contraindicated in:-Hypersensitivity-Nasal polyp-Angio-edema-Bronchospastic reactivity to aspirin or other NSAID’s.-Caution if the pt. on anticoagulant.-Taken after food
Mefenamic acid-Mild to moderate pain
Tab. 500 mgCap. 250 mgSyrup 50 mg/5ml
Adult:500mg initiallythen 250 mg every 6 hours with food children 6 months :25 mg/kg dailyin divided doses
-Ponstan 500 mg=13 SR-Fendol 500 mg= 7 SR-Mafepain 500 mg= 9 SR
-Avoid prescribing for dental pain in last trimester of pregnancy. -Caution if the pt. on anticoagulant.
Diclofenac Sodium
-Mild to moderate pain -Pain of rhematoid arthritis & osteoarthri- tis. -Gout & Ankylosing spondylitis
Tab. 25-50-100 mgInj. 75 mg/ampoule
150-200mg/ day in 2-4 divided doses.
-Voltaren 50 mg =38 SR-Olfen 50 mg =21 SR-Rofinac 50 mg = 32 SR-Diclogesic 50 mg = 17 SR-Vortex 50 mg =10 SR-Colfen 50 mg = 9 SR
-It can cause dry mouth & stomatitis.-Avoid prescribing for dental pain in last trimester of pregnancy.
Paracetamol 500 mg with Caffeine 30 mg & Codeine
Mild to moderate pain
________
2 tab. Every 4 hours to max. 8 tab. daily.
-Solpadeine = 9 SR -Fevadol plus = 8 SR
-Do not give if the pt. has allergy to propyphenazone-Not recommended for pregnant, breast-feeding women & for children<12 years.
Paracetamol 250 mg
, caffeine 50 mg
&
propyphenazone 150 mg
-Treatment of
headache.
________
Adult: 1-2 tab
12-16y 1 tab.
Up to 3 doses /
day-Saridon
= 5 SR ________
3. Miscellaneous
Drug Indications Forms Usual dose Trade &price Comment
Triamcinolone orabase
-Oral and perioral lesions -Aphthous ulcers.
Orabase: containstriacilmone 0.1% in adhesive basis
2-4 times daily Kenalog in Orabase =7 SR
-Use is limited for 5 daysfor children ,and short term for elderly.-Contraindicated in the presence of fungal, viral or bacterial infections.
Pyralvex-Treatment of oral ulcers.
10 ml with brush 3-4 times daily Norgine Not recommended for children under 12 years.
Lignocaine Hydrochloride
“lidocaine”
-Pain due to ulcers Jelly 2%Ointment 5%Spray 80 g
When needed Xylocaine 5% 35 g=11 SRSpray 80g =29 SR
_____________
Sodium fluoride
Prevention of dental caries & decrease teeth hypersensitivity
Tab. 1 mg -Zymafluor 1mg = 18 SR
-Adults should be expectorate after use & not to eat, drink or rinse for 30 minutes.-Child ages 6-16y should be expectorate after use, rinse mouth thoroughly to avoid swallowing fluoride.-Must ascertain fluoride conc. In-patient’s drinking water before prescribing.
Baclofen
-Relief of muscle spasm.
Tab. 10-25 mg 5 mg tid×3 days then, 10 mg tid× 3days then, 15 mg tid×3 days then 20 mg tid× 3days then triturated to response, not to exceed 80 mg/day
Lioresal25 mg =121 SR
-Some pt. has hypersensitivity to the medicament.-It may cause dry mouth-The medicament has a sedative effect.
Chlorzoxazone
-Relief of muscle spasm.
Tab. 250-500 mg (DSC)
Adult 250-750 mg tid-qidChild 20 mg/kg/day in 3-4 divided doses.
Parafon 500 mg=19 SR
-Combination of the drug with aspirin or NSAIDs will improve the response.
4. Mouthwashes
Mouthwash Indications Forms Usual dose Trade &price Comment
Chlorhexidine Mouth wash
-Antibacterial mouth rinse-Denture stomatitis-Oral hygiene and plaque inhibition.
-Oral rinse 0.2% Swish 15ml undiluted oral rinse aroundin mouth for one minute, then expectorate2 times daily
Corsodyl=12 SR
- Contraindicated if pt. has hypersensitivity-Pt. instructed not to eat, drink or rinse mouth with water after use for several hours.-It my cause taste changes.-Do not swallow the medication.-Perform scaling before starting rinse.-It causes staining of teeth & esthetic restorations.
