1.
.2mg: the maximum dose of epinephrine in a healthy patient is?
2.
.04mg: the maximum dose of epinephrine in a heart / cardiac patient is?
3.
1:200,000: recommended dose of epinephrine to combine with a local anesthetic is?
4.
5 contraindications to taking aspirin: Gout, ulcers, pregnancy, children with chicken pox or flu, asthmatics, patients on other anticoagulants
5.
5-10%: _____ of patients are admitted to the hospital because of adverse reactions to a dug
6.
absorption: the study of how a drug becomes available for use in the body
7.
Acetaminophen: Not related to Salicylates or NSAIDS, have antipyretic and analgesic effects ONLY!! DOC for patients on anticoagulants, with peptic ulcer disease, an ASPIRIN hypersensitivity, childen because it does not cause reye syndrome, OVERDOSE effects: hepatotoxicity or even death
8.
Acetylcholine: Mediator in the PANS
9.
active absorption: carrier molecule (protein/enzyme) actively moves the drug across the membrane
10.
acyclovir: decreases pain and speed the healing of sores or blisters in people who have varicella (chicken pox), herpes zoster (shingles), first time or repeat outbreaks of genital herpes, and herpes labialis
11.
addiction of opioids: the rate of development of addiction and tolerance is related to the strength of the opioid and the frequency of use, tolerance can develop to all of the effects of the opioids except miosis and constipation
12.
administration: how do drugs enter our bodies?
13.
adrenal crisis: a medical emergency that happens to people who are taking steroids 5-10mg of prednisone for longer than 2 weeks time , avoid stress, steroid supplementation may be necessary, but most dental patients will not, supplementation is based on patient anxiety and type of procedure being performed
14.
adverse reactions of aspirin: gastrointestinal (most common), bleeding, reye syndrome, hepatotoxicity, renal toxicity, hypersensitivity
15.
adverse reactions of NSAIDS: gastrointestinal (less than aspirin), bleeding, renal effects, and hypersensitivity reactions
16.
adverse reactions of opioid analgesics: respiratory depression- usually the cause of death with overdose, nausea and emesis- result from stimulation in the medulla, constipation and urinary retention, myosis, histamine release- stimulate release resulting in itching and urticaria, CNS effects, Cardiovascular effects, biliary tract constriction, pregnancy and nursing considerations
17.
agonist: drugs that bind with the receptor to produce a therapeutic response
18.
allergic reactions with opioid analgesics: most common allergic reaction- skin rash and uticaria, due to histamine releasing properties,
19.
Allopurinol, & Probenecid: Drugs used for the prevention of a gout attack
20.
amantadine: flu medication- inhibits the penetration of the absorbed virus into the host's cells or inhibits the uncoating of the influenza A virus
21.
amides: parenteral, allergic reactions uncommon, Ex: lidocaine, prilocaine, mepivicaine, articaine
22.
amides: metabolized in the liver by cytochrome P450 mixed function oxidase, except for articaine, use caution for patients with Liver disease
23.
amoxicillin: _____ is not effective against penicillinase
24.
amoxicillin: DOC for antibiotic prophylaxis
25.
angina pectoris: pain in the chest that radiates up the left am or in the mandible, rapid pulse and rapid breathing
26.
Angiotensin Receptor Blockers: used to treat congestive heart failure and hypertension, losartan (cozaar), candesartan (atacand)
27.
antagonist: drugs that prevent the action of an agonist, produce no pharmacological effect
28.
anti-infective: suppress or destroy infections
29.
Antiarrhythmic agents: Digoxin- sodium channel blockers, quinidine, lidocaine, b-blockers- propranolol, acebutolol, potassium channel blockers-bretylium, calcium channel blockers- verapamil, diltiazem
30.
antibacterial: suppress or destroy bacteria
31.
anticoagulants: coumarin, warfarin (coumadin)-most common, the #1 drug interaction is ASPIRIN, increases bleeding tendencies, antibiotics can also penetrate the effects, dose reduction ONLY under advise of treating physician and allow several days for a change in effect, most dental procedures require no change in the dose of warfarin.
32.
antifungal agents: prevent synthesis of ergosterol, which disrupts fungal cell membranes
33.
antimicrobial: suppress or destroy microorganisms
34.
antiotension convertinf enzymes (ACE) inhibitors: Used primarily for the treatment of CHF, is now the first line therapy for CHF, also used for hypertension. Ex: Lisinopril (Prinivil, Zestril), Captopril (Capoten), Enalopril (Vasotec)
35.
antiviral medications: prevent or interfere with viral replication
36.
articaine: the newest local anesthetic approved in the US, great lipid solubility, diffuses through bone, methemoglobinemia with high doses, rarely causes paresthesia (prolonged feeling of numbness) following a mandibular block, vasoconstrictor: epinephrine
37.
