Pharmacology Chapters 16-19

Front 1

Anticonvulsants:
The majority of patients have idiopathic epilepsy -- the cause is _____.

Back 1

Unknown

Front 2

Management of the Patient taking Anticonvulsants:
1.
2.
3.
4.

Back 2

1. Review ER
2. Thorough Medical History
3. Are Other CNS Drugs Additive
4. Watch Drug Interactions

Front 3

Management of the Patient taking Anticonvulsants:

1.Remove hands and dental instruments from the mouth, turn the head to the side. (Review ER)

2. How often and how long are the _______, what drugs are taken? (Thorough Medical History)

3. Don't add ______ drugs which could be additive with seizure meds. (Are Other CNS Drugs Additive)

4. Hepatic microsomal enzymes, Darvocett, Doxycyline (Watch Drug Interactions)

Back 3

Seizures, gastrointestinal

Front 4

Anticonvulsants:
The Major Seizure Group:

1. Partial Seizure
A. ______

-Little movement
-A brief loss of consciousness
-Begin in childhood and then disappear in middle age.

Drug: _______ ________

B. _______
-Longer period of unconsciousness
-Major motor activity of large muscles

Drugs:
1.
2.
3.
4.

C. _______ _______ _______
-Lasts longer than 30 minutes

Drugs: ________ ________ & ________

Back 4

Absence, Valproic Acid, Tonic-Clonic Seizures (grand mal)

1. Valproic Acid
2. Phenytonin
3. Phenobarbital
4. Carbamazepine

C. Status Epilepticus Seizures

Drug: Parenteral Benzodiazepine & Diazepam (Valium)

Front 5

Anticonvulsants: In Tonic-Clonic Seizures:

-The body 1st becomes ______
-The patient falls to the floor
-Urination, apnea, cry
-Jerking of face, limbs, body
-Patient may bite ______
-Patient becomes limp and comatose
-Return to consciousness with confusion, headache and drowsiness.
-Some patients experience ______

Back 5

rigid, tongue, aura

Front 6

Adverse Effects of Anticonvulsant Drugs:
1.
2.
3.
4.

Abrupt withdrawal from medication can trigger seizures.

Back 6

1. Central Nervous System Depression
2. Gastrointestinal
3. Teratogenicity
4. Idiosyncratic

Front 7

Adverse Effects of Anticonvulsant Drugs:

1. Impaired learning and cognitive ability, hyperactivity or sedation- CNS depression- often tolerance build up, but drug still works.

2. Anorexia, nausea, vomiting- Gastrointestinal

3. Alteration in growth- ______

4. Rash, Steven-Johnson Syndrome, Systemic Lupus, Erythema Multiforme- Idiosyncratic

Back 7

Teratogenicity

Front 8

Used to treat seizures and Trigeminal Neuralgia (Tic Douloureux)

Back 8

Carbamazepin (Tegretol)

Front 9

Adverse Reactions of Carbamazepin (Tegretol)

-______- Dry mouth, Glossitis, Stomatitis -Chewable Carbamazepine, contains sugar
-______- Dizzy vertigo, fatigue, speech disturbances
-______- Nausea, vomit, anorexia
-Hematologic
-Dermalogic

Back 9

Oral, CNS Depression, Gastrointestinal

Front 10

Management of patient taking Carbamazepine (Tegretol):

-Check for dry mouth, glossitis, stomatitis
-_____ ______- watch drugs that alter coagulation
-Drug Interactions- _________ & ______
-Lab Testing- Hematologic, Ophthalmologic, Urinalysis, Liver function.
-______-High caries rate

Back 10

Additive Bleeding; Doxycycline, Erythromycin, Children

Front 11

Anticonvulsants:
Valproates (Depakote):

Also Used for ________.
Bleeding time can be prolonged.

Management:
Additive Bleeding
Look for signs of hepatotoxicity (Liver Damage)

Back 11

Migraines

Front 12

Anticonvulsants:
Barbiturates (Phenobarbital):

Most common side effect is ______.
Skin reactions occur in 1-3% of patients.
-Barbiturates must be discontinued if ______ reactions occur.

