BOOK
Pharmacology and Therapeutics for Dentistry - E-Book
Frank J. Dowd | Bart Johnson | Angelo Mariotti
(2016)
Additional Information
Book Details
Abstract
Gain a complete understanding of drugs affecting patient care! Pharmacology and Therapeutics for Dentistry, 7th Edition describes how to evaluate a patient’s health and optimize dental treatment by factoring in the drugs they take. It explores the basic principles of pharmacology, the ways that drugs affect the body, and the potential for adverse drug interactions. Developed by Frank Dowd, Barton Johnson, and Angelo Mariotti, with chapters from a team of expert contributors, this is the only book written by dental pharmacologists for the dental market. 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.
- Concise, comprehensive coverage helps you provide safe and effective dental care, exploring the fundamentals of pharmacology and clearly explaining actions of specific drug groups on systems in the human body in addition to covering special topics such as pain control, fear and anxiety, and oral complications of cancer therapy.
- An emphasis on the dental applications of pharmacology shows how to evaluate a patient’s health and optimize dental treatment by factoring in any medications the patient may be taking.
- Practical appendices provide easy access to essential information, summarizing topics such as drug interactions in clinical dentistry, antiseptics and disinfectants, herbs, controlled substances, protein biopharmaceuticals, drugs used to treat glaucoma, and abbreviations.
- Clinical Rationale for and Significance of Prescription Writing chapter and two appendices on drug prescribing cover both the medications that a patient may already be taking and drugs that a dentist may prescribe for treatment.
- Nearly 50 expert contributors represent a diverse, authoritative panel of authors from many of the major dental schools.
- NEW! Reorganized content is more concise, more relevant, and more visual, with a stronger focus on what you need to know for clinical practice.
- NEW! Case studies at the beginning of chapters and case discussions at the end help you connect pharmacologic concepts and principles with clinical practice.
- NEW summary tables and boxes provide quick reference to vital information, and include all-new tables on drug indications and mechanisms.
- NEW! Full-color design and illustrations are added to this edition, enhancing realism and visual learning.
- NEW companion website provides references linked to PubMed.
- NEW! Bullet points list key information at the beginning of each chapter, highlighting need-to-know concepts.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| IFC | ES1 | ||
| Pharmacology and Therapeutics for Dentistry | i | ||
| Pharmacology and Therapeutics for Dentistry | iii | ||
| Copyright | iv | ||
| ABOUT THE EDITORS | v | ||
| FRANK J. DOWD | v | ||
| BARTON S. JOHNSON | v | ||
| ANGELO J. MARIOTTI | v | ||
| Dedication | vii | ||
| TRIBUTES | viii | ||
| REMEMBERING JOHN A. YAGIELA, DDS, PhD, AND ENID A. NEIDLE, PhD | viii | ||
| CONTRIBUTORS | ix | ||