Hexetidine -Oral hygine Mouth wash or
gargle 0.1%15ml undiluted 2-3times daily
Oraldene = 7 SR ________
Povidone-lodine
Treatment &preventionof microbial infections
-Cleanser: skin7.5% “30 m1-118 ml”-Foam 7.5% 170 g
10ml undiluted for up 30 sec. up to 4 times daily
-Betadine =15 SR-Poviderim
-Do not swallow the medication -Avoid contact with eyes.-Contraindicated in pt. with hypersensitivity to iodine .-Cautions with pregnancy & breast feeding.
Orasept
Ingredients: Benzoic acid, Thymol, Menthol, Methyl salicylate & Eucalyptol
-Prevention & reduction of gingivitis. -General oral hygiene & bad breath.
-Mouthwash 250 mlSwish 15 ml undiluted oral rinse aroundin mouth for one minute, then expectorate2 times daily
Orasept 250ml =10 SR
________
Colgate - Plax Ingredients:
Triclosan 0.03 % Sodium fluoride
0.025%
-Fight plaque-Fight caries-Treatment of halitosis
250-500 ml15ml undiluted for one minute 2 times daily
-Classic /red-Soft mint / green 250 ml=14 SR 500 ml=22 SR
-Not recommended for child < 6 years.
Sensodyne
-Anti plaque-Relieves minor mouth irritation
250 ml15ml undiluted for 30 seconds2 times daily
250 ml=16 SR
-Not recommended for child<6 years.-Not recommended if the pt. sensitive to cytylpyridinium.-Used after brushing.
Pearl dropsSmokers 1+1
-Helps in the removal of tar.-Fight tobacco odor. -Fight plaque-Fight caries
400 ml 15ml undiluted
for 30 seconds2 times daily
400 ml=13 SR
-Not recommended for child < 6 years.
Oral-B Fight plaque & cavities 300 ml15ml undiluted for 30 seconds2 times daily
300 ml=16 SR-Not recommended for child < 6 years.
Drugs & Dentistry IIDrugs & Dentistry II
Most common drugs prescribed by the dentist:Most common drugs prescribed by the dentist:
Drug Forms Usual Dose Trade Names
Amoxicillin
Capsule 250-500 mg
Suspension 125 mg/5ml
250 mg/5ml
Adult:
250-500 mg q8h
Child:
20 mg/kg/day
in divided doses
-Amoxil
-Ultramox
-Amoxidar
Co-Amoxiclav.“Amoxicillin withClavulanic Acid"
Tablet 375-625 mg
1 g
Suspension 156 mg/5ml
228 mg/5ml
457 mg/5ml
Adult: 375-625 mg q8h
or 1 g q12h
Children 40kg
20-40 mg/kg/day amoxicillin
with 5-10 mg calvulanic acid
in three divided doses.
-Augmentin
-Amoclan
-Amoclan Forte
-Megamox
-Klavox
-Julmentin
Cephalexin
Capsule 250-500 mg
Syrup 125 mg/5ml
Adult: 250-500 mg q6h
Child: 6.5-50 mg/kg/day
in 4 doses
-Keflex
-Cefrin
Acetaminophen
Tablet 325-500 mg
Syrup 120 mg/5ml 125 mg/5ml
Adult: 0.5-l gm every 4-6 hours to max.4 gm daily
Child: 1 year 60-120 mg/day 1 -5 y 120-150 mg/day 6 -12 y 250-500 mg/day
-Adol-Panadol-Tylenol-Fevadol-Dafalgan -Panacetamol syrup-Tempra
Ibuprofen
Tablet 200 – 400 mg
& 600 mg
Syrup 100 mg/5ml
400 mg every 4-6 hours
for mild to moderate pain
-Brufen
-Ibofen
-Profinal
-Sapofen
Diclofenac
Sodium
Tablet 25-50-100 mg
Injection 75 mg/ampoule
150-200 mg/day
in 2-4 divided doses.
-Voltaren -Olfen
-Rofinac -Diclogesic
-Vortex -Colfen
5. The Antibiotics may decrease the activity of oral contraceptive pills, so the pt. should be instructed to use additional method of contraception during the antibiotic course.
6. If the infection not improved within 3days, change the drug and do sensitivity test.7. Recommended antibiotics during pregnancy: Penicillin & Cephalosporine.8. Recommended antibiotics for lactating mother : Cephalosporine & Erythromycin.
