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


Treat periodontal disease, dentin hypersensitivity, high caries index, xerostomia, nonviral oral ulcerations and prophylaxis



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Treat periodontal disease, dentin hypersensitivity, high caries index, xerostomia, nonviral oral ulcerations and prophylaxis.

Skin cleanser for surgical scrub, germicidal hand rinse, cleanser for skin wounds.

Dental Considerations: Local anesthesia with vasoconstrictor ok. Staining of teeth, tongue and restorations, nasal congestion and dyspnea. Increased calculus formation, taste alterations, mucosal desquamation and irritation, transient parotitis.

Dental Drug Interactions: None

Precautions: Pregnancy Category B, no breast-feeding data.




  • Quinolone

Action: Bactericidal inhibits DNA gyrase, which is required for DNA replication, transcription, repair, recombination, transposition and maintenance of helical structure.

Use: Treat skin, lower respiratory tract infections, UTI, sexually transmitted disease and bacterial conjunctivitis (topical).

Dental Considerations: Local anesthesia with vasoconstrictor ok. Headache, dry mouth, candidiasis, photophobia, paresthesia and tinnitus.

Dental Drug Interactions: Increases caffeine and oral anticoagulant levels. Decreased absorption with bicarbonates.

Ofloxacin (Floxin)

Ciprofloxacin (Cipro) Typhoid fever, used alone or with metronidazole for periodontal disease, infectious diarrhea


Levofloxacin (Levaquin)

Gatifloxacin (Tequin)

. Antibiotic

  • Nitrofurantoin (Macrodantin, Macrobid)

Action: Inhibits several bacterial enzyme systems interfering with metabolism and possibly cell wall synthesis.

Use: UTI, good against gram positive and some gram negatives. Pseudomonas, Serratia and Proteus are resistant.

Dental Considerations: Local anesthesia with vasoconstrictor ok. Angioedema, brown discoloration of saliva, tooth staining, chills, fever, headache, sore throat, paresthesia, anemia, arthralgia.

Dental Drug Interactions: Increases effects of anticholinergics.

  • Trimethoprim and Sulfmethoxazole (Bactrim, Septra, Sulfatrim)

Action: Both interfere with bacterial folic acid synthesis in a different manner.

Use: Treat UTI, acute otitis media in children. Prophylaxis and treatment of Pneumocystitis carinii pneumonitis (AIDS), shigellosis, typhoid fever, Nocardis asteroides infections.

Dental Considerations: Local anesthesia with vasoconstrictor ok. Stevens-Johnson syndrome, Erythema multiforme, blood dyscrasias, fever, stomatitis and psuedomembranous colitis.

Dental Drug Interactions: Increases effects of oral anticoagulants.




  • Topical

Mupirocin (Bactroban)

Action: Inhibits bacterial protein and RNA synthesis.

Use: Impetigo caused by S. aureus, B-hemolytic Streptococcus, S. pyogenes. Nasal membrane infection from S. aureus.

Dental Considerations: Local anesthesia with vasoconstrictor ok.

Dental Drug Interactions: None

Antibiotic +

  • Topical

Neomycin, Polymyxin B, and Hydrocortisone (Cortisporin Ophthalmic Suspension)

Action: Neomycin interferes with bacterial protein synthesis. Hydrocortisone is anti-inflammatory.

Polymyxin alters cell wall permeability and damages bacterial cytoplasmic membrane permitting leakage of intracellular constituents.

Use: Steroid responsive inflammatory condition where bacterial infection or risk exists. Ophthalmic conditions.

Dental Considerations: Local anesthesia with vasoconstrictor ok.

Dental Drug Interactions: None




Antibiotic +

  • Topical

Tobramycin and **Dexamethasone (TobraDex)

Action: *Interferes with bacterial protein synthesis by binding to 30S and 50S ribosomal subunits. *Results in defective bacterial cell membrane. **Anti-inflammatory.

Use: Treat external ocular infection caused by susceptible gram-negative bacteria and steroid responsive inflammatory conditions.

Dental Considerations: Local anesthesia with vasoconstrictor ok.

Dental Drug Interactions: None

Antifungal Agent

Fluconazole (Diflucan)

Action: Inhibits ergosterol biosynthesis causing direct damage to fungal cell membrane and inhibition of cell membrane synthesis.

Use: Oropharyngeal candidiasis, chronic mucocutaneous candidiasis, urinary candidiasis and cryptococcal meningitis.

Dental Considerations: Local anesthesia with vasoconstrictor ok. Headache and Stevens-Johnson syndrome. Pregnancy no, lactation ok.

Medical Considerations: 1-10%; skin rash, nausea, vomiting, abdominal pain and diarrhea.

Medical Considerations: Other adverse reactions; cramping, flatus, increased AST/ALT, exfoliative skin disorders, abnormal liver function.

Dental Drug Interactions: Increases warfarin and benzodiazepine activity.

Medical Drug Interactions: Increases activity of cyclosporine, oral hypoglycemics, theophylline and phenytoin. Rifampin decreases fluconazole activity. Risk arrhythmias with some antihistamines.

Precautions: Use with caution if renal or hepatic impairment.




Nystatin (Mycostatin)

Action: Binds to sterols in fungal cell membrane, changing cell wall permeability allowing for leakage of cellular contents. Also interferes with fungal DNA replication.




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