| PREFACE | xi | ||
| HOW TO APPROACH PHARMACOLOGY | xi | ||
| SUFFIXES AS CUES FOR REMEMBERING DRUG CLASSES | xi | ||
| ACKNOWLEDGMENTS\r | xii | ||
| INTRODUCTION | xiii | ||
| HISTORY | xiii | ||
| SCOPE OF PHARMACOLOGY | xiv | ||
| NEW TO THE 7TH EDITION | xv | ||
| CONTENTS | xvii | ||
| I - Principles of Pharmacology | 1 | ||
| 1 - Pharmacodynamics: Mechanisms of Drug Action* | 2 | ||
| CASE STUDY | 2 | ||
| DRUGS, RECEPTORS, AND SIGNAL TRANSDUCTION | 2 | ||
| Receptor Classification | 2 | ||
| Ion channel–linked receptors | 3 | ||
| G protein–coupled receptors | 4 | ||
| Transmembrane receptors that have enzymatic cytosolic function | 4 | ||
| Transmembrane receptors that bind to a separate cytosolic enzyme | 5 | ||
| Intracellular receptors | 5 | ||
| Drug-Binding Forces | 5 | ||
| Structure–Activity Relationships | 5 | ||
| Drug Size, Shape, and Isomerism | 5 | ||
| Events Following Drug Binding: Signal Transduction | 5 | ||
| Ion channel receptors | 6 | ||
| G protein–linked receptors | 6 | ||
| Transmembrane receptors that have enzymatic cytosolic activity | 8 | ||
| Transmembrane receptors that bind to a separate cytosolic enzyme | 9 | ||
| Intracellular (nuclear) receptors | 9 | ||
| CONCENTRATION–RESPONSE RELATIONSHIPS | 9 | ||
| Occupation Concept | 9 | ||
| Agonists | 10 | ||
| Indirect agonists | 11 | ||
| Antagonists | 11 | ||
| Allosteric effects | 12 | ||
| Spare receptors | 12 | ||
| Receptor Diversity | 12 | ||
| Pharmacodynamic Tolerance | 12 | ||
| Multistate Model of Drug Action | 12 | ||
| RECEPTOR-INDEPENDENT DRUG ACTIONS | 13 | ||
| Chemically Reactive Agents | 13 | ||
| Physically Active Agents | 14 | ||
| Counterfeit Biochemical Constituents | 14 | ||
| CASE DISCUSSION | 14 | ||
| GENERAL REFERENCES | 14 | ||
| 2 - Pharmacokinetics: The Absorption, Distribution, and Fate of Drugs* | 15 | ||
| CASE STUDY | 15 | ||
| PASSAGE OF DRUGS ACROSS MEMBRANES | 15 | ||
| Passive Diffusion | 15 | ||
| Simple diffusion | 15 | ||
| Active Transport | 17 | ||
| Endocytosis and Exocytosis | 18 | ||
| ABSORPTION | 18 | ||
| Oral Ingestion | 18 | ||
| Influence of pH | 19 | ||
| Mucosal surface area | 20 | ||
| Gastric emptying | 20 | ||
| Influence of dosage form | 20 | ||
| Active transport | 21 | ||
| Drug inactivation | 21 | ||
| Other enteral routes | 21 | ||
| Inhalation | 21 | ||
| Parenteral Injection | 22 | ||
| Intravenous route | 22 | ||
| Intramuscular route | 23 | ||
| Subcutaneous route | 23 | ||
| Other parenteral injection routes | 23 | ||
| Topical Application | 23 | ||
| Skin | 23 | ||
| Mucous membranes | 23 | ||
| Iontophoresis | 23 | ||
| DISTRIBUTION | 24 | ||
| Capillary Penetration | 24 | ||
| Entry of Drugs into Cells | 24 | ||
| Restricted Distribution | 24 | ||
| Central nervous system | 24 | ||
| Placental transfer | 24 | ||
| Volume of Distribution | 26 | ||
| Drug Binding and Storage | 27 | ||
| Plasma protein binding | 27 | ||
| Tissue binding | 27 | ||
| Storage | 27 | ||
| Redistribution | 27 | ||
| Saliva | 28 | ||
| METABOLISM | 29 | ||
| Hepatic Microsomal Metabolism | 29 | ||
| Oxidation | 29 | ||
| Reduction | 30 | ||