Back 12

Sedation, Skin

Front 13

Anticonvulsants:
Phenytoin/ Hydantonin (Dilantin):

-Also used for _______ _______.
-Used to treat ________ & _______ ________.
-May Produce _______ deficiency- first seen as mucosal ulceration or glossitis

Back 13

Neurological Pains; Seizures & Trigeminal Neuralgia, Vitamin D Deficiency

Front 14

Anticonvulsants:
Phenytoin/ Hydantonin (Dilantin):

_______ ________- Crainiofacial anomalies
-Gingival Enlargement

Back 14

Fetal Hydantoin

Front 15

Anticonvulsants:
Gingival Enlargement due to Dilantin:

Symptoms can occur within a few ______ or a few _______.

Affected areas in order of severity:
Maxillary Anterior Facial
Mandibular Anterior Facial
Maxillary Posterior
Mandibular Posterior

The better the oral hygiene, the less likely enlargement is to occur.

Back 15

weeks or years.

Front 16

Anticonvulsants:
Management of Gingival Hyperplasia:

-Alter Drug-Change Drug- Gabapentin (Neurontin).
-Discontinue the drug-Enlargement will decrease over ______.
-Surgical intervention should be considered after _____ months discontinuation of the drug.
-Improve oral hygiene- better restoration and home care
-Gingivectomy- _____% require surgery again & again.

Back 16

1 Year, 18, 30%

Front 17

Anticonvulsants:
Management of patient taking Phenytoin (Dilantin):

-If patient has nausea, avoid drugs that are gastric irritants.
-Monitor _____ ______.
-Provide extensive oral hygiene instruction.
-Schedule frequent _______.

Back 17

Gingival Enlargement, Prophylaxis

Front 18

Anticonvulsants:
Emergency treatment of Epileptic patient:

-Detailed medical history
-Does the patient have an aura before the seizure?

In Tonic/Clonic seizure episodes:
Move patient to the _____.
Tilt head to the side to prevent aspiration.
Remove objects from the mouth _______ the seizure.
Do not use a ______ ______.

Back 18

Floor, Before, Tongue Blade

Front 19

Allergic Reactions-Histamines:

Histamines are stored in ______ _____.
When an allergic reaction occurs, the Mast Cell degranulats and histamine is released.

Back 19

Mast Cells

Front 20

Histamines: H1:

H1-agonists effects:
1.
2.
3.
4.
5.

Back 20

1. Vasodilation
2. Increased capillary permeability
3. Bronchoconstricion
4. Pain
5. Itch

Front 21

Histamines: H2:

H2-Agonist Effect:

1.

Back 21

1. Increased Gastric Acid Secretion

Front 22

Allergic RXN: Release of Histamine: Anaphylaxis:

1. Bronchoconstricion- difficult to _____.
2. Convulsion
3. _______ Blood Pressure
4. Lapse of Consciousness
5. Shock
6. Cardiovascular Collapse

Back 22

breathe, decrease

Front 23

Antihistamines (H1-Receptor Antagonist)

Used for mild allergic reactions
Produce Anticholinergic effect of ______.
Additive with ______ depressants.

Back 23

Xerostomia, CNS

Front 24

Antihistamines:

1.
2.
3.
4.

Back 24

1. Benadryl
2. Chlor-Trimeton
3. Phenergan
4. Claritin

Front 25

H1- Receptor Antagonist & Blockers:
-_______ capillary permeability
-_______ swelling
-Counteract Bronchoconstricion
-Suppress itch & pain
-Anticholinergic effect of "drying up"
-CNS depression

Back 25

decrease, decrease

Front 26

Uses of Antihistamines:

1.
2.
3.
4.
5.

Back 26

1. Local Anesthetic
2. Allergic Reactions
3. Prevent motion sickness
4. Preoperative Sedation
5. OTC sleeping pills

Front 27

Uses of Histamines:
-Sominex, Nytol- _______
-Sinutab, Tolerance can develop-reverse______.
Dramamine-________

Back 27

OTC Sleeping Pills, Allergic Reactions, Prevent Motion Sickness

Front 28

Cardiovascular Contraindications to Dental Treatment:

DO NOT TREAT!

-Acute or recent myocardial infarction (heart attack) within the preceding _____-_____ months.

-Unstable or recent onset of angina pectoris.

-Uncontrolled congestive heart failure.

-Uncontrolled Arrhythmias

-Significant, uncontrolled hypertension.

Back 28

3-6 Months,

Front 29

Cardiovascular Considerations:

Limit the dose to ____ carpules of anesthetic with epinephrine. 1:100,000.

The amount of epinephrine must be weighed against the fact that poor pain management can produce the release of endogenous epinephrine.

