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Pharmacology

Refresher: Why use Analgesics?

This summary is based on the Clinical Info provided by the Canadian Pharmacists Association: Drugs in Dentistry (December 2012) By Dr. Dan Haas, DDS, PhD, FRCDC Consider the following points in the use of analgesics: Eliminate the source of pain, if possible. Individualize regimens. Optimize dose and frequency before switching. Maximize the nonopioid before adding the opioid. Consider a loading dose and/or a preoperative dose for nonsteroidal anti-inflammatory drugs (NSAIDs). Avoid chronic use of any analgesic. Reduce the dose in older individuals. Be aware of the contraindications and cautions for NSAIDs, including ASA (see also individual product monographs and CPhA monographs as ...

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Efudex: Should it be prescribed by dentists?

This question was submitted by a general dentist: When discussing sun damage to lips, a couple of patients indicated that their physician prescribed Efudex. There is apparently no follow-up by the physician and no indication to the patients as to what the desired outcome of the said treatment should be. Should dentists be prescribing this medication and what would the appropriate follow-up and regimen be with this chemotherapeutic agent? Dr. Mark Donaldson provided the following initial and quick response Dr. Mark Donaldson is Director of Pharmaceutical Services at the Kalispell Regional Medical Center,  Clinical Professor in the Department of Pharmacy at ...

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Are there dietary-supplement interactions with medications commonly used in dentistry?

This snapshot is adapted from the article by Drs. Mark Donaldson and Riva Touger-Decker published in the Journal of the American Dental Association: Dietary supplement interactions with medications used commonly in dentistry Dr. Mark Donaldson is Director of Pharmaceutical Services at the Kalispell Regional Medical Center, is Clinical Professor in the Department of Pharmacy at the University of Montana, and is Clinical Associate professor in the School of Dentistry at the Oregon Health and Sciences University Dr. Riva Touger-Decker is Chair of the Nutrition Sciences Department and Professor in the Diagnostic Sciences, Rutgers School of Dental Medicine  Context  Because nearly 70% ...

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Codeine or other opioids: Which to use to relieve pain in pediatric patients?

This summary is based on the Rapid Response Report developed by the Canadian Agency for Drugs and Technologies in Health: Codeine Compared with Other Opioids for Pain Relief in Pediatric Patients: Comparative Clinical Effectiveness, Safety, and Guidelines Full Report (PDF) Research Questions What is the evidence for the clinical effectiveness of codeine compared with other opioids for pain relief in pediatric patients? What is the evidence for the safety of codeine compared with other opioids when administered to pediatric patients? What are the evidence-based guidelines regarding the use of codeine compared with other opioids for pain relief in pediatric patients? Key Messages Two non-randomized ...

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Codeine and Acetaminophen: how safe and clinically effective are they?

This summary is based on the Rapid Response Report developed by the Canadian Agency for Drugs and Technologies in Health: Codeine and Acetaminophen for Pain Relief: A Review of the Clinical Efficacy and Safety Full Report (PDF) Context Pain has been defined as “an unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of such damage.” Pain can be classified as being either acute or chronic. The distinction between acute and chronic pain is usually based on a subjective interval of time since pain onset, the two most commonly used intervals being months and 6 ...

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Brief: How would you manage a medical emergency in your dental office?

This Summary is an adaptation of the Clinical Info on Medical Emergencies provided by the Canadian Pharmacists Association (CPhA)  Treatment of a medical emergency in a dental office begins with assessment and, if necessary, treatment of airway, breathing and circulation (cardiopulmonary resuscitation). Most often, only after these basics are addressed should drugs be considered. They should, however, be readily available for such emergencies. A sugar source, such as orange juice or non-diet soft drink should be readily available for use in the management of hypoglycemic reactions. Additional agents may be appropriate depending on the nature of the dental practice.   ...

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Does Your Patient Need Penicillin?

This Post is adapted from the Canadian Pharmacists Association (CPhA) Drug Monograph: Penicillin G/Penicillin V Product Summary Table Pharmacology Penicillins G and V, known as the natural penicillins, are bactericidal against susceptible organisms. Penicillins interfere with the synthesis of cell wall mucopeptides, resulting in the formation of defective cell walls that will lyse and eventually result in death of the organism. The spectra of activity of penicillins G and V are similar: Penicillin G is more active against gram-negative organisms (e.g., Neisseria) and some anaerobes than is penicillin V. Penicillin G can be given parenterally, enabling the attainment of high serum ...

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What are NSAIDs?

This Post is adapted from the Canadian Pharmacists Association (CPhA) Drug Monograph: Nonsteroidal Anti-inflammatory Drugs (NSAIDs) Click here to view the Product Summary Table (web image) Click here to download the Product Summary Table (PDF) Indications and Clinical Use As anti-inflammatory, analgesic and antipyretic agents, NSAIDs provide symptomatic relief but do not cure the underlying disease. No NSAID has been proven superior for symptom relief. The choice of drug depends on individual risk factors, such as NSAID toxicity, individual patient response, compliance potential, dosage forms, cost and available evidence. For compliance, drugs with a long half-life or available in dosage ...

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