| Hydrolysis | 30 | ||
| Dehalogenation | 30 | ||
| Glucuronide conjugation | 31 | ||
| Non-Microsomal Metabolism | 31 | ||
| Oxidation | 31 | ||
| Reduction | 31 | ||
| Hydrolysis | 32 | ||
| Conjugation reactions | 32 | ||
| Non-Hepatic Metabolism | 32 | ||
| Factors Affecting Drug Metabolism | 34 | ||
| Entry into the liver | 34 | ||
| Enzyme inhibition | 36 | ||
| Enzyme induction | 36 | ||
| Transporter inhibition and induction | 36 | ||
| Genetic factors | 37 | ||
| Age | 37 | ||
| EXCRETION | 37 | ||
| Renal Excretion | 37 | ||
| Glomerular filtration | 37 | ||
| Tubular reabsorption | 37 | ||
| Active secretion | 37 | ||
| Clearance | 37 | ||
| Biliary Excretion | 38 | ||
| Other Routes of Excretion | 38 | ||
| TIME COURSE OF DRUG ACTION | 38 | ||
| Kinetics of Absorption and Elimination | 38 | ||
| Zero-order kinetics | 38 | ||
| First-order kinetics | 39 | ||
| Capacity-limited reactions | 39 | ||
| Single-Compartment Model | 39 | ||
| Plasma concentration: single doses | 40 | ||
| Plasma concentration: repeated doses | 40 | ||
| A Two-Compartment Model | 41 | ||
| Context-Sensitive Half-Times | 43 | ||
| DISCREPANCIES BETWEEN PLASMA CONCENTRATIONS AND RECEPTOR ACTION | 43 | ||
| CASE DISCUSSION | 43 | ||
| GENERAL REFERENCES | 43 | ||
| 3 - Pharmacotherapeutics: The Clinical Use of Drugs* | 44 | ||
| CASE STUDY | 44 | ||
| MEASURING DRUG RESPONSES IN POPULATIONS; QUANTAL DOSE–RESPONSE CURVES | 44 | ||
| FACTORS INFLUENCING DRUG EFFECTS | 45 | ||
| Patient Factors | 45 | ||
| Body weight and composition | 45 | ||
| Age | 45 | ||
| Genetic influences | 46 | ||
| Sex, pregnancy, and lactation | 46 | ||
| Environmental factors | 46 | ||
| Physiologic variables | 47 | ||
| Pathologic factors | 47 | ||
| Drug Factors | 48 | ||
| Variables in drug administration | 48 | ||
| Drug tolerance | 48 | ||
| Factors Associated with the Therapeutic Regimen | 48 | ||
| Placebo effects | 48 | ||
| Patient noncompliance | 48 | ||
| Drug interactions | 49 | ||
| ADVERSE DRUG REACTIONS | 49 | ||
| Classification of Adverse Drug Reactions | 49 | ||
| Extension effects | 49 | ||
| Side effects | 49 | ||
| Idiosyncratic reactions | 51 | ||
| Drug allergy | 51 | ||
| Pseudoallergic and secondary reactions | 53 | ||
| Carcinogenesis | 53 | ||
| Special Problems | 53 | ||
| Drug abuse | 53 | ||
| Drug poisoning | 54 | ||
| Drugs and pregnancy | 54 | ||
| DEVELOPMENT OF NEW DRUGS | 54 | ||
| Sources of New Drugs | 55 | ||
| Evaluation of New Drugs | 56 | ||
| Preclinical testing | 56 | ||
| Clinical trials | 58 | ||
| Drug approval and continued surveillance | 59 | ||
| Impact of FDA regulations on the development of new drugs | 59 | ||
| Drug Nomenclature | 59 | ||
| SOURCES OF DRUG INFORMATION | 60 | ||
| Official Compendia | 60 | ||
| Unofficial Compendia | 60 | ||
| Books on Pharmacology and Therapeutics | 60 | ||
| Periodicals | 61 | ||
| Dental Sources of Information | 61 | ||
| Electronic Media | 61 | ||
| CASE DISCUSSION | 61 | ||
| GENERAL REFERENCES | 62 | ||
| 4 - Pharmacogenetics: Pharmacogenomics | 63 | ||
| CASE STUDY | 63 | ||
| PHARMACOKINETICS/PHARMACODYNAMICS | 65 | ||