Back 29

2

Front 30

Cardiovascular Considerations:

Use _____ rate of injection
Aspirate

A "Fright or Flight" reaction related to the patient's anxiety also results in the release of endogenous epinephrine.

Back 30

Slow

Front 31

Cardiovascular Considerations:

Is premedication needed?

Pacemaker- _______

Periodontal disease

Back 31

Cavitron

Front 32

Congestive Heart Failure: Cardiac Glycosides:

The heart pumps blood to meet the ______ needs of the tissue.

If the heart muscle is failing, the heart enlarges to produce more pumping

In congestive Heat Failure, one or both sides of the heart fails.

Back 32

oxygen

Front 33

Congestive Heart Failure:

Left Side Failure: (Usually fails 1st)
Blood backs up into the _____
The patient should be semireclined

Right Side Failure:
_______ _____, feet & legs swell.

Back 33

Lungs, Peripheral edema

Front 34

Congestive Heart Failure, Digoxin:

Pharmacological Effect:;
_____ the force and strength of contraction.
Reduces edema, as the blood begins to pump, it is filtered through the kidneys.
Size of the heart is ______.

Back 34

Increases, reduced

Front 35

Congestive Heart Failure:
Digoxin:

Adverse Reactions:
1.
2.
3.
4.

Back 35

1. Gastrointestinal
2. Arrhythmias
3. Neurologic
4. Oral

Front 36

Congestive Heart Failure:
Digoxin:

Adverse Reactions:

Anorexia, Nausea, Vomiting- ________.

Heart beat unstable- ______.

Neurologic- headache, drowsiness, visual ( ______ & ______ )

-Oral- ______ salvation

Back 36

Gastrointestinal, Arrhythmias, Green & Yellow, Increased

Front 37

Congestive Heart Failure:
Digoxin:

-Management of the Dental Patient taking Digoxin:

1. Watch for overdose side effects (nausea, vision, change, copious saliva)

2. Use Epinephrine with caution

3. Monitor plus to check for _______.

4. _______ & _______ can increase Digoxin levels.

Back 37

Bradycardia, Tetracycline & Erythromycin

Front 38

Antiarrhythmic Agents:

The rhythm of the cardiac muscles are _______.

The SA node directs all the cells in the heart.

The SA node is innervated by the ________ & _________ _______ system.

Back 38

Automatic; Parasympathetic & Sympathetic Nervous System

Front 39

Antiarrhythemic Agents:

The SA node- AV node- Purkinje Fibers.

If some part of this system is damaged, the action potential cannot flow through this order. The antiarrythmic drugs work by depressing parts of the heart that are beating _______.

Back 39

Abnormally

Front 40

Antiarrhythmic Drugs:

1.
2.
3.

Check for abnormal or extra beats when taking the patients blood pressure and pulse.

Back 40

1. Calcium Channel Blockers
2. Quinidine (Na Channel Blocker)
3. Beta Blockers "olol" (Nonspecific)

Front 41

Antianginal Drugs:

-Angina Pectoris:

Characterized by pain or discomfort in the chest radiating to the ______ arm and shoulder, neck, back and lower jaw.

Occurs when the arteries do not provide enough oxygen.

It can be precipitated by _______ induced by physical exercise or emotional states.

Back 41

left, stress

Front 42

Antianginal Drugs:

1.
2.
3.

Back 42

1.Nitroglycerin- Like compounds
2. Calcium Channel Blockers (Verapamil)
3.Beta-Adrenergic Blocking Agents ("olol"

Front 43

Antianginal Drugs:
1. Nitroglycerin- like compounds
-Mechanism: ________.

Administered: ______ or as a ______.

Adverse Reactions- Severe headaches, flushing, hypotension, lightheadedness, syncope.

Tab can cause a burn under the tongue.

Back 43

Vasodilates, Sublingually or as a spray

Front 44

Antianginal- Nitroglycerin-like:

Storage: _____ _____ container.
Tightly closed.
No _____, it can be absorbed into the ______.
Not refrigerated due to condensation.
If opened, write down the date, throw away after the expiration date printed on the bottle (3-6 Months)

Back 44

Brown Glass, plastic, plastic,

Front 45

Dental Management: Antianginal Nitroglycerin:

Administered 1 tablet followed by another in _____ minutes up to _____tablets.

If the pain does not subside, consider that this is a myocardial infarction. (heart attack)

Back 45

5, 3

Front 46

Management of patient taking Nitroglycerin:

-Make sure the patient brought the Nitroglycerin to the appointment.
-____ ____ before using.
-Provide analgesic for headache
-Watch for syncope
-Consider premed with the Nitroglycerin or Benzodiazepine or Nitrous Oxide
-Store correctly-no heat, moisture
-watch expiration date
-Go over the emergency plan.

