Pharmacology reference by Michael L. Iczkovitz, D. D. S



Download 418.73 Kb.
Page22/33
Date conversion26.11.2016
Size418.73 Kb.
1   ...   18   19   20   21   22   23   24   25   ...   33

Dental Considerations: Local anesthesia with vasoconstrictor ok. Commonly causes oral discomfort secondary to ulcerative stomatitis. Gingivitis, glossitis and pharyngitis. Severe headache, cranial nerve palsy, rash, photosensitivity, chills, fever, arthralgia and blood dyscrasias.

Dental Drug Interactions: Corticosteroids (except dexamethasone) and NSAIDs decrease effect of methotrexate. Toxicity increased by salicylates, alcohol and penicillin.

Dental Drug Interactions: Possible fatal reactions with NSAIDs and high dose IV methotrexate.

Tamoxifen (Nolvadex)

Action: An antiestrogen hormone, binds to estrogen receptors on tumors and other tissue targets results in decreased DNA synthesis and inhibits estrogen effects.

Use: Palliative or adjunctive treatment of advanced breast cancer. Treatment of mastalgia, gynecomastia, male breast cancer and pancreatic carcinoma.

Dental Considerations: Local anesthesia with vasoconstrictor ok. Blood dyscrasias and headache.

Dental Drug Interactions: None




Mercaptopurine (Purinethol)


Action: Purine antagonist which inhibits DNA and RNA synthesis.

Use: Treatment of acute leukemias (ALL, CML)

Dental Considerations: Local anesthesia with vasoconstrictor ok. Drug fever,

stomatitis, blood dyscrasias and glossitis.



Dental Drug Interactions: None

Anti-Neoplastic Agent


Paclitaxel (Taxol)

Action: Inhibits microtubule network reorganization essential for cell division.

Use: Treat metastatic ovarian carcinoma, metastatic breast cancer, lung cancer, AIDs

related Kaposi’s sarcoma



Dental Considerations: Local anesthesia with vasoconstrictor ok. Mucositis, blood

dyscrasias, myalgia, arthralgia, fever.



Dental Drug Interactions: Increased activity with ketoconazole.
Imatinib (Gleevec)

Action: A protein tyrosine kinase inhibitor, inhibiting certain leukemic line cell growth.

Use: Treatment of chronic myeloid leukemia (CML).

Dental Considerations: Local anesthesia with vasoconstrictor ok. Headache, TMJ-

arthralgia, TMJ-myalgia, pharyngitis.



Dental Drug Interactions: Increases Imatinib concentration; itraconazole,

ketoconazole, erythromycin, clarithromycin. Decadron decreases Imatinib

concentration.

Immune Globulin

Action: Provides passive immunity by increasing the antibody titer and antigen-antibody reaction potential. Interferes with receptors on the reticuloendothelial system for autoimmune cytopenias and ITP, possibly contains antiviral antibodies.

Use: I.M. for exposure to hepatitis A, measles, varicella and possibly rubella. Prophylactic for travelers to certain areas. I.V. to treat immunodeficiency syndrome, idiopathic thrombocytopenia and chronic lymphocytic leukemia. Used to prevent or modify acute bacterial or viral infections in immunodepressed states; autoimmune neutropenia, bone marrow transplantation, Kawasaki disease, Gullian-Barre syndrome, demyelinating polyneuropathies.

Dental Considerations: Local anesthesia with vasoconstrictor ok. Facial flushing, chills, fever, myalgia and headache.

Dental Drug Interactions: None




Interferon

Action: Alters the expression and response to surface antigens and can enhance immune cell activities. Mechanism in treatment of multiple sclerosis is unknown.

Use: Treatment of relapsing forms of multiple sclerosis. Slows accumulation of physical disability and decreases frequency of clinical exacerbations. Given by intramuscular injection.

Dental Considerations: Local anesthesia with vasoconstriction ok. Headache and blood dyscrasias.

Dental Drug Interactions: None.

Interferon Beta-1a (Avonex)




Immunosuppressant Agent
Cyclosporine (Sandimmune)

Action: Inhibits production and release of interleukin II, which activates

resting T lymphocytes.



Use: Immunosuppressant used for kidney, liver, heart and bone marrow

transplants.



Dental Considerations: Local anesthesia with vasoconstrictor ok.

Gingival hyperplasia, headache, myalgia, paresthesia, sinusitis.



Dental Drug Interactions: Azole antifungals increase effects.
Azathioprine (Imuran)

Action: Antagonizes purine metabolism and may inhibit synthesis of DNA,

RNA, and proteins. May also interfere with cellular metabolism and

Inhibit mitosis.

Use: Adjunct with other agents in prevention of rejection of solid organ

transplants. Used in severe unresponsive rheumatoid arthritis.



Dental Considerations: Local anesthesia with vasoconstrictor ok. Fever,

blood dyscrasias, aphthous stomatitis, arthralgia, myalgia.



Dental Drug Interactions: None.
Mycophenolate (CellCept)

Action: Inhibits purine synthesis of human lymphocytes and proliferation

of human lymphocytes.



Use: Prevent organ rejection for allogenic renal transplants.

Dental Considerations: Local anesthesia with vasoconstrictor ok.

Headache, fever, oral monoliasis, blood dyscrasias and pharyngitis.



Dental Drug Interactions: None.
Tacrolimus (Prograf)

Action: Suppresses humoral immunity, inhibits T cell activation, very

potent.


Use: Immunosuppressant drug used in liver, kidney, heart, lung or small

bowel transplant recipients.



Dental Considerations: Local anesthesia with vasoconstrictor ok.

Headache, fever, blood dyscrasias and paresthesias.



Dental Drug Interactions: Don’t use with nephrotoxic antibiotics,

increases nephrotoxicity. Not good to use with macrolide antibiotics and

azole antifungals. Methylprednisolone is synergistic with it. Seldane

and Hismanal cause cardiac arrhythmias with it.



Immunosuppressant Agent

Leflunomide (Arava)

Action: Inhibits pyrimidine synthesis, anti-inflammatory and antiproliferative effects.

Use: Active rheumatoid arthritis, reduce signs and symptoms and retards structural

damage.


Dental Considerations: Local anesthesia with vasoconstrictor ok. Dry mouth, taste

disturbance, oral ulcers, candidiasis, paresthesias, sinusitis, arthralgia, headache, pain,

fever, stomatitis, gingivitis, enlarged salivary gland, tooth disorder, myalgia, blood

dyscrasias.



Dental Drug Interactions: May increase levels of NSAIDs.
1   ...   18   19   20   21   22   23   24   25   ...   33


The database is protected by copyright ©dentisty.org 2016
send message

    Main page