| PHENOTYPE/GENOTYPE | 65 | ||
| MONOGENIC VERSUS POLYGENIC PHENOTYPES | 65 | ||
| ETHNIC DIFFERENCES IN PHARMACOGENETICS | 66 | ||
| PHARMACOGENETICS OF DRUG METABOLISM | 66 | ||
| Acetylation Polymorphisms (www.pharmgkb.org/gene/PA18) | 67 | ||
| Oxidation Polymorphisms | 67 | ||
| Thiopurine S-Methyltransferase Polymorphism (www.pharmgkb.org/gene/PA356) | 67 | ||
| Dihydropyrimidine Dehydrogenase Polymorphism (www.pharmgkb.org/gene/PA145) | 67 | ||
| Uridine Diphosphate Glucuronosyltransferase Polymorphism (www.pharmgkb.org/gene/PA420) | 68 | ||
| Drug Transporter Polymorphisms | 68 | ||
| PHARMACOGENETIC POLYMORPHISMS IN DRUG TARGETS | 68 | ||
| β-Adrenergic Receptor Polymorphisms | 68 | ||
| Dopamine and Other Receptor Polymorphisms | 68 | ||
| IMPLICATIONS FOR DENTISTRY | 68 | ||
| CASE DISCUSSION | 69 | ||
| GENERAL REFERENCES | 69 | ||
| II - Pharmacology of Specific Drug Groups | 70 | ||
| 5 - Introduction to Autonomic Nervous System Drugs\r | 71 | ||
| CASE | 71 | ||
| AUTONOMIC NERVOUS SYSTEM | 71 | ||
| Anatomy | 71 | ||
| Sympathetic nervous system | 71 | ||
| Parasympathetic nervous system | 72 | ||
| Functional Characteristics | 72 | ||
| NEUROTRANSMITTERS | 73 | ||
| Location of Adrenergic and Cholinergic Junctions | 75 | ||
| ADRENERGIC NEUROTRANSMISSION | 75 | ||
| Catecholamine Synthesis | 75 | ||
| Catecholamine Release | 75 | ||
| Adrenergic Receptors | 76 | ||
| Catecholamine Fate | 76 | ||
| CHOLINERGIC TRANSMISSION | 77 | ||
| Synthesis, Release, and Fate of Acetylcholine | 77 | ||
| Cholinergic Receptors | 77 | ||
| SIGNAL TRANSDUCTION AND SECOND MESSENGERS | 77 | ||
| Ion Channel–Linked Receptors | 77 | ||
| G protein–linked receptors | 77 | ||
| Gs protein–dependent events | 78 | ||
| Gi protein–dependent events | 78 | ||
| Gq protein–dependent events | 78 | ||
| Additional second messenger systems | 78 | ||
| OTHER AUTONOMIC NEUROTRANSMITTERS AND CO-TRANSMITTERS | 79 | ||
| Dopaminergic Transmission | 79 | ||
| Purinergic Transmission | 79 | ||
| Co-release of Neurotransmitters | 79 | ||
| CENTRAL CONTROL OF AUTONOMIC FUNCTION | 79 | ||
| SPECIFIC SITES AND MECHANISMS OF ACTION OF AUTONOMIC DRUGS | 79 | ||
| CASE DISCUSSION | 80 | ||
| GENERAL REFERENCES | 81 | ||
| 6 - Cholinergic Agonists and Muscarinic Receptor Antagonists | 82 | ||
| CASE | 82 | ||
| CHOLINERGIC AGONISTS | 82 | ||
| CHOLINOMIMETIC AGONISTS (DIRECTLY ACTING) | 83 | ||
| Chemistry and Classification | 83 | ||
| Choline esters | 83 | ||
| Natural alkaloids and congeners | 83 | ||
| Mechanism of Action | 83 | ||
| Pharmacologic Effects of ACh and Other Muscarinic Receptor Agonists | 84 | ||
| Peripheral muscarinic effects | 84 | ||
| . Intraocular pressure (IOP) is decreased as a result of miosis, particularly if the tension was elevated initially. In addition... | 84 | ||
| . The direct effects on the heart are subject to autonomic modification. For example, a baroreceptor-mediated increase in sympat... | 84 | ||
| . The stimulation of muscarinic (M2) receptors on the intact vascular endothelium is unique because it produces a profound vasod... | 84 | ||
