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17 Cards in this Set

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Epinephrine
Class: Nonspecific adrenergic Receptors (Agonist)
MOA: Direct stimulation of α and β adrenergic receptors
Indications: Emergency bronchodilation, Local vasoconstriction (D), Decreases bleeding, Increase length of analgesia, Hypotension, shock, Allergy
Pharm effects: Bronchodilation, vasoconstriction
Effect on dental tx (Adverse effects, Contraindicaitons, w/analgesic):
Cardiac: β1 stimulation increases the work of the heart and decreases cardiac efficiency
Cerebrovascular disease: Use with caution in pts with cerebrovascular disease
Diabetes: Increases in circulating blood glucose from stimulation of liver glycogenolysis and glucagon secretion, Inhibition of insulin secretion
Parkinson’s disease: May cause temporary worsening of symptoms
Thyroid disease: Use with caution in pts w/ thyroid disease
Interactions:
Trycyclic antidepressants: Block reuptake and degradation of epi, leading to more cardiac adverse effects
β-Blockers: non selective block β receptors in the peripheral blood vessels, epi acts as a pure α agonist and blood pressure rises
selective block β1 receptors in the heart, at high doses block β2 receptors in peripheral blood vessels
Upper limit: 0.04 mg total per procedure
Methylphenidate (Ritalin)
Class: α sympathetic adrenergic receptor agonist
MOA: Release of Norepi from synaptic vesicle
Indications:
ADHD
narcolepsy
Pharm effects: Increased wakefulness and focus.
Effect on dental tx (Adverse effects, Contraindicaitons, w/analgesic):
Abuse and addiction (Schedule 2), Dyskinesia, Muscle tightness, bruxism
Amphetamine (Adderall)
Class: α sympathetic adrenergic receptor agonist
MOA: Release of Norepi from synaptic vesicle
Indications:
ADHD
narcolepsy
Pharm effects: Increased wakefulness and focus.
Effect on dental tx (Adverse effects, Contraindicaitons, w/analgesic):
Abuse and addiction (Schedule 2), Dyskinesia, Muscle tightness, bruxism, use vasoconstrictor with caution, enhance body's response to epi.
Clondine (Catapres)
Class: Presynaptic α2 adrenergic receptor agonist
MOA: Inverse agonist- binds to α2 medullary receptors in the brain which inhibit sympathetic outflow to the body and α receptors in blood vessels are inhibited
Indications: Epidural injection: used with opiates to relieve the pain associated with end-stage cancer, HTN
Pharm effects:
Decreased vascular resistance, Decreased renal vascular resistance, Decreased heart rate, Decreased BP
Effect on dental tx (Adverse effects, Contraindicaitons, w/analgesic): Dry mouth, Orthostatic hypotention
Albuterol (Proventil)
Class: β2 sympathethic Adrenergic Receptors Agonist
MOA: Stimulation of β2 receptors in lungs to cause bronchodilation,
Dosage form: Albuterol inhalation aerosol
β2 receptors in the lungs will receive most of the drug to decrease the chance for adverse effects
Indications: Asthma, COPD
Pharm effects: bronchodilation
Effect on dental tx (Adverse effects, Contraindicaitons, w/analgesic): Unusual taste and drying or irritation of the oropharynx (D), xerostomia
Terazosin (Hytrin)
Class: α1 blocker
MOA: α1 receptor blockade leading to smooth muscle relaxation
α1D subtype blockade in prostate gland
Indications: HTN,Post myocardial infarction, CHF, Treatment of arrhythmias, Ischemic heart disease, Benign prostatic hyperplasia
Pharm effects: Decrease arterial tone
Effect on dental tx (Adverse effects, Contraindicaitons, w/analgesic): Dry mouth, Dizziness, Orthostatic hypertension
Metoprolol (Toprol)
Class: β1 selective blocker
MOA: Competitive inhibitors of epinephrine and norepi at β1.