Back 46

Sit down

Front 47

PDE5- Phosphodiesterase ( _____, _____ )
* Causes low blood pressure

If patient has taken PDE5 within 24 hour period.
No _________.
Call 911-Severe low blood pressure

Back 47

Viagra, Clalis, Nitroglycerin

Front 48

Antihypertensive Drugs:-Most common cardiovascular disease:
Blood pressure greater than ____/____
The most common symptom: ______
High blood pressure occurs without regard to _____ or ______.
High blood pressure causes damage to the organs: kidneys, brain, retina.

Back 48

140/90, nothing "Silent Killer", stress or tension

Front 49

Hypertension:
Untreated hypertensive patients are more likely to have kidney and heart disease and _______ problems

Back 49

Cardiovascular Problems

Front 50

The Big 5 Antihypertensive Drugs:
1.
2.
3.
4.
5.

Back 50

1. Diuretics
2. Beta Blockers
3. Calcium Channel Blockers
4. Angiotensin- Converting Enzyme (ACE) Inhibitors
5. Alpha Blockers

Front 51

Antihypertensive Drugs: Diuretics:

_______ ________- Hydrocholorothiazide (HCTZ)

Mechanism of Action: inhibit reabsorption of sodium.

Adverse Reaction:
Hypokalemia, Hyperuricemia, xerostomia, watch NASAIDS

Watch epinephrine-cardiac dose

Back 51

Thiazide Diuretics

Front 52

Antihypertensive Drugs: Diuretics:
_____ _____-Furosemide (Lasix)

Potassium-Sparing Diuretics- Spironolactone

K+ invlolved in nerve impulses, contractions of smooth muscle, normal renal function.-not as much as delpletion

Back 52

Loop Diuretics

Front 53

Antihypertensive-Beta-Adrenergic Blockers: "olol"

Side effects:
Bradycardia, mental depression, decreased sexual ability

Can produce ________

Back 53

Xerostomia

Front 54

Antihypertensive Drugs: Beta Adrenergic Blockers:

Non selective Beta Blockers can have a drug interaction with _______.

After injection, the blood pressure goes higher.
The Vagus nerve is triggered= blood pressure drops.
-Reflex Bradycardia

Back 54

Epinephrine

Front 55

Beta Blockers + Epinephrine

The amount of caution required depends upon the patient's underlying cardiovascular disease, blood pressure and the dose of the Beta Blocker given.

________+ ________= increased blood pressure hypertension

Back 55

Propanolol + epinephrine

Front 56

Beta Blocker + Epinephrine:

Limit epinephrine to the cardiac dose
Monitor blood pressure
No gingival retraction cord containing epinephrine
No __: ______ anesthetic

Back 56

1:50,000

Front 57

Antihypertensive Drugs: Calcium Channel Blockers:

Verapamil
Nifedipine- Procardia, Adalat

Adverse Oral Manifestations:
_______, gingival enlargement

Back 57

Xerostomia

Front 58

Antihypertensive Drugs: Calcium Channel Blockers:Nifedipine:

Gingival Enlargement begins 1-several months after beginning therapy.
Begins as a nodular, firm tissue that bleeds upon probing
Begins in the anterior labial papillae and can include lingual and palatal papillae
-Oral hygiene instruction: ______ ______, reduce the plaque.
After Nifedipine is discontinued, the enlargement reverts to normal.
If drug therapy can not be discontinued, gingivectomy or gingivoplasty may be required.

Back 58

frequent recall

Front 59

Antihypertensive Drugs: Angiotensin-Converting: ACE Inhibitors: Adverse Reactions:
-Hypotension
-Allergic reactions-angioedema, rash
- __________
-______ ______
Diabetic neuropathy
-________-altered taste (reported w/ captopril)

Back 59

Neutropenia, Dry Cough, Dysgeusia

Front 60

Management of the dental patient taking Antihypertensives:

Check for _________
If on Nifedipine, check for gingival enlargement.
Check blood pressure at each appointment.
Avoid Opioids- additive side effect sedation and constipation.
If on diuretics, check for hypokalemia.
If on ACE inhibitors, check for neutropenia
Hypotension-______ _____ _______.

