BOOK
Pharmacology and Therapeutics for Dentistry - E-Book
John A. Yagiela | Frank J. Dowd | Bart Johnson | Angelo Mariotti | Enid A. Neidle
(2010)
Additional Information
Book Details
Abstract
Use your knowledge of pharmacology to enhance oral care! Pharmacology and Therapeutics for Dentistry, 6th Edition describes how to evaluate a patient’s health and optimize dental treatment by factoring in the drugs they take. It explores the basic fundamentals of pharmacology, special topics such as pain control, fear and anxiety, and oral complications of cancer therapy, and most importantly, the actions of specific drug groups on the human body. Whether you’re concerned about the drugs a patient is already taking or the drugs you prescribe for treatment, this book helps you reduce risk and provide effective dental care.
- An emphasis on the dental applications of pharmacology relates drugs to dental considerations in clinical practice.
- Dental aspects of many drug classes are expanded to include antibiotics, analgesics, and anesthetics.
- The Alternative Medicine in Dentistry chapter discusses chemicals used as alternative medicines and assesses their potential benefits and risks.
- The Nonopioid Analgesics chapter groups together non-opioid analgesics, nonsterioidal anti-inflammatory drugs, and antirheumatic and antigout drugs, making these easier to locate and study.
- Coverage of the endocrine system includes four separate chapters for the most comprehensive coverage.
- Drug Interactions in Clinical Dentistry appendix lists potential interactions between drugs a patient is taking for nondental conditions and drugs that may be used or prescribed during dental treatment, including effects and recommendations.
- Glossary of Abbreviations appendix includes the most common abbreviations used for drugs or conditions.
- New Pharmacogenetics and Pharmacogenomics chapter covers the effects of genetic traits of patients on their responses to drugs.
- A NEW introductory section offers tips for the study of dental pharmacology and relates pharmacology to dental considerations.
- An updated discussion of drug-drug interactions covers the harmful effects of mixing medications.
- Coverage of adverse effects and mechanisms of COX-2 inhibitors, antibiotic prophylaxis, and antiplaque agents explains the dental risks relating to common drug treatments.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | cover | ||
| Half title page | i | ||
| Pharmacology and Theraputics for Dentistry | iii | ||
| Copyright page | iv | ||
| Contributors | v | ||
| Preface | vii | ||
| HOW TO APPROACH PHARMACOLOGY | vii | ||
| SUFFIXES AS CUES FOR REMEMBERING DRUG CLASSES | vii | ||
| ACKNOWLEDGMENTS | viii | ||
| Table of Contents | ix | ||
| Introduction | xi | ||
| HISTORY | xi | ||
| SCOPE OF PHARMACOLOGY | xi | ||
| I Principles of Pharmacology | 1 | ||
| 1 Pharmacodynamics: Mechanisms of Drug Action | 2 | ||
| DRUG-RECEPTOR INTERACTIONS | 2 | ||