Augmentin: clouvaunic acid +amoxicillin, prevents penicillinase from breaking it down
38.
B-Adrenergic Blocking Agents: these drugs treat Hypertension, Congestive Heart Failure, Angina
39.
barbiturates: Ex: phenobarbitol, butabarbitol, secobarbitol, methohexitol, thiopental, CNS depression is the main effect, original sedative, hypnotic agents, used as anticonvulsants
40.
benefits of vasoconstrictors: prolong anesthetic action, suppress systemic absorption of anesthetic, increase duration and intensify block, reduces toxicity, delays absorption, hemostasis, decreases bleeding
41.
benzodiazepines: Ex: diazepam (valium), lorazepam (ativan),alprazalom (xanax)-used for anti-anxiety control, insomnia, epilepsy, local anesthetic overdose, muscle spasms, these drugs are used before surgery, and are more commonly prescribed
42.
biologically equivalent: two formulations of a drug produce similar concentrations in blood and tissues
43.
biologically, therapeutically: Generic drugs must be ___ and ___ equivalent
44.
bupivicaine: more potent and less toxic than other amides, the most lipid soluble, longest lasting, vasoconstrictor: epinephrine
45.
Calcium Channel Blockers: Used for hypertension, arrhythmia, and angina, Ex: diltiazem (cadizem), verapamil (Isoptin), amlodipine (norvasc), felodipine (plendil)
46.
cardiac arrest: use AED, & immediate CPR to treat this
47.
cephalosporins: bacteriacidal, inhibit cell wall formation, used if there is a penicillin allergy
48.
cephalosporins: _____ are contraindicated in patients allergic to peniillins
49.
cephalosporins: ____ are contraindicated in patients allergic to penicillin's
50.
chemical name: is determined by the chemical structure of a drug and tells the chemist how to make it
51.
chemically: a drug can be ____ equivalent but neither of the others
52.
chemically equivalent: two formulations of a drug meet established chemical and physical standards
53.
cidal antibiotics: Penicillin, Cephalosporins, Vancomycin, Aminoglycosides
54.
clotrimazole: topical, used to treat oropharyngeal candidiasis
55.
colchicine, & NSAIDS: Drugs used for the acute treatment of gout
56.
combination drugs: combining an opioid with a non-opioid analgesic produces and additive analgesic effect with fewer adverse reactions
57.
common order of nerve function loss: 1) Autonomic
2)Cold
3) Warmth
4) Pain
5)Touch
6)Pressure
7)Vibration
8)Proprioceptive
9)Motor
8)
58.
composition of local anesthetics: vasoconstrictor, antioxidant (Bisulfite), retards oxidation of epinephine, sulfur allergies- watch in asthmatics- can send into an attack, alkalinizing agent- sodium hydroxide, adjusts the pH, methylparaben and propylparaben- preservatives not in dental cartridges
59.
contraindications for NSAIDS: Gout, Ulcers, Pregnancy, Pts. on other anticoagulants, and Pts. with hypersensitivity reactions to aspirin
60.
contraindications for the use of vasoconstrictors: heart attack in the last 6 months, uncontrolled hypertension, daily angina, uncontrolled hyperthyroidism, uncontrolled arrhythmias, and drugs
61.
contraindications of nitrous oxide: patients with respiratory obstruction, COPD,emotional instability, debilitating cardiac or cerebrovascular disease, pregnancy, psychiatric disorders or compulsive personalities, claustrophobic, children with severe behavioral problems, cystic fibrosis, and abuse of vitamin B12
62.
controlled substance act of 1970: what is the law that controls scheduled drugs
63.
cyclooxygenase II (COX) specific agents: EX: celebrex (celecoxib), Rofecoxib (Vioxx), and valdecoxib (Bextra)-Taken off the market because they caused severe side effects and death
64.