Back 60

Xerostomia, raise chair slowly

Front 61

Antihyperlipidemic Drugs:
Elevations of plasma lipid concentrations

-VLDL
-____(bad Cholesterol)
-____(good Cholesterol), they carry the cholesterol away.

1st treatment is exercise and decreasing saturated fats

Back 61

LDL, HDL

Front 62

Antihyperlipidemic Drugs: HMG-CoA Reductase Inhibitiors:

Lovastatin, Lipitor, Zocor
Adverse: Gastrointestinal, constipation, gas, blurred vision
Dental Complications & Considerations: Patients who take antihyperlipidemic agents have a highers risk of _______ as are at an increased risk for cardiovascular emergencies.

Back 62

arteriosclerosis

Front 63

Antihyperlipidemic Drugs:
Be prepared for _______-Always expect one.

Know the blood pressure and the pulse rate.

Back 63

Emergencies

Front 64

Anticoagulants:
Warfarin (Coumadin)
Heparin:
Components of Coagulatoin:
Thromboplasm, factors V,VII & X, calcium ions from prothrombin, thrombin, fibrinogen and fibrin.
Many of these factors are formed in the ______.

Anticoagulants-IV Hospital

Back 64

Liver

Front 65

Anticoagulants:
_______ -(clots that break off and lodge in smaller vessels or major organs)

Anticoagulants attempt to prevent intravascular clotting so that emboli are not formed.

Back 65

Emboli

Front 66

Anticoagulant Drugs: Warfarin:
Monitoring:
International Normalized Ration (INR)
The INR number that we want is between _____ & ______.

Prothrombin time (PT) is not used as much now.

Back 66

2 & 3

Front 67

Anticoagulants: Warfarin:

Adverse Reactions:
Aspirin-
Alters Clotting, Irritates the gastrointestinal tract which can cause more _______.

Antibiotics-
-Can potentiate the effects of Warfarin
-Antibiotics affect the bacteria in the intestines that synthesize Vitamin _____.
-_______ has no effect upon the blood thinner.

-Alcohol inhibits the metabolism of Warfarin

Back 67

Bleeding, K, Clindamycin

Front 68

Management of the Patient Taking Warfarin (Coumadin):
-Obtain a PT or INR time
-If the PT or INR is greater than a 2x normal, check with physician
-Check with MD regarding stop and start time
-Avoid _______.
-Acetaminophen and Opioids are ok
-Use local pressure if there is oozing following subgingival curretage.
-Prophylactic antibiotics my be required after _______.
-Monitor healing.

Back 68

Aspirin, Surgery

Front 69

Psychotherapeutic Drugs: Psychoses:
1.
2.
3.
4.
5.
6.

Back 69

1. Auditory Hallucinations
2. Delusions
3. Unwanted Thoughts
4. Disorganized Behavior
5. Agitation
6. Distorted Speech

Front 70

Psychotherapeutic Drugs: Schizophrenia: The Most common type of Psychosis:

1.
2.
3.

Back 70

1. Loss of Reality
2. Delusions of Paranoia
3. Auditory Hallucination

Front 71

Psychotherapeutic Drugs: Affective Disorder:

1.
2.

Back 71

1. Unipolar Depression
2. Bipolar Depression

Front 72

Psychotherapeutic Drugs: Affective Disorder:

Exhibit only Depression: ______
Exhibit both Depression & Manic Phases: _______

Back 72

Unipolar, Bipolar

Front 73

Psychotherapeutic Drugs: Neuroses (Phobias): Obsessive Compulsives:

1.
2.
3.
4.
5.

Back 73

1. Anxiety Disorder
2. Panic Disorder
3. Personality Disorder
4. Managed with Antidepressants and/or Antipsychotic
5. Anxiety, possibly Benzodiazepines

Front 74

Psychotherapeutic Drugs: Neuroses (Phobias):

Personality Disorder: _______, ______, ______

Back 74

Sexual, Alcoholism, Drug

Front 75

Psychotherapeutic Drugs: Precautions when treating patients with mental disorders:

1.
2.
3.

Back 75

1. Watch Your Speech
2. Compliance
3. Suicide

Front 76

Psychotherapeutic Drugs: Precautions when treating patients with mental disorders:

Watch your speech: they may be perceived as _______.

Compliance: These patients don't take their _______.

Suicide: Watch the quantity of drug prescribed. : Never exceed the amount that could be used to commit suicide

Back 76

Threatening, Medicine

Front 77

Psychotherapeutic Drugs: Depression:

When a patient is severely depressed, they have no motivation.