| . The smooth muscle of the bronchioles is constricted by muscarinic receptor agonists | 84 | ||
| . Motility, peristaltic contractions, amplitude of contraction, and tone are all increased by muscarinic receptor agonists. Conv... | 84 | ||
| . All glands that are innervated by cholinergic fibers are potentially stimulated by cholinergic drugs. These include the saliva... | 84 | ||
| . Muscarinic receptor agonists stimulate contraction of the detrusor muscle, which results in decreased bladder capacity and ope... | 84 | ||
| Peripheral nicotinic effects | 84 | ||
| Central nervous system effects | 84 | ||
| Absorption, Fate, and Excretion | 86 | ||
| Adverse Effects | 86 | ||
| ANTICHOLINESTERASES | 86 | ||
| Summary and Historical Development | 86 | ||
| Chemistry and Classification | 87 | ||
| Mechanism of Action | 88 | ||
| Pharmacologic Effects | 89 | ||
| Absorption, Fate, and Excretion | 89 | ||
| Adverse Effects | 89 | ||
| GENERAL THERAPEUTIC USES FOR DIRECTLY AND INDIRECTLY ACTING CHOLINERGIC AGONISTS | 90 | ||
| Glaucoma | 90 | ||
| Xerostomia | 90 | ||
| Reversal of Neuromuscular Block | 91 | ||
| Myasthenia Gravis | 91 | ||
| Antidote for Atropine Poisoning | 91 | ||
| Paralytic Ileus and Bladder Atony | 91 | ||
| Senile Dementias of the Alzheimer Type | 91 | ||
| ANTIMUSCARINIC DRUGS | 91 | ||
| Chemistry and Classification | 92 | ||
| Mechanism of Action | 92 | ||
| Pharmacologic Effects | 92 | ||
| Peripheral Nervous System Actions | 93 | ||
| Eye | 93 | ||
| Respiratory tract | 93 | ||
| Salivary glands | 93 | ||
| Gastrointestinal tract | 93 | ||
| Cardiovascular system | 94 | ||
| Genitourinary tract | 94 | ||
| Body temperature | 94 | ||
| Central Nervous System Effects | 94 | ||
| Medulla and higher cerebral centers | 94 | ||
| Antitremor activity | 94 | ||
| Vestibular function | 94 | ||
| Absorption, Fate, and Excretion | 94 | ||
| General Therapeutic Uses | 94 | ||
| Other Uses | 94 | ||
| Antidote to anticholinesterases | 94 | ||
| Antidote to poisoning by mushrooms containing muscarine | 95 | ||
| Adverse Effects | 95 | ||
| Drug Interactions | 96 | ||
| Botulinum Toxin | 96 | ||
| THERAPEUTIC USES IN DENTISTRY | 96 | ||
| Cholinergic Agonists | 96 | ||
| Antimuscarinic Drugs | 96 | ||
| 7 - Drugs Affecting Nicotinic Receptors* | 98 | ||
| CASE STUDY | 98 | ||
| DRUGS AFFECTING GANGLIONIC TRANSMISSION | 98 | ||
| Ganglionic Transmission | 98 | ||
| Nicotinic Receptor Stimulating Drugs | 99 | ||
| Nicotine | 99 | ||
| Varenicline | 99 | ||
| Ganglionic Blockers | 100 | ||
| Pharmacologic effects | 100 | ||
| Absorption, fate, and excretion | 100 | ||
| General therapeutic uses | 100 | ||
| Adverse effects | 100 | ||
| DRUGS AFFECTING NEUROMUSCULAR TRANSMISSION | 100 | ||
| Skeletal Neuromuscular Transmission | 100 | ||
| Neuromuscular Junction Blockers | 101 | ||
| Classification and mechanism of action | 101 | ||
| . Nondepolarizing, or competitive, neuromuscular blocking drugs include tubocurarine (d-tubocurarine) and several other benzylis... | 101 | ||
| . Similar to most nondepolarizing blockers, succinylcholine (also known as suxamethonium chloride), the major depolarizing agent... | 102 | ||