DEA (drug enforcement agency): what agency regulates scheduled drugs
65.
digitalis glycosides: Digoxin- the most common type of drugs used in the treatment of congestive heart failure (CHF)
66.
distribution: the circulation of a drug within the body
67.
diuretics: the 1st line of therapy for hypertension, also used for CHF,
68.
docosanol (10% Abreva): treatment of oral herpes simplex virus, OTC< topical, apply within 12 hours of prodromal symptoms to decrease the healing time
69.
dose: potency and ____ have an inverse relationship
70.
dose effect curve: how we measure how well a drug works, the intensity of a drug changes as the dose changes, adverse and therapeutic effects are dose related
71.
drug: a chemical substance that affects biologic systems
72.
drugs that alter in cellular environment: physical alterations, osmotic pressure, lubrication, absorption, or conditions on the surface of the cell membrane
73.
drugs that alter in cellular function: how most drugs wok, drug binds to a receptor like a puzzle piece, and then alters the function of the cell, intensity of a drug response is related to how well the fit of the drug molecule is to the receptor and the # of receptor sites occupied by the drug
74.
efficacy: minimal intensity of effect or response that can be produced by a drug regardless of dose, assessment of effectiveness
75.
enteral routes: when a drug is placed directly into the GI tract either by oral or rectal routes
76.
esters: metabolized in blood plasma by plasma pseudocholinsterase primarily
77.
esters: topical, higher rate of allergic reactions, Ex: cocaine, bezocaine, teracaine, procaine( novacaine), propoxycaine
78.
excretion: how a drug leaves the body
79.
excretion: most drugs eliminate the inactive compounds from the body in the urine
80.
fluconazole: systemic used to treat both vaginal and oral candidiasis, but not very effective, can take up to 5 days to relieve symptoms
81.
fungal infections: ___ ___ are common after antibiotic or steroid use, or in immunocomprimised patients
82.
gastric acid: Penicillin G is inactivated by___ ____?
83.
General Anesthetics: Ex: halothane, methoxyflurane, influrane, isoflurane, used in surgerys
84.
general side effects of antibiotics: gastrointestinal- most common (nausea, vomiting, and diarrhea), suprainfections- candidiasis, drug interactions- oral contraceptives- make oral contraceptives less effective, anticoagulants- potentiate the effects of oral anticoagulants, and allergic reactions
85.
generic name: the official name of the drug, starts with a lower case letter, only 1 per drug, and the name is selected by the US adopted name council
86.
Group A Drug: least teratogenic drugs, or best to take during pregnancy if needed
87.
Group B Drug: there is no demonstrated risk to the fetus in laboratory animals, or that animal studies show a risk that cannot be substantiated by studies in pregnant women
88.
Group C Drugs: an agent for which there is insufficient data in animals or women to ensure safety during pregnancy
89.
Group D Drugs: there is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk
90.
Group X Drugs: means never use if you are pregnant or may become pregnant
91.
half life: the amount of time for a drug's concentration in the blood to decrease by one half
92.
heparin: anticoagulants injected used in hospital settings or hospice only, use caution with ASPIRIN
93.
Hyperlipidemia Medications: statins- atorvastatin (lipitor), rosuvastatin (crestor),simvastatin (zocor), bile acid sequestrates, fibrates, niacin
94.
hypoglycemia: insulin shock, the most common cause is excessive doses of insulin in diabetic patients
95.
imidazoles: clotrimazole, fluconazole (diflucan), ketoconazole
96.
indications for nitrous oxide: a patient exhibits fear and anxiety, if a patient refuses or is allergic to general anesthetics, patients that have a prominent gag reflex, and patients who are impatient during long appointments
97.
Inhalation route: gaseous, microcrystalline, liquid, or powder, rapid delivery
98.
inscription: name dose size and concentration on a prescription
99.
Interferons: Hepatitis C and MS drugs= alfa-2a, peginterferon alfa -2a, beta-1b
100.
intradermal route: injection into the epidermis or dermis EX: TB skin test
101.
intravenous route advantages: most rapid response, more predictable drug response, route of choice in emergencies
102.
intravenous route disadvantages: inflammation at site, drug irretrievability, allergies, side effects related to high plasma concentration
103.
ketoconazole: topical and systemic, used to inhibit CYP P450
104.
lethal dose: death is the endpoint, dose that produces death in 50% of subjects
105.
lidocaine: is the most common local anesthetic agent, has a rapid onset, diffuses well through the tissues, medium duration, topical anesthetic also, vasoconstrictor: epinephrine
106.
liver: the #1 primary site in the body where metabolism occurs (where a drug is converted or changed)
107.
Loop diuretics: fluosemide (lasix)
108.
mechanism of action: bind to opioid receptors in the CNS, and spinal cord, No loss of consciousness.