Drugs & Dentistry IIIDrugs & Dentistry IIICommon drugs purchased from pharmacies in city
Drugs listed here are the ones commonly purchased from pharmacies in Jeddah city. Trade names, indications and dental considerations, which related to the drug & the disease, are included in an informative and concise form. For more information you are advised to refer to the product information insert. (Antimicrobial, analgesics & mouthwashes are included in D & D I )
Cardiovascular System
Drug Trade Names Indications Considerations
Calcium channel blockersNifedipine -Adalat-Retard
-Adalat.-Cardiopine.
-Prophylaxis &treatment of angina.-Hypertention.-Raynaud’s disease.
-It cause gingival hyperplasia and dry mouth
Verapamil -Isoptin .-Calan.
-Atrial fibrillation & flutter.-Arrhythmias.-Angina &hypertension.-Congestive heart failure.-Tachycardia .
- It cause gingival enlargement, dry mouth (rare)&Stevens-Johnson syndrom
Digoxin
-Lanoxin Treatment of congestive heart
failure,atrial fibrillation & or
flutter and supra-ventricular
tachycardia.
- It could cause sensitive gag reflux.
Diuretiecs
Spironolactone-Aldactone.-Spiroctan.-Noractone.
-Primary aldosteronism. Hypertension, Hypokalaemia -Edema in liver cirrhosis.-Nephrotic syndrom.-Congestive heart failure.-Hirutism associated with polycystic ovary syndrom .-Menstrual irregularities.
-It may cause dry mouth & lichenoid drug reaction .
Centrally acting antihypertensive
Methyldopa -Aldomet
-Moderate to sever hypertent- ion.-Hypertensive crisis.-Toxemia of pregnancy.
- It could cause dry mouth, bleeding & lichenoid reaction.
ACE Inhibitors
Captopril-Capoten
-Mild to moderate essential hypertension.-Congestive heart failure.
-It causes adrenal suppression &candidal infection.-It could cause dry mouth, glossitis, oral ulceration , Stevens –Johnson syndrome,bleeding , lichenoid drug reaction .
Cardiovascular System
Drug Trade Names Indications Considerations
Antiarrhythmics
Amiodarone-Cordarone -Arrhythmia. - It may cause dry mouth.
Glyceryl Trinitrate
Nitroglycerin
NitrodermTTS10
-Angised
-Glyceryl
-Trinitrate
-Nitroderm
-Tridil
-Treatment and prophylaxis
of angina pectoris.
-CHF associated with acute
MI.
-It could cause dry mouth & burning
sensation.
-Ensure that patient’s drug is easily
available if angina occurs.
Drug Trade Names Indications Considerations
Antiplatelets Acetylsalicylic acid
-Asprin-Rivo-Aspav-Aspico
-Fever & minor pain-Rheumatic arthritis-Transient Ischemic Attack -MI risk reduction-Rheumatic fever
-Aspirin inhibits platelet aggregation.-Produce gastric ulcer in long term therapy -Exacerbates bronchoconstriction in asthmatic pt. -High doses should be avoided in pregnancy
Oral anticoagulants Warfarin Sodium
-Coumadin
-Prophylaxis of thrombo- embolism .-MI & bypass surgery.-Prophylaxis & treatment of venous thrombosis & pulmonary embolism.-Decrease risk of cerebral embolism &TIA.
-Try to avoid IM injection.-Ask for INR before any dental sugary.-Prothrombin Time should be not more than twice the normal value. -Vit. K is the antagonist of warfarin action ’10 mg will reverse the action in 24 hours ’
Respiratory System
Drug Trade Names Indications Considerations
Antihistamines. Promethazine
-Phenergan -Histaloc -Promantine
-Antihistaminic.-Motion sickness.-Sedative & hypnotic.-Antiemetic. -Hay fever.
- It could cause dry mouth.
Cough prep. Triprolidine &
Pseudoephedrine - Actified
-Temporary relife of nasal congestion.-Decongest sinus opening.-Running nose, sneezing.-Itching of nose or throat.-Hay fever or other upper respiratory allergies.-Watery eyes due to common cold.
- It cause dry mouth & lichenoid reaction
Dextromethorphan
-Kafosed.-Tusilar.-Contrasal.-Romilar.-Simatus.
- Dry or painful cough.-Non-productive cough.