Indications: HTN, Post myocardial infarction, CHF, Treatment of arrhythmias, Ischemic heart disease
Pharm effects:
Decrease force and rate of myocardial contraction
Decrease oxygen consumption of the heart
Decrease of blood pressure in hypertensive pts
CO decreases
HR decreases
Reduction in plasma renin activity
Decreases CNS sympathetic outflow
Alteration in baroreceptor responsiveness
Effect on dental tx (Adverse effects, Contraindicaitons, w/analgesic): Altered taste, Lichenoid rxns, Orthostatic hypertension, Enhanced pressor response to epi
Propranolol (Inderal)
Class: Nonselective β blocker
MOA: Non selective competitive inhibitor of beta receptors
Indications: HTN, Post myocardial infarction, CHF, Treatment of arrhythmias, Ischemic heart disease, CVD, Stage fright, Tremor, Migraine headache, Sexual aggression
Pharm effects:
Decrease force and rate of myocardial contraction
Decrease oxygen consumption of the heart
Decrease of blood pressure in hypertensive pts
CO decreases
HR decreases
Reduction in plasma renin activity
Decreases CNS sympathetic outflow
Alteration in baroreceptor responsiveness
Effect on dental tx (Adverse effects, Contraindicaitons, w/analgesic): Altered taste, Lichenoid rxns, Orthostatic hypertension, May enhance the pressor response to epinephrine, Hypertension and bradycardia
Carvedilol (Coreg)
Class: β blocker
MOA: Antagonist at β1 and α1 receptors
Indications: HTN, Post myocardial infarction, CHF, Treatment of arrhythmias, Ischemic heart disease
Pharm effects:
Decrease force and rate of myocardial contraction
Decrease oxygen consumption of the heart
Decrease of blood pressure in hypertensive pts
CO decreases
HR decreases
Reduction in plasma renin activity
Decreases CNS sympathetic outflow
Alteration in baroreceptor responsiveness
Effect on dental tx (Adverse effects, Contraindicaitons, w/analgesic): Postural hypotension, Periodontitis possible (mechanism unknown)
Tamsulosin (Flomax)
Class: α sympathetic antagonist
MOA: Blockade of α1A and α1D adrenergic receptor subtypes found only in prostate gland
Indications: Benign prostatic hyperplasia
Pharm effects: Relaxation of smooth muscle in prostate and bladder neck
Effect on dental tx (Adverse effects, Contraindicaitons, w/analgesic): Orthostatic hypotension
Tacrine (Cognex)
Class: Cholinesterase inhibitor
MOA: Elevates acetylcholine in cerebral cortex by slowing degradation of acetylcholine.
Indications: Alzheimer’s, Parkinson’s disease with dimentia
Pharm effects: Prolong acetylcholine half-life in the brain
Effect on dental tx (Adverse effects, Contraindicaitons, w/analgesic):
Contraindications: Asthma, Cardiovascular disease, Ulcer
Adverse effects: Nausea, Diarrhea, Vomiting, Rhinitis, Urinary frequency, Bronchospasm, Hypotension, Arrhythmias, (parasympathetic reactions)
Ipratropium(Atrovent)
Class: Anticholinergic
MOA: Blocks action of acetylcholine at parasympathetic sites in bronchial smooth muscle causing bronchodilation
Indications: Asthma , COPD
Pharm effects: bronchodilation
Effect on dental tx (Adverse effects, Contraindicaitons, w/analgesic):
Effects potentiated by antihistamines
CYP2D6 inhibitors: may diminish the therapeutic effect of Codeine
Severe dry mouth
Tiotropium(Spiriva)
Class: Anticholinergic
MOA: Competitively and reversibly inhibits the action of acetylcholine at type 3 muscarinic receptors in bronchial smooth muscle
Indications: Asthma, COPD (prolonged half life)
Pharm effects: bronchodilation
Effect on dental tx (Adverse effects, Contraindicaitons, w/analgesic):
Effects potentiated by antihistamines
CYP2D6 inhibitors: may diminish the therapeutic effect of Codeine
Severe dry mouth
Ipratropium /albuterol (Combivent)
Class: muscarinic antagonist, short acting beta 2 adrenergic agonist
MOA: Acetylcholine blocker at bronchial smooth muscles, Beta 2 agonist
Indications: COPD for pts requiring second bronchodilator
Pharm effects: bronchodilator
Effect on dental tx (Adverse effects, Contraindicaitons, w/analgesic:
Effects potentiated by antihistamines
CYP2D6 inhibitors: may diminish the therapeutic effect of Codeine
Severe dry mouth
Tolterodine (Detrol)
Class: Anticholinergic
MOA: Competitive agonist of muscarinic receptors
Indications: Dysuria, Urgency, incontinence
Pharm effects: Antispasmodic, Contracts urinary sphincter
Effect on dental tx (Adverse effects, Contraindicaitons, w/analgesic):
Effects potentiated by antihistamines
CYP2D6 inhibitors: may diminish the therapeutic effect of Codeine
Severe dry mouth
Darifenacin (Enablex)
Class: Anticholinergic
MOA: M3 selective agent limits bladder contrctions, less dry mouth and constipation
Indications: Bladder overactivity
Pharm effects: antispasmodic
Effect on dental tx (Adverse effects, Contraindicaitons, w/analgesic):
Effects potentiated by antihistamines
CYP2D6 inhibitors: may diminish the therapeutic effect of Codeine
Severe dry mouth
Varenicline (Chantix)
Class: Partial nicotine agonist
MOA: Produces agonist activity while simultaneously preventing nicotine binding to α4β2 recpetors, Stimulates receptor-mediated activity, but at a significantly lower level than nicotine
Indications: Smoking cessation
Pharm effects: reduces cravings and decreases pleasurable effects of tobacco
Effect on dental tx (Adverse effects, Contraindicaitons, w/analgesic): Nightmares, Psychosis, xerostomia