| Receptor Classification | 2 | ||
| Ion channel–linked receptors | 2 | ||
| G protein–linked receptors | 3 | ||
| Enzyme-linked receptors | 4 | ||
| Intracellular receptors | 4 | ||
| Drug-Binding Forces | 5 | ||
| Covalent bonds | 5 | ||
| Ionic bonds | 5 | ||
| Cation-π interactions | 5 | ||
| Hydrogen bonds | 5 | ||
| Van der Waals forces | 6 | ||
| Hydrophobic interactions | 6 | ||
| Cooperation of binding forces | 6 | ||
| Structure-Activity Relationships | 6 | ||
| Consequences of Drug Binding | 7 | ||
| Ligand competition | 7 | ||
| Conformational induction | 7 | ||
| Conformational selection | 8 | ||
| Subsequent events | 8 | ||
| DOSE-RESPONSE RELATIONSHIPS | 8 | ||
| Occupation Theory | 8 | ||
| Agonists | 9 | ||
| Antagonists | 10 | ||
| Limitations of occupation theory | 10 | ||
| Stimulus-Response Coupling | 11 | ||
| Receptor Diversity | 13 | ||
| Receptors with Multiple Ligand-Binding Sites | 13 | ||
| Pharmacodynamic Tolerance | 13 | ||
| MULTISTATE MODEL OF DRUG ACTION | 13 | ||
| RECEPTOR-INDEPENDENT DRUG ACTIONS | 15 | ||
| Chemically Reactive Agents | 15 | ||
| Physically Active Agents | 15 | ||
| Counterfeit Biochemical Constituents | 16 | ||
| CITED REFERENCES | 16 | ||
| GENERAL REFERENCES | 16 | ||
| 2 Pharmacokinetics: | 17 | ||
| PASSAGE OF DRUGS ACROSS MEMBRANES | 17 | ||
| Passive Diffusion | 17 | ||
| Simple diffusion | 17 | ||
| Facilitated diffusion | 19 | ||
| Active Transport | 19 | ||
| Endocytosis and Exocytosis | 20 | ||
| ABSORPTION | 21 | ||
| Oral Ingestion | 21 | ||
| Influence of pH | 21 | ||
| Mucosal surface area | 22 | ||
| Gastric emptying | 22 | ||
| Influence of dosage form | 22 | ||
| Active transport | 23 | ||
| Drug inactivation | 23 | ||
| Other enteral routes | 24 | ||
| Inhalation | 24 | ||
| Parenteral Injection | 24 | ||
| Intravenous route | 24 | ||
| Intramuscular route | 25 | ||
| Subcutaneous route | 25 | ||
| Other parenteral injection routes | 25 | ||
| Topical Application | 25 | ||
| Skin | 25 | ||
| Mucous membranes | 26 | ||
| Iontophoresis | 26 | ||
| DISTRIBUTION | 26 | ||
| Capillary Penetration | 26 | ||
| Entry of Drugs into Cells | 26 | ||
| Restricted Distribution | 27 | ||
| Central nervous system | 27 | ||
| Placental transfer | 27 | ||
| Volume of Distribution | 28 | ||
| Drug Binding and Storage | 28 | ||
| Plasma protein binding | 29 | ||
| Tissue binding | 29 | ||
| Storage | 30 | ||
| Redistribution | 30 | ||
| Saliva | 30 | ||
| METABOLISM | 31 | ||
| Hepatic Microsomal Metabolism | 31 | ||
| Oxidation | 31 | ||
| Reduction | 33 | ||
| Hydrolysis | 33 | ||
| Dehalogenation | 33 | ||
| Glucuronide conjugation | 34 | ||
| Nonmicrosomal Metabolism | 34 | ||
| Oxidation | 34 | ||
| Reduction | 34 | ||
| Hydrolysis | 34 | ||
| Conjugation reactions | 36 | ||
| Nonhepatic Metabolism | 36 | ||
| Factors Affecting Drug Metabolism | 37 | ||
| Entry into the liver | 37 | ||
| Enzyme inhibition | 38 | ||
| Enzyme induction | 38 | ||