Topical Nasal
Decongestants
Xylometazoline
Hydrochloride
-Otrivine
-Nasivin
-Xylometazoline
-Nasal congestion due to
seasonal allergic rhinitis.
-Chronic rhinitis and
rhinitis occurring with the
common cold & respiratory
tract infection.
Pseudoephedrine
Hydrochloride-Otrinol
-Nasal congestion.
Anti T.B.Ethambutol
-Myambutol-Ethanbutol
-Treatment of T.B. in the first 2 months
-Look for oral signs of T.B.-Avoid elective dental procedures in active infections.
Rifampicin
-Rimactan
-Rifadin
-Rimactazid
-T.B “intial treatment”.
-Eradicate nasal colonis-
ation in meningococcal
infections
-Look for oral signs of T.B.-Avoid elective dental procedures in active infections.
Isoniazid “INH”
-INH
-Rimifon
-Rimactazid “INH+
Rifampicin”
- Treatment and prevention
of T.B
-Look for oral signs of T.B.-Avoid elective dental procedures in active infections.
Respiratory System
Drug Trade Names Indications Considerations
Anti asthmatics
Aminophylline
-Euphylline
-Aminomal
-Phyllocontin
-Reversible airway
obstructions.
-Status asthmaticus & left
ventricular failure.
-It increases the action of erythromycin.
- Ensure that patient’s drug is easily
available if attach occurs.
Beclomethasone -Bectoide
-Viorex
Chronic airway obstructions
-It causes adrenal suppression &
candidal infection .
-It could cause dry mouth & hoarseness.
-Pt. Instructed to gargle and rinse with water
after each dose to help in preventing
candidiasis.
- Ensure that patient’s drug is easily
available if attach occurs.
Cromolyn Sodium -Intal
-Opticrom
-Prophylaxis of asthma &
allergic conditions.
-Chronic bronchitis.
-Emphysema.
-Asthmatic patients.
-Frequently it cause mouth dryness &
burning mouth senseation .
- Ensure that patient’s drug is easily
available if attach occurs.
Ketotifen Fumarate -Zaditen -Prophylaxis of asthma. - Ensure that patient’s drug is easily
available if attach occurs.
Salbutamol-Ventolin
-Butalin
-Bronchodilator for.
treatment of asthma.
-Reversible airway
obstruction.
-It may cause mouth & throat irritation.
- Ensure that patient’s drug is easily
available if attach occurs.
Theophylline -Quibron-T/SR
-Bronquim
-Bronchial asthma.
-Chronic obstructive
pulmonary disease.
- It could cause dry mouth.
- Ensure that patient’s drug is easily
available if attach occurs.
Central Nervous System
Drug Trade Names Indications Considerations
Antiparkinsons
Levodopa -Carbidopa -Sinemet -Used in parkinsonism - It cause dry mouth.
Antidepresents
Amitriptyline -Tryptizol
-Saroten
-Elavil
-Depression.
-Analgesic for certain chronic
& neuropathic pain.
-Migraine prophylaxis.
- It cause dry mouth, stomatitis & salivary
gland pain.
Clomipramine -Anafranil-Depressive illness-Phobic & obsessional states
- It cause dry mouth & bleeding.
Imipramine-Tofranil
-Imiprex
-Depressive illness
-Nocturnal enuresis in
children &school phobia.
-Sever symptoms of cocaine
withdrawal.
-It cause dry mouth & stomatitis
Antimigraine
Ergotamine
-Migril
-Cafergot
-Treatment of vascular
headache “migraine”,
-Cluster headache.
Sumatriptan
-Imigran -Treatment of migraine with
or without aura
- It may cause discomfort in jaw, mouth or
tongue.
Central Nervous System
Drug Trade Names Indications Considerations
Antiepileptics
Carbamazepine -Tegretol
-Tegretol Retard
-First line agent in treatment
of partial seizures.
-Trigeminal neuralgia.
-Diabetes insipidus.
-Pain syndrome.
-Schizophrenia.
-It may cause:
-Stevens –Jonson syndrom.
-SLE-like syndrom.
- Dry mouth & glossitis.
Phenytoin Sodium -Epanutin
-Dilantin
-Anticonvulsant
-Antiarrhythmic.
-Prevention of seizures
following head truma &
neurosurgery .
-It may cause:
-Gingival hyperplasia.
-Lupus erythematosus .
-Stevens –Jonson syndrom.
-Osteamalacia.