109.
mechanism of action of aspirin: inhibits prostaglandin synthesis by inhibiting the enzyme cyclooxygenase (COX) in the hypothalamus
110.
median effective dose: amount of dug that produces a therapeutic effect in 50% of the subjects ED50
111.
mepivicane: rate of onset, duration, potency, and toxicity similar to lidocaine, plain form without vasoconstrictor-3%, used for short procedures if vasos are contraindicated, systemic toxicity is more likely, not effective topically, vasoconstrictor: levonordefrin
112.
metabolism: how a drug is changed by the body
113.
minocycline: arestin- often used topically to treat aggressive periodontal disease
114.
mixed agonist-antagonists: has both agonist and antagonist properties, when used alone behaves as a agonist, when administered with other drugs that compete for the same receptor sites, it will act as an antagonists
115.
mixed opioids: pentazocine (talwin)- the only antagonist-agonist opioid available in oral form, Dezocine, Nalbuphine, Butorphanol, Partial agonists-Buprenorphine
116.
myocardial infarction: sever pain, pressure, or heaviness in the chest that radiates to other parts of the body, sweating, nausea, vomiting, irregular rapid pulse,
117.
nitroglycerin: drug of choice for acute angina, also used for prophylaxis
118.
nitrous oxide-oxygen: used for dental procedures, and surgery
119.
non receptor chemical: may bind a molecule in the activation pathway of the drug,may also directly inhibit the agonist, Ex: antivenom for a snakebite
120.
non receptor physical agonist: activates pathway that oppose the action of the agonist, Ex: epinephrine
121.
nonnucleoside analogs: delaviradine, nevirapine = antiretroviral agents
122.
nonselective B-adrenergic blocking drugs: block both B1 & B2 receptors, Ex: propranolol (Inderol), contraindicated in asthmatics, USE CAUTION WITH EPINEPHRINE!
123.
Nonselective NSAIDS: Ibuprofen, Naproxen/ Naproxen Sodium (Aleve), pharmacologic effects the same as aspirin- antipyretic, analgesic, anti-inflammatory, anti-thrombotic
124.
nucleoside analogs: didanosine, lamivudine, stavudine, zalcitabine, zidovudine= antiretroviral agents
125.
nystatin: used topically, poorly absorbed from the GI tract when taken orally, DOC: oral candidiasis, both fungistatic and fungicidal properties
126.
opioid analgesics: morphine, Demerol, dilaudad, codeine- used to treat dental patientswho cannot tolerate NSAIDS or when NSAIDS are contraindicated,
127.
opioid antagonists: naloxone (narcan)- DOC for treating agonist or mixed opioid overdoses, reverses opioid-induced respiratory depression, parenteral administration, Nalmefene- Parenteral administration also, Naltrexone -prevent opioid and alcohol use in addicts, orally administered , and long acting
128.
pain: sensory (afferent) neurons can transmit the sensation of ____.
129.
parenteral routes: when a drug bypasses the GI tract, by being placed by one of these routes: intravenously, intramuscular, subcutaneous, intradermal, intrathecal, intraperitoneal, inhalation, or topical
130.
partial agonist: drugs that have some receptor fit and produce a slight therapeutic response, but inhibit other responses
131.
passive absorption: occurs by diffusion (movement from a higher concentration gradient to a lower concentration gradient)
132.
penciclovir: used to treat oral herpes simplex, used topically, shown to reduce the duration and pain of the lesion on the lips and face associated with both primary and recurrent herpes simplex
133.
penecillin V: the drug of choice for dental infections
134.
Penicillin's: bacteriacidal antibiotics, beta-lactam, effective against 90% of bacteria involved in dental infections, most effective against rapidly growing organisms, most commonly prescribed in the dental offices
135.
peripheral nerve cell membrane: local anesthetic site of action
136.
pharmacokinetics: what happens to drugs once they have been administered
137.
pharmacologic effects of aspirin: antipyretic (fever reducer), analgesic (pain reliever), anti-inflammatory (decreases inflammation), antithrombotic (reduces blood clotting)
138.
pharmacology: the study of drugs and their effects on living organisms
139.
pharmocodynamics: how drugs exert their effects
140.
phenytoin: the most common treatment for epilepsy, treats trigeminal neualgia and antiarrtythmic, adverse effects are gingival enlargement!!