When they start to take _______, the improvement causes them to consider suicide.

Back 77

Antidepressants

Front 78

Antipsychotic Drugs: Phenothiazines:

Chlorpromazine (______)
Prochlorperazine (______)

Dopamine Antagonist

Back 78

Thorazine, Compazine

Front 79

Antipsychotic Drugs: Phenothiazines: Pharmacologic Effects:

1.
2.
3.

Back 79

1. Antipsychotic Effect
2. Antiemetic Effect
3. CNS Depression

Front 80

Antipsychotic Drugs: Phenothiazines: Pharmacologic Effects:

Calm emotions with suppression of hallucinations and delusions. -Slow psychomoter activity-_______ Effect

Treat nausea & vomiting-_____ Effect

CNS Depression-Additive with Anticoagulants

Back 80

Antipsychotic, Antiemetic

Front 81

Atypical Antipsychotic Drugs:

Risperidone (Risperdal)
Olanzapine (Zyprexa)

Have action at more than one receptor site _______,_______,_______

Fewer side effects amplify

Back 81

Dopamine, Serotonin, Norepinephrine

Front 82

Adverse effects of Antipsychotics:
1.
2.
3.
4.
5.
6.

Back 82

1. Sedation
2. Extrapyramidal
3. Tardive Dyskinesia
4. Orthostatic Hypotension
5. Seizure
6. Anticholinergic Effects

Front 83

Adverse Effects of Antipsychotics:

-______- Tolerance develops to the sedative effect but not to the antipsychotic effect.

-______- Muscle spasm of the face, neck, tongue, and back
Parkinsonian tremor, rigidity. Intermittent pain in TMJ area.

-_______- movement of tongue, lips/face.

Back 83

Sedation, Extrapyramidal, Tardive Dyskinesia

Front 84

Adverse Effects of Antipsychotics:

-______- raise the chair slowly

-_______- blurred vision, xerostomia, constipation

Back 84

Orthostatic Hypertension, Anticholinergic Effects

Front 85

Adverse Effects of Antipsychotics:

Treatment of Acute Mandibular Spasm:
*Do not force the patients mouth open.
*The patient may not be able to open or close the mouth

Treatment:
*____ the dose of medication
*Add an anticholinergic to counteract the spasm (Cogentin, Artane)

Back 85

Lower

Front 86

Drug Interaction of Antipsychotics:
1.
2.
3.

Back 86

1.Central Nervous System
2.Epinephrine
3.Anticholingeric (Atropine)

Front 87

Do not use Epinephrine in ______ ______ ______, it will lower their blood pressure even more.

Back 87

acute hypotensive crisis

Front 88

Dental Implications of Antipsychotics:

1.
2.
3.
4.
5.
6.

Back 88

1. Sedation
2. Orthostatic Hypotension
3. Anticholinergic Effects-(Xerostomia)
4. TMJ Pain
5. Tardive Dyskinesia
6. CNS Depression

Front 89

Management of Dental patient taking Antipsychotic Drugs:

-Use caution with patient interaction, they may misinterpret.
-Xerostomia
-Good Oral hygiene
-Check TMJ
-Raise patient slowly in chair
-______may be difficult
-Its okay to administer anesthetic with epinephrine, but do not sure in emergency situations

Back 89

Compliance

Front 90

Antidepressant Tricyclics:

1.
2.

Back 90

1. Amitriptyline
2. Trazdone

Front 91

Antidepressant Drugs: Tricyclics:
Pharmacological Effect:

Feeling of well-being, elevated mood, increased ability to concentrate, improvement in ______.

Overdose: Myocardial Infarct, Congestive heart failure

Back 91

Sleep

Front 92

Adverse Effects of Tricyclic Antidepressants:

Additive with other CNS depressants
Anticholinergic: Xerostomia, Tachycardia, Blurred Vision, Constipation, Urinary Retention

Dental Implications:
1.
2.

Back 92

Xerostomia
No Epinephrine

Front 93

Antidepressant Drugs:
MAOI's: Monamine Oxidase Inhibitors
Interact with may drugs and food -______, ______,______
Drug of "Last Resort"

Back 93

cheese, wine, fish

Front 94

Bipolar Drug-Lithium:

Watch for signs of toxicity: Muscle rigidity, tremor, Salt intake and sweating can influence Lithium.

Additive with other CNS Drugs

_______or ______ ______

Back 94

Xerostomia or excess salivation