| Transporter inhibition and induction | 39 | ||
| Genetic factors | 39 | ||
| Age | 39 | ||
| Pathology | 39 | ||
| EXCRETION | 39 | ||
| Renal Excretion | 40 | ||
| Glomerular filtration | 40 | ||
| Tubular reabsorption | 40 | ||
| Active secretion | 40 | ||
| Clearance | 40 | ||
| Biliary Excretion | 40 | ||
| Other Routes of Excretion | 41 | ||
| TIME COURSE OF DRUG ACTION | 41 | ||
| Kinetics of Absorption and Elimination | 41 | ||
| Zero-order kinetics | 41 | ||
| First-order kinetics | 41 | ||
| Capacity-limited reactions | 41 | ||
| Single-Compartment Model | 41 | ||
| Plasma concentration—single doses | 43 | ||
| Plasma concentration—repeated doses | 43 | ||
| Multiple-Compartment Models | 44 | ||
| Context-Sensitive Half-Lives | 44 | ||
| PHARMACOKINETIC-PHARMACODYNAMIC MODELING | 46 | ||
| CITED REFERENCES | 46 | ||
| GENERAL REFERENCES | 47 | ||
| 3 Pharmacotherapeutics: | 48 | ||
| FACTORS INFLUENCING DRUG EFFECTS | 48 | ||
| Patient Factors | 49 | ||
| Body weight and composition | 49 | ||
| Age | 49 | ||
| Sex, pregnancy, and lactation | 50 | ||
| Environmental factors | 50 | ||
| Physiologic variables | 50 | ||
| Pathologic factors | 50 | ||
| Genetic influences | 52 | ||
| Drug Factors | 52 | ||
| Variables in drug administration | 52 | ||
| Drug tolerance and sensitization | 52 | ||
| Factors Associated with the Therapeutic Regimen | 53 | ||
| Placebo effects | 53 | ||
| Medication errors and patient noncompliance | 54 | ||
| Drug interactions | 54 | ||
| ADVERSE DRUG REACTIONS | 54 | ||
| Classification of Adverse Drug Reactions | 54 | ||
| Extension effects | 54 | ||
| Side effects | 55 | ||
| Idiosyncratic reactions | 55 | ||
| Drug allergy | 56 | ||
| Pseudoallergic and secondary reactions | 58 | ||
| Carcinogenesis | 58 | ||
| Special Problems | 58 | ||
| Drug abuse | 59 | ||
| Drug poisoning | 59 | ||
| Drugs and pregnancy | 59 | ||
| DEVELOPMENT OF NEW DRUGS | 61 | ||
| Sources of New Drugs | 61 | ||
| Evaluation of New Drugs | 61 | ||
| Preclinical testing | 61 | ||
| Clinical trials | 64 | ||
| Drug approval and continued surveillance | 64 | ||
| Impact of FDA regulations on the development of new drugs | 64 | ||
| Drug Nomenclature | 65 | ||
| SOURCES OF DRUG INFORMATION | 65 | ||
| Official Compendia | 65 | ||
| Unofficial Compendia | 66 | ||
| Books on Pharmacology and Therapeutics | 66 | ||
| Periodicals | 66 | ||
| Dental Sources of Information | 67 | ||
| Electronic Media | 67 | ||
| CITED REFERENCES | 67 | ||
| GENERAL REFERENCES | 68 | ||
| 4 Pharmacogenetics and Pharmacogenomics | 69 | ||
| PHARMACOKINETICS AND PHARMACODYNAMICS | 70 | ||
| PHENOTYPE AND GENOTYPE | 70 | ||
| MONOGENIC VERSUS POLYGENIC PHENOTYPES | 71 | ||
| ETHNIC DIFFERENCES IN PHARMACOGENETICS | 72 | ||
| PHARMACOGENETICS OF DRUG METABOLISM | 72 | ||
| Acetylation Polymorphisms | 72 | ||
| Oxidation Polymorphisms | 72 | ||
| Plasma Cholinesterase Polymorphisms | 73 | ||
| Thiopurine S-Methyltransferase Polymorphism | 73 | ||
