Contraindications: Don’t use within 14 days of taking MAO inhibitors. Don’t give if hyperthyroid, CHF, arrhythmias, immediately post MI, child <12 yrs. Use with caution if urinary hesitancy or angle-closure glaucoma.
Drug Interactions: Increased CNS depression with alcohol, narcotics, barbiturates, sedatives, hypnotics. Increased effects of anticholinergics.
Increased toxicity with TCAs. Increased effect of direct acting sympathomimetics (epinephrine and levonordefrin).
Action: Acts central to depress synaptic pathways. Has atropine like effects as well as euphorgenic and analgesic properties.
Action: Induces erythropoiesis by stimulating division and differentiation of erythroid progenitor cells. Also induces release of reticulocytes from the bone marrow into the blood stream where they mature to erythrocytes.
Use: Anemia associated with the following; end stage renal disease, AZT therapy for AIDs, chemotherapy for cancer and prematurity.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Headache and arthralgias.
Dental Drug Interactions: None
Action: Inhibits DNA synthesis, no effect on synthesis of protein or RNA.
Use: Treat chronic myelocytic leukemia, melanoma, ovarian carcinoma, head and neck cancer, adjunct in management of sickle cell anemia.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Stomatitis, erythema of face, headache and significant blood dyscrasias. If surgical procedure make sure WBCs adequate to prevent infection, platelets adequate for hemostasis, RBCs adequate for oxygen if sedation or GA.
Dental Drug Interactions: Hepatotoxicity with alcohol and hepatotoxic drugs.
Action: Inhibits enzyme that reduces folic acid, which is needed for nucleic acid synthesis in all cells.
Use: Treat trophoblastic neoplasms, leukemias, psoriasis, rheumatoid arthritis and hydatidiform mole. Carcinomas of the breast, head, lung, esophagus, stomach, and testes. Osteosarcomas and sarcomas. Gestational choriocarcinoma.