Ethosuximide -Zarontin
-Emeside
-Absence seizures.
- Side effects : gingival
bleeding ,ulceration , swelling of tongue
& gingival enlargement ( Rare) .
Sodium Valproate -Depakine
-Epilim
-Convulex
-Indicated when both absence
& generalized tonic-clonic
seizures are present.
-Alternative to primary
anticonvulsants in
generalized tonic –clonic
seizures.
Sedative-Hypnotic
Clonazepam-Rivotril
-Status epilepticus-May used as an antipanic agent.
-It cause dry mouth.-Ask about epilepsy type, seizure frequency & the onset of the last attack.
Gastro-intestinal System
Drug Trade Names Indications Considerations
H2 receptor antagonists
Ranitidine-Zantac -Tanidina -Antagonin
-Reduction of gastric aciditiy -Benign gastric &duodenal ulcers .-Reflux oesophagitis
-Long term therapy lead to vit. B12 deficiency.-Decrease absorption of diazepam & ketoconazole.
Cimetidine
-Cimedine -Tagamet
-Short term treatment of benign gastric& duodenal ulcers.-Prophylaxis of duodenal ulcer. Gastric hypersecretory states.-Gastro-esophageal reflux. -Prevention of upper GI bleeding in ill pt.
-Decrease absorption of ketoconazole & tetracycline.-Increase blood levels of metronidazol & lidocaine.
Antimuscarinic
Hyoscine N-
Butylbromid.
-Buscopan
-Scopinal
-Spasmopan
-Butacid
-Spasmonore
-Adjunct in gastro- intestinal
disorders characterized by
smooth muscle spasm.
-It cause dry mouth, thirst & difficulty in
swallowing.
Laxatives
Bisacodyl
-Dulcolax.
-Laxocodyle
-Constipation.
-Bowel evacuation befor: -
Surgery, endoscopy &
radiology.
Musculoskeletal and joint
Drug Trade Names Indications Considerations
Antigout
Allopurinol-Zyloric
-No-Uric
-Prevention of attack of gout
-Arthritis &nephropathy
-Prevent calcium oxalate
calculi.
-Treatment of hyperuricemia
which may occure during
treatment of tumers or
leukemia.
-It could cause stomatitis, lichenoid
reaction & salivary gland swelling.
-Main clinical feature is arthritis that
could affect TMJ.
Nutrients, Vitamins & Blood modifiers
Drug Trade Names Indications Considerations
Nutrients& VitaminsFolic Acid
Vit. B9-Folicum-Folvite
-Megalobastic anemiadue to folic acid deficiency.-Chronic alcoholism.-Pregnancy &lactation.-Sprue & ileal diseases.-Nutritional deficiency& haemolytic aneamia.
-Glossitis or atrophy of the tongue and angular cheilitis may be a symptom of folic acid deficiency.
Ascorbic acid Vit. C
Vitamin-c chew- able-Upsa-c-Calcefor
-Prevention & treatment of scurvy.-Urinary acidification.-Prevention & decreasing of cold
- Incidence of erosion & caries has been reported with excessive use of chewable ascorbic acid tablets.
B-complex vitamins B1,B6,B12
-Becozym -B-complex plus vitamin- cused in conditions characterized by depletation or increase demand of the water –soluble vitamins.
Blood Modifiers
Ferrous Fumarate
- Fersamal .
- Galfer .
-Prevention and treatment of
iron deficiency anemias
-Absorption of tetracyclines &
penicillamine may decrease if given
together with this drug.
-Oral manifestation of iron deficiency:
- Atrophic glossitis.
- Angular cheilitis &some times
aphthous ulceration.
Ferrous Sulphate -Prevention & treatment of
iron deficiency anemias
-If not diluted it may cause teeth
discoloration, so rinsing mouth is indicated
after taken the preparation .
-It may cause dysphagia.
-it may reduce the absorption of
tetracyclines & penicillamine.
-Oral manifestation of iron deficiency:
- Atrophic glossitis.
- Angular cheilitis &some times
aphthous ulceration.
Endocrine System
Drug Trade Names Indications Considerations
Antidiabetes
Insulin Human Reg. -Humalin-R -Diabetes mellitus-Diabetic pt. may be more susceptible to
infection & have delay wound healing.
Insulin Human –NPH
-Humalin-N -Diabetes Mellitus -Diabetic pt. may be more susceptible to
infection & have delay wound healing.