| Dihydropyrimidine Dehydrogenase Polymorphism | 73 | ||
| Uridine Diphosphate Glucuronosyltransferase Polymorphism | 73 | ||
| Drug Transporter Polymorphisms | 73 | ||
| PHARMACOGENETIC POLYMORPHISMS IN DRUG TARGETS | 73 | ||
| Malignant Hyperthermia | 73 | ||
| β-Adrenergic Receptor Polymorphisms | 74 | ||
| Dopamine and Other Receptor Polymorphisms | 74 | ||
| Miscellaneous Drug Targets | 74 | ||
| IMPLICATIONS FOR DENTISTRY | 74 | ||
| CITED REFERENCES | 74 | ||
| GENERAL REFERENCES | 76 | ||
| II Pharmacology of Specific Drug Groups | 77 | ||
| 5 Introduction to Autonomic Nervous System Drugs | 78 | ||
| AUTONOMIC NERVOUS SYSTEM | 78 | ||
| Anatomy | 78 | ||
| Sympathetic nervous system | 78 | ||
| Parasympathetic nervous system | 78 | ||
| Functional Characteristics | 79 | ||
| NEUROTRANSMITTERS | 80 | ||
| Location of Adrenergic and Cholinergic Junctions | 82 | ||
| Mechanism of Neurotransmitter Release | 82 | ||
| ADRENERGIC NEUROTRANSMISSION | 82 | ||
| Catecholamine Synthesis | 82 | ||
| Catecholamine Release | 82 | ||
| Adrenergic Receptors | 83 | ||
| Catecholamine Fate | 85 | ||
| CHOLINERGIC TRANSMISSION | 85 | ||
| Synthesis, Release, and Fate of Acetylcholine | 85 | ||
| Cholinergic Receptors | 85 | ||
| SIGNAL TRANSDUCTION AND SECOND MESSENGERS | 86 | ||
| Ion Channel–Linked Receptors | 86 | ||
| G protein–linked receptors | 86 | ||
| Gs protein–dependent events | 86 | ||
| Gi protein–dependent events | 86 | ||
| Gq protein–dependent events | 87 | ||
| Additional second messenger systems | 87 | ||
| DOPAMINERGIC TRANSMISSION | 87 | ||
| PURINERGIC TRANSMISSION | 88 | ||
| PEPTIDE TRANSMISSION AND CO-RELEASE OF NEUROTRANSMITTERS | 88 | ||
| CENTRAL CONTROL OF AUTONOMIC FUNCTION | 89 | ||
| SPECIFIC SITES AND MECHANISMS OF ACTION OF AUTONOMIC DRUGS | 89 | ||
| CITED REFERENCES | 89 | ||
| GENERAL REFERENCES | 90 | ||
| 6 Adrenergic Agonists | 91 | ||
| HISTORY | 91 | ||
| CLASSIFICATION OF ADRENERGIC DRUGS AND RECEPTORS | 91 | ||
| CHEMISTRY AND STRUCTURE-ACTIVITY RELATIONSHIPS | 91 | ||
| PHARMACOLOGIC EFFECTS | 93 | ||
| Endogenous Catecholamines: Norepinephrine and Epinephrine | 93 | ||
| Vascular effects | 93 | ||
| Cardiac effects | 94 | ||
| Effects on nonvascular smooth muscle | 94 | ||
| Effects on salivary glands | 95 | ||
| Metabolic responses | 95 | ||
| Central nervous system effects | 95 | ||
| Dopamine | 95 | ||
| Cardiovascular effects | 95 | ||
| Other effects | 95 | ||
| α-Adrenergic Receptor Agonists | 96 | ||
| β-Adrenergic Receptor Agonists: Isoproterenol | 97 | ||
| Cardiac and vascular effects | 97 | ||
| Effects on bronchial smooth muscle | 97 | ||
| Metabolic and other effects | 97 | ||
| Dobutamine | 97 | ||
| Selective β2-Adrenergic Receptor Agonists | 97 | ||
| Mixed-Acting and Indirect-Acting Adrenergic Agonists | 97 | ||
| ABSORPTION, FATE, AND EXCRETION | 98 | ||
| GENERAL THERAPEUTIC USES | 99 | ||
| Local Vasoconstriction | 99 | ||