| Pharmacologic effects | 104 | ||
| . On slow intravenous infusion, depolarizing and nondepolarizing neuromuscular blocking agents first affect the facial muscles a... | 104 | ||
| . None of the neuromuscular blocking drugs described here has any apparent influence on the CNS. The reason for this is the inab... | 104 | ||
| . Because of their selectivity for the NM receptors of the muscle endplate, neuromuscular blocking drugs as a group have no majo... | 104 | ||
| . Several neuromuscular blocking agents, most prominently tubocurarine, cause the release of histamine from mast cells into the ... | 104 | ||
| . Although none of the neuromuscular blocking drugs has any direct effect on vascular tone, all can produce hypotension by a com... | 105 | ||
| Absorption, fate, and excretion | 105 | ||
| General therapeutic uses | 105 | ||
| . To secure a patent, protected airway, an endotracheal tube is often inserted in patients receiving general anesthesia or patie... | 105 | ||
| . Neuromuscular blocking agents, especially intermediate-acting competitive blockers, are frequently used as adjuncts to general... | 105 | ||
| . In mild cases of tetanus, the patient is generally able to sustain respiration except during intermittent spasms. Here, neurom... | 106 | ||
| . In the treatment of depressive illness with electroconvulsive therapy, the therapeutic result is a consequence of the electric... | 106 | ||
| . Succinylcholine is used to produce a short-lived muscular relaxation to permit numerous brief nonsurgical manipulations, such ... | 106 | ||
| Adverse effects | 106 | ||
| Drug interactions | 106 | ||
| . Inhibitors of acetylcholinesterase, by blocking the enzymatic hydrolysis of ACh at the motor endplate, increase the amount of ... | 106 | ||
| . Anesthetics that stabilize excitable membranes, most prominently ether and the halogenated inhalation agents, tend to interact... | 106 | ||
| . Some antibiotics, such as the aminoglycosides, reduce the amount of ACh released by the motor nerve terminal in response to an... | 106 | ||
| . Catecholamines and other sympathomimetic agents may increase the amount of ACh released from the motor neuron and antagonize t... | 106 | ||
| . Lithium salts, used for the prophylaxis and treatment of manic-depressive illness, can slow the onset of neuromuscular blockad... | 106 | ||
| . Administration of a non | 107 | ||
| Other Drugs That Relax Skeletal Muscle | 107 | ||
| Diazepam | 107 | ||
| Baclofen | 107 | ||
| Tizanidine | 107 | ||
| Cyclobenzaprine | 107 | ||
| Other centrally acting muscle relaxants | 107 | ||
| Botulinum toxin | 107 | ||
| Dantrolene | 107 | ||
| APPLICATIONS IN DENTISTRY | 108 | ||
| CASE DISCUSSION | 108 | ||
| 8 - Adrenergic Agonists\r | 110 | ||
| CASE STUDY | 110 | ||
| HISTORY | 110 | ||
| CLASSIFICATION OF ADRENERGIC DRUGS AND RECEPTORS | 110 | ||
| CHEMISTRY AND STRUCTURE–ACTIVITY RELATIONSHIPS | 111 | ||
| PHARMACOLOGIC EFFECTS | 111 | ||
| Vascular effects | 111 | ||
| Cardiac effects | 112 | ||
| Effects on nonvascular smooth muscle | 113 | ||