141.
pinocytosis: cells engulf the drug particle
142.
potassium-sparing diuretics: amiloride,spironolactone (aldactone)
143.
potency: the amount of a drug required to produce the desired therapeutic effect,
144.
prescription: order of a specific medication for a specific patient at a particular time, with appropriate instructions for how the patient is to use the medication
145.
prescription body: includes: Rx symbol, inscription: name and dose of drug, size and concentration, subscription: amount to be dispensed, transcription: directions to the patient
146.
prescription closing: includes: prescriber's signature, DEA # if required, refill instructions, and generic substitution instructions
147.
prescription heading: includes: name, address, phone #, of the prescriber, and name, age, address, and phone # of the patient, also date of the prescription
148.
prilocaine: less potent, less toxic, longer duration of action than lidocaine, methemoglobinemia with high doses, should not be administered to pts. with oxygenation problems, vasoconstrictor: epinephrine
149.
prophylaxis only: beta blockers and calcium channel blockers
150.
protease inhibitors: indinavir, nelfinavir, ritonavir, saquinavir = antiretroviral agents
151.
purine, pyrimidine: most antiviral agents used to treat herpes are either ____ or _____ analogues that inhibits DNA synthesis, Acyclovir, docosanol, penciclovir, and famciclovir
152.
receptor competitive: competes with the agonist for the receptor, produces no effect when combined with the receptor
153.
receptor noncompetitive: binds to a different receptor site than the agonist, cannot elicit a response with more agonist
154.
route of administration: this affects both the onset and duration of response, onset: the time required for the drug to begin to have its effects, duration: the length of a drugs response
155.
salicylism: aspirin toxicity
156.
schedule I drugs: high potential for abuse, no accepted medical use in the US
157.
schedule II drugs: high abuse potential, psychological or physical dependence possible, requires written prescription with the providers signature, written in ink or typed only, no refills permitted
158.
schedule III drugs: potential fo abuse is less than I or II, abuse may lead to moderate to low psychological dependence, may be telephoned to the pharmacy, may be refilled as many as 5 times in 6 months
159.
schedule IV drugs: low potential for abuse, abuse may lead to psychological or physical dependence, may be telephoned in to pharmacy, may be refilled as many as 5 times in 6 months
160.
schedule V drugs: low potential for abuse, limited physical and psychological dependence
161.
selective B-adrenergic blocking dugs: block B1 receptors more than B2 receptors, Ex: Atenolol (tenormin), metaprolol (lopressor)
162.
static antibiotics: tetracyclines, aminoglycosides, erythromycin,azithromycin, clarithromycin, and clindamycin
163.
subcutaneous route: injection of solutions or suspensions of drugs into subcutaneous tissue, EX: insulin
164.
subscription: the amount of drug to be dispensed (Disp:)
165.
suprainfection: opportunistic infection, only an infection when the body is immunocomprimised
166.
syncope: the most common emergency in the dental office
167.
tetracylines: bacteria static, inhibit bacterial protein synthesis, broad spectrum
168.
the 5 major routes of drug administration: Oral Route, Rectal Route, IV route, IM Route, & Topical Route
169.
the cardiovascular drug classes: diuretics, B-adrenergic blocking agents, calcium channel blockers, antiotension converting enzymes (ace) inhibitors, angiotension receptor blockes
170.
the major classes of anti-anxiety drugs: barbiturates, benzodiazepines, general anesthetics, nitrous oxide-oxygen,
171.
the pharmacologic effects of opioid analgesics: analgesia, euphoria, sedation, antitussive effect, (dextromethorphan), antidiarrheal (lomotol, imodium)
172.
therapeutic effect: result of which are judged to be desirable and beneficial
173.
therapeutic index: lethal dose divided by median effective dose
174.
therapeutically: if a drug is biologically equivalent then most of the time it is also _____ equivalent
175.
therapeutically equivalent: two formulations of a drug have equal therapeutic effects during a clinical trial
176.
thiazide diuretics: hydrochlorothiazide (HCTZ)
177.
topical route: application to body surfaces EX: transdermal patch
178.
Trade or Brand Name: starts with a capital letter, it is made to be easily remembered and promoted commercially, can be more than 1 of these names per drug
179.
transcription: directions to the patient (Sig:)
180.
type I allergic reaction: immediate hypersensitivity, occurs quickly after a drug is administered, mediated by immunoglobulin E (IgE) antibodies, anaphylactic shock is possible-acute life threatening
181.
Type II allergic reaction: cytotoxic/cytolytic, complement dependent reactions, IgG or IgM antibodies, causes cytolytic reactions- cells bursting
182.
Type III allergic reaction: immune complex / arthus/ serum sickness, mediated by IgG antibodies, manifests as serum sickness
183.
type IV allergic reaction: delayed type hypersensitivity, mediated by T-lymphocytes and macrophages, manifests as dermatitis, EX: poison ivy
184.
valacyclovir , famciclovir: DOC for treatment of herpes zoster (shingles), and herpes labialis