| Treatment of Hypotension and Shock | 99 | ||
| Bronchodilation | 100 | ||
| Uterine Relaxation | 100 | ||
| Ophthalmic Uses | 100 | ||
| Treatment of Allergic States | 100 | ||
| Central Nervous System Stimulation | 100 | ||
| Treatment of Hypertension | 101 | ||
| THERAPEUTIC USES IN DENTISTRY | 101 | ||
| ADVERSE EFFECTS | 103 | ||
| CITED REFERENCES | 104 | ||
| GENERAL REFERENCES | 105 | ||
| 7 Adrenergic Antagonists | 106 | ||
| HISTORY | 106 | ||
| SELECTIVE α1-ADRENERGIC RECEPTOR ANTAGONISTS | 106 | ||
| Prazosin and Analogues | 107 | ||
| Absorption, fate, and excretion | 107 | ||
| Therapeutic uses | 107 | ||
| Adverse effects | 107 | ||
| Alfuzosin | 108 | ||
| Tamsulosin | 108 | ||
| NONSELECTIVE α-ADRENERGIC RECEPTOR ANTAGONISTS | 108 | ||
| Imidazolines | 108 | ||
| β-Haloalkylamines | 108 | ||
| β-ADRENERGIC RECEPTOR ANTAGONISTS | 109 | ||
| Chemistry | 109 | ||
| Pharmacologic Effects | 109 | ||
| Effects on the cardiovascular system | 111 | ||
| Effects on smooth muscle | 111 | ||
| Gastrointestinal tract effects | 111 | ||
| Metabolic effects | 111 | ||
| Ocular effects | 112 | ||
| Central nervous system effects | 112 | ||
| Absorption, Fate, and Excretion | 112 | ||
| Therapeutic Uses | 112 | ||
| Hypertension | 112 | ||
| Ischemic heart disease | 112 | ||
| Post–myocardial infarction | 112 | ||
| Congestive heart failure | 112 | ||
| Treatment of arrhythmias | 113 | ||
| Other uses | 113 | ||
| Adverse Effects | 113 | ||
| Effects on the heart | 113 | ||
| Effects on smooth muscle | 113 | ||
| Metabolic effects | 114 | ||
| Central nervous system effects | 114 | ||
| DRUGS WITH COMBINED α-ADRENERGIC AND β-ADRENERGIC RECEPTOR ANTAGONIST ACTIVITY | 114 | ||
| Labetalol | 114 | ||
| Carvedilol | 114 | ||
| DRUGS THAT REDUCE SYMPATHETIC OUTFLOW | 114 | ||
| Centrally Acting Adrenergic Agonists | 114 | ||
| Monoamine Oxidase Inhibitors | 114 | ||
| IMPLICATIONS FOR DENTISTRY | 115 | ||
| Physical Implications | 115 | ||
| Drug Interactions | 115 | ||
| CITED REFERENCES | 115 | ||
| GENERAL REFERENCES | 116 | ||
| 8 Cholinergic Drugs | 117 | ||
| CHOLINOMIMETIC AGONISTS | 117 | ||
| Chemistry and Classification | 117 | ||
| Choline esters | 117 | ||
| Natural alkaloids and congeners | 117 | ||
| Mechanism of Action | 117 | ||
| Pharmacologic Effects | 118 | ||
| Peripheral muscarinic effects | 119 | ||
| Eye. | 119 | ||
| Heart. | 119 | ||
| Vascular smooth muscle. | 119 | ||
| Bronchial smooth muscle. | 120 | ||
| Gastrointestinal smooth muscle. | 120 | ||
| Secretory glands. | 120 | ||
| Urinary tract. | 120 | ||
| Peripheral nicotinic effects | 120 | ||
| Central nervous system effects | 120 | ||
| Absorption, Fate, and Excretion | 120 | ||
| Adverse Effects | 120 | ||
| ANTICHOLINESTERASES | 121 | ||
| Chemistry and Classification | 121 | ||
| Mechanism of Action | 122 | ||
| Pharmacologic Effects | 123 | ||
| Absorption, Fate, and Excretion | 123 | ||
| Adverse Effects | 123 | ||
| GENERAL THERAPEUTIC USES | 124 | ||
