CHAPTER 1WO

Drug Action & Handling

CRUG:
biologicallyactive substance used to modifycellular function

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off onset
CAISSOONPPATIONS SSARIBUHIOR =
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metabolism, elimination
metabolism, #Merapeutic range,therapenic) CHO

metabolism Effectof
drug 0 dose
=>
Liver

excretion #=axis and M a*i5

excretion
Kidney rESPONSE
->
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Characterization of
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I
 CHAPTER THIRTEEN
Gastrointestintestina / Disorders
Drugs Include . . .

histamine blocking agents

◦ -
Two main
categories
•

proton pump inhibitors Of GI diseases :

mixed anti infective therapy Lakers)
•

antacids •
Ulcers
misc .GL drugs
◦

laxatives or antidiarrheals
◦

antiemetic
•
GERD
agents to manage IBD
◦

Ulcers
what is it ? Treatment
sores in stomach
lining / small intestine ↳ antibiotics
◦
•

caused by A. pylori
◦
Hz blocker
-

secondary to longterm PPI

◦

NSAIDs
◦

DH considerations
◦

avoid use of NSAIDs or aspirin

drugscancausexerostomialreccomend products)
◦

taste changes or enamel loss -_

refer to primary care physician

GERD
what is it ? Treatment
/
through cardiac sphincter oesophagus decrease stomach acid OR
◦

stomach contents reflux

◦

lifestyle related llargemeals /ayingflataftereatingl

, constricting cardiac sphincter
•

can lead to Barrett esophagus •

Hi blocking ,PPls > OTC antacids

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 GERD cont . . .

DH considerations
◦

avoid use of NSAIDs or aspirin

drugs can cause xerostomialreccomend products/ or alter taste
◦

Client may not tolerate being fully supine

◦

taste change or enamel loss refer to physician =

Histamines blocking agents

-

OTC
management of GERD symptoms and ulcer treatment
◦

block and inhibit gastric acid secretion by the inhibition of the

action of histamine at the Hz receptors of the parietal cells
Should be administered AM and PM
•

Examples :
•
cimetidine tagametl ◦

nizatidine ( Axidl
•
Famotidine (Peracid) ◦

ranitidinelzantac )

Hz Side Effects
Blocking
-

Slurred speech headache sexual dysfunction

• • •

delusions gynomastia granulocyte Persia

◦ • ◦

confusion ◦

low sperm count

◦

thrombocytopenia
neutropenia reversible hepatitis abnormal liver function
◦ • ◦

Drug Interactions ( cimetidine)

Ketoconazole itraconazole antifungal
◦
+ -

alcohol
◦

benzodiazepines

2
 Proton PUMP Inhibitors
◦
inhibitors of gastric secretions
•
maintenance therapy for GERD
•

more potent than Hz receptor blockers

-

Examples :
•
Omeprazolelprilosec) •

Rabeprazolelaciptlex)
◦

Lansoprazolelprevacid)
◦

Pantoprazolelprotonix)

side-Effects
•
headache ◦
dizziness •

mucosa/ atrophy /tongue)

nausea dry mouth osteoporotic fractures
◦ ◦

gastro duodenum tumours diarrhea ,( C- dit associated)

• •
-

antiemetic
→
prevent vomiting
Phenothiazines severe nausea Sedation
◦
:
>

anticholinergicmotion sickness inner ear issues

•
:
.

antihistamines :( i. Bendryl/ sedation

trimethobenzamide chemoreceptor trigger zone
.at/ergytoesterL-A.ometodopramide:nausealvomittingin
◦
:

cancer patients
•

cannabinoids : cannabis Similar effects

.

5- 1-1-13 receptor
antagonists and cancer patients
•

:
post -

op

antidiarrheals
kaolin and pectin / kaopectate) Loperamidelotclmmodiuml
• ◦

Diphenoxylatew / atropine ltomotil)

◦

3
 CHAPTER TWELVE
cardiovascular disease

contraindications to dental treatmentw/CD

Examples include ... ·

M1 w/in 6 months
·

hypertension ·

unstable/ onset
recent of angina pectoris
·

angina pectoris ·

uncontrolled heartfailure / arythmias

coronaryartery disease
·

significant, uncontrolled hypertension

·

arythmias
·

careful w/anesthetics containing vasoconstrictors

·

·
heartfailure
correlation between CD and periodontal disease
·

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WhatIs It?

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 HEARTFAILURECONT
ARB's Han) BAdrenogenic Blockers

* atenciaWit9,8EFs
deiro
ACEs Patients with symptoms of
atiersonthat cannottolerate
HE
·

(e- +

ex.candestartan
·

OR historyof Mr
·

Antelosteronenntagona"smnoproplispratanois
*
·

eg. spironolactone
Vasodilators
·
cardial glycosides (digitals)
Digoxin
-

mostcommon

- anseGiromItingBraaNaNo
·adverse reactions common
·
workload
reduce heart's

OrpaPinayScIn'a'j'aYmo+'Fake
·
ACEIs
orARBs
ex.hydralazyne
IF
·

channel blockers