Glibenclamide
-Daonil
-Diatab
-Euglucon
-Glynase
-Diabetes mellitus
-Diabetic pt. may be more susceptible to
infection & have delay wound healing.
Gliclazid
-Diamicron -Non insulin-dependent
diabetes mellitus.
-Diabetic pt. may be more susceptible to
infection & have delay wound healing.
Metformin
-Glucophage
-Glucomet
-Melbin
- Non insulin-dependent
diabetes mellitus.
-Diabetic pt. may be more susceptible to
infection & have delay wound healing.
Endocrine System
Drug Trade Names Indications Considerations
Corticosteroids
Prednisolone-Prednisolone
-Deltacortef
-Gupisone
-Precortisly
-In general, it is indicated in
autoimmune diseases.
-Multiple sclerosis.
-Adrenocortical
insufficiency
-Adreno-genital syndrom .
-Arthritis.
-Collagen diseases.
-Rheumatic carditis.
-Nephrotic syndrom
-Skin disease.
eg.pemphigus
-Ulcerative coltitis.
-Throbocytopenia.
-Organ transplantation
-Acute asthma.
-Group of oral lesions eg.
L.P, pemphigus vulgaris,
EM &cicatrical pemphigoid
-Behcet’s disease.
-Prevention of post –
herpetic neuralgia.
-Contraindicate in viral infections.
–It delays wound healing.
-It causes candidal infection & dry mouth.
-Symptoms of oral infection may be
masked.
-Assess need for supplemental doses for the
dental treatment.
-Prophylactic antibiotic may be indicated to
prevent infection in surgery or deep
scaling
Forms:
-Tablet: 1 mg , 5 mg
20 mg , 25 mg
-Enema 20 mg/100 ml
Dexamethasone
-Decadron
-Oradexo
-Acute exacerbation of
chronic allergic disorder
-Cerebral edema.
-Multiple sclerosis
-Antiemetic with cancer
therapy.
As prednisolone
Hydrocorisone
-Cortef
-Solu-cortef
-Cortiderm
-Hydrocortone
-Replacement therapy in
adrenal cortical
insufficiency salt-losing
forms of congenital adrenal
hyperplasia syndromes.
-Addison’s disease
As prednisolone
Drugs & Dentistry IVDrugs & Dentistry IVProphylactic Antibiotic Regimens for Bacterial Prophylactic Antibiotic Regimens for Bacterial
Endocarditis for Dental proceduresEndocarditis for Dental procedures
Situation Agent Regimen Trade names Forms
Standard general
prophylaxisAmoxicillin
Adults: 2 g
Children: 50 mg/kg
Orally ,one hour before procedure
-Amoxil
-Ultramox
-Amoxidar
Cap. 250-500 mg
Sus. 125 mg/5ml
250 mg/5ml
Unable to take oral
medicationAmpicillin
Adults : 2 g
Children : 50 mg/kg ,IM or IV
within 30 min. before procedure
-Pentrexyl
-Polycillin
Inj. 250 mg/vial
500 mg/vial
1 g /vial
Allergic to penicillin
Clindamycin
or
Adults: 600 mg
Children: 20 mg/kg
Orally,one hour before procedure.
-Dalacin-C Cap. 150 mg
Cephalexin
or
Adults: 2 g
Children: 50 mg/kg
orally, one hour before the
procedure.
-Keflex
-Cefrin
Tab. 250-500 mg
Cefadroxil
or
-Ultracef
-Cefadrox
Tab. 1 g
Cap. 500 mg
Sus. 125-250mg/5ml
Azithromycin
or
Adults: 500 mg
Children: 15 mg/kg
Orally, one hour before the
procedure
-Zithromax Cap. 250 mg
Clarithromycin -Klacid Tab. 250-500 mg
Sus. 125 mg/5ml
250mg/100 ml
Allergic to penicillin &
unable to take oral
medication
Clindamycin
or
Adults: 600 mg
Children: 20 mg/kg
IV within 30 min. before
procedure.
-Dalacin-C Inj. 300-600
900 mg
Cefazolin Adults: 1 g
Children: 25 mg/kg
IM or IV within 30 min. before
procedure.
-Cefamezin
-Totacef
Inj. 250-500 mg
1 g
1. Total dose of the children must not exceed the adult dose.2. Do not prescribe cephalosporins if the pt. has immediate-type hypersensitivity to penicillins due to the cross reaction between the tow drugs.