| Glaucoma | 125 | ||
| Xerostomia | 125 | ||
| Reversal of Neuromuscular Block | 126 | ||
| Myasthenia Gravis | 126 | ||
| Antidote for Atropine Poisoning | 126 | ||
| Paralytic Ileus and Bladder Atony | 126 | ||
| Senile Dementias of the Alzheimer Type | 127 | ||
| Other Uses | 127 | ||
| THERAPEUTIC USES IN DENTISTRY | 127 | ||
| CITED REFERENCES | 127 | ||
| GENERAL REFERENCES | 128 | ||
| 9 Antimuscarinic Drugs | 129 | ||
| CHEMISTRY AND CLASSIFICATION | 129 | ||
| MECHANISM OF ACTION | 129 | ||
| PHARMACOLOGIC EFFECTS | 130 | ||
| Peripheral Nervous System Actions | 131 | ||
| The eye | 131 | ||
| Respiratory tract | 131 | ||
| Salivary glands | 131 | ||
| Gastrointestinal tract | 131 | ||
| Cardiovascular system | 131 | ||
| Genitourinary tract | 132 | ||
| Body temperature | 132 | ||
| Central Nervous System Effects | 132 | ||
| Medulla and higher cerebral centers | 132 | ||
| Antitremor activity | 132 | ||
| Vestibular function | 132 | ||
| ABSORPTION, FATE, AND EXCRETION | 132 | ||
| GENERAL THERAPEUTIC USES | 132 | ||
| Ophthalmology | 132 | ||
| Respiratory Tract | 132 | ||
| Salivary Secretion | 133 | ||
| Gastrointestinal Tract | 133 | ||
| Cardiovascular System | 133 | ||
| Genitourinary Tract | 133 | ||
| Preanesthetic Medication | 133 | ||
| Central Nervous System | 133 | ||
| Antidote to Anticholinesterases | 133 | ||
| Antidote to Poisoning by Mushrooms Containing Muscarine | 133 | ||
| ADVERSE EFFECTS | 134 | ||
| DRUG INTERACTIONS | 134 | ||
| BOTULINUM TOXIN | 134 | ||
| THERAPEUTIC USES IN DENTISTRY | 134 | ||
| IMPLICATIONS FOR DENTISTRY | 134 | ||
| CITED REFERENCES | 135 | ||
| GENERAL REFERENCES | 135 | ||
| 10 Drugs Affecting Nicotinic Receptors* | 136 | ||
| DRUGS AFFECTING GANGLIONIC TRANSMISSION | 136 | ||
| Ganglionic Transmission | 136 | ||
| Ganglionic Stimulating Drugs | 136 | ||
| Nicotine | 136 | ||
| Other ganglionic stimulants | 138 | ||
| Ganglionic Blockers | 138 | ||
| Classification | 138 | ||
| Pharmacologic effects | 138 | ||
| The eye. | 139 | ||
| Salivary glands. | 139 | ||
| Cardiovascular system. | 139 | ||
| Respiratory tract. | 139 | ||
| Gastrointestinal tract. | 139 | ||
| Urinary tract. | 139 | ||
| Sweat glands. | 139 | ||
| Central nervous system. | 139 | ||
| Absorption, fate, and excretion | 139 | ||
| General therapeutic uses | 139 | ||
| Adverse effects | 140 | ||
| Implications for dentistry | 140 | ||
| DRUGS AFFECTING NEUROMUSCULAR TRANSMISSION | 140 | ||
| Neuromuscular Transmission | 140 | ||
| Neuromuscular Junction Blockers | 140 | ||
| Nondepolarizing agents | 140 | ||
| Depolarizing agents | 141 | ||
| Pharmacologic effects | 142 | ||
| Neuromuscular junction. | 142 | ||
| Central nervous system. | 142 | ||
| Autonomic nervous system. | 143 | ||
| Histamine release. | 143 | ||
| Cardiovascular system. | 143 | ||
| Absorption, fate, and excretion | 143 | ||
| General therapeutic uses | 144 | ||
| Endotracheal intubation. | 144 | ||
| Surgery. | 144 | ||
| Tetanus. | 144 | ||
| Electroconvulsive therapy. | 144 | ||
| Other uses. | 144 | ||
| Adverse effects | 144 | ||
| Drug interactions | 144 | ||
| Anticholinesterases. | 144 | ||
| Sugammadex. | 145 | ||
| General anesthetics. | 145 | ||
| Antibiotics. | 145 | ||
| Sympathomimetics. | 145 | ||
| Lithium. | 145 | ||
| Neuromuscular blocking agents. | 145 | ||
| Applications in dentistry | 145 | ||
| Other Agents Affecting Neuromuscular Transmission | 146 | ||
| Diazepam | 146 | ||
| Baclofen | 146 | ||
| Tizanidine | 146 | ||
| Cyclobenzaprine | 146 | ||
| Hemicholinium | 146 | ||
| Botulinum toxin | 146 | ||
| α-Bungarotoxin | 146 | ||
| Tetrodotoxin | 146 | ||
| Dantrolene | 146 | ||
| CITED REFERENCES | 147 | ||
| GENERAL REFERENCES | 148 | ||
| 11 Introduction to Central Nervous System Drugs* | 149 | ||
| INVESTIGATION OF THE BRAIN | 149 | ||
| ANATOMIC ORGANIZATION OF THE CENTRAL NERVOUS SYSTEM | 149 | ||
| Cerebral Cortex | 150 | ||
| III Special Subjects in Pharmacology and Therapeutics | 751 | ||
| 47 Analgesic Use for Effective Pain Control* | 752 | ||
| PAIN CLASSIFICATION | 752 | ||
| PAIN ASSESSMENT | 752 | ||
| MISCONCEPTIONS REGARDING PAIN AND ANALGESICS | 753 | ||
| CHOICE OF ANALGESIC REGIMEN | 754 | ||
| Analgesic Selection | 754 | ||
| Local anesthetics | 754 | ||
| Nonopioid analgesics | 754 | ||
| Opioid analgesics | 755 | ||
| Principles of Analgesic Use | 757 | ||
| CITED REFERENCES | 757 | ||
| 48 Management of Fear and Anxiety | 759 | ||
| GENERAL PRINCIPLES | 759 | ||
| Indications for Use | 759 | ||
| Identification of Fearful or Anxious Patients | 760 | ||
| Treatment Planning | 760 | ||
| Patient Selection | 760 | ||
| PHARMACOLOGIC APPROACHES | 761 | ||
| MINIMAL AND MODERATE SEDATION | 762 | ||
| Inhalation Sedation | 763 | ||
| Advantages | 763 | ||
| Disadvantages | 763 | ||
| APPENDIXES | 877 | ||
| APPENDIX 1 Drug Interactions in Clinical Dentistry* | 877 | ||
| Classification of Drug Interactions | 877 | ||
| Antagonism | 877 | ||
| Potentiation | 878 | ||
| Unexpected drug effect | 878 | ||
| Summation | 878 | ||
| Synergism | 878 | ||
| Mechanisms of Drug Interactions | 878 | ||
| Pharmaceutical interactions | 878 | ||
| Pharmacokinetic interactions | 878 | ||
| Absorption. | 878 | ||
| Distribution. | 879 | ||
| Metabolism. | 879 | ||
| Excretion. | 879 | ||
| Pharmacodynamic interactions | 879 | ||
| Factors Influencing Drug Interactions | 879 | ||
| Drug Interactions Used in Pharmacotherapeutics | 880 | ||
| APPENDIX 2 Glossary of Abbreviations* | 885 | ||
| Index | 897 | ||
| A | 897 | ||
| B | 903 | ||
| C | 905 | ||
| D | 909 | ||
| E | 913 | ||
| F | 915 | ||
| G | 916 | ||
| H | 917 | ||
| I | 920 | ||
| J | 922 | ||
| K | 922 | ||
| L | 922 | ||
| M | 924 | ||
| N | 927 | ||
| O | 929 | ||
| P | 930 | ||
| Q | 934 | ||
| R | 934 | ||
| S | 936 | ||
| T | 938 | ||
| U | 941 | ||
| V | 941 | ||
| W | 942 | ||
| X | 942 | ||
| Y | 942 | ||
| Z | 942 |