| Effects on salivary glands | 113 | ||
| Metabolic responses | 113 | ||
| Central nervous system effects | 113 | ||
| Dopamine | 113 | ||
| Cardiovascular effects | 113 | ||
| Other effects | 114 | ||
| α-Adrenergic Receptor Agonists | 114 | ||
| β-Adrenergic Receptor Agonists: Isoproterenol | 114 | ||
| Cardiac and vascular effects | 115 | ||
| Effects on bronchial smooth muscle | 115 | ||
| Metabolic and other effects | 115 | ||
| Dobutamine | 115 | ||
| Selective β2-Adrenergic Receptor Agonists | 115 | ||
| Mixed-Acting and Indirect-Acting Adrenergic Agonists | 115 | ||
| ABSORPTION, FATE, AND EXCRETION | 115 | ||
| GENERAL THERAPEUTIC USES | 116 | ||
| Local Vasoconstriction | 117 | ||
| Treatment of Hypotension and Shock | 117 | ||
| Bronchodilation | 117 | ||
| Ophthalmic Uses | 117 | ||
| Treatment of Allergic States | 117 | ||
| Central Nervous System Stimulation | 117 | ||
| Treatment of Hypertension | 118 | ||
| THERAPEUTIC USES IN DENTISTRY | 118 | ||
| ADVERSE EFFECTS | 119 | ||
| CASE DISCUSSION | 121 | ||
| 9 - Adrenergic Antagonists | 122 | ||
| CASE STUDY | 122 | ||
| HISTORY | 122 | ||
| SELECTIVE Α1-ADRENENERGIC RECEPTOR ANTAGONISTS | 123 | ||
| Prazosin and Analogues | 123 | ||
| Absorption, fate, and excretion | 123 | ||
| Therapeutic uses | 123 | ||
| Adverse effects | 124 | ||
| Alfuzosin | 124 | ||
| Tamsulosin | 125 | ||
| NONSELECTIVE Α-ADRENERGIC RECEPTOR ANTAGONISTS | 125 | ||
| Β-ADRENERGIC RECEPTOR ANTAGONISTS | 125 | ||
| First-Generation β-Adrenergic Receptor Blockers, Nonselective Antagonists | 125 | ||
| Second-Generation β-Adrenergic Receptor Blockers, β1-Selective Antagonists | 125 | ||
| Third-Generation β-Adrenergic Receptor Blockers, Antagonists with Additional Actions | 125 | ||
| Chemistry | 126 | ||
| Pharmacologic Effects | 126 | ||
| Effects on the cardiovascular system | 126 | ||
| Effects on smooth muscle | 127 | ||
| . By blocking the β2-adrenergic receptors associated with airway smooth muscle, propranolol and other nonselective β blockers pr... | 127 | ||
| . β2-Adrenergic receptors are also expressed on vascular smooth muscle and account for additional unwanted side effects of nonse... | 127 | ||
| Gastrointestinal tract effects | 127 | ||
| Metabolic effects | 127 | ||
| Ocular effects | 127 | ||
| Central nervous system effects | 127 | ||
| Absorption, Fate, and Excretion | 128 | ||
| Therapeutic Uses | 128 | ||
| Hypertension | 128 | ||
| Ischemic heart disease | 128 | ||
| Myocardial infarction | 129 | ||
| Heart failure | 129 | ||
| Treatment of arrhythmias | 129 | ||
| Non-cardiovascular uses | 129 | ||
| Adverse Effects | 129 | ||
| Effects on the heart | 129 | ||
| Effects on smooth muscle | 129 | ||
| Metabolic effects | 130 | ||
| Central nervous system effects | 130 | ||
| DRUGS THAT REDUCE SYMPATHETIC OUTFLOW | 130 | ||
| Centrally Acting Adrenergic Agonists | 130 | ||
| Monoamine Oxidase Inhibitors | 131 | ||
| IMPLICATIONS FOR DENTISTRY | 131 | ||
| Physical Implications | 131 | ||
| Drug Interactions | 131 | ||
| 10 - Psychopharmacology: Antipsychotic and Antidepressant Drugs* | 133 | ||
| CASE STUDY | 133 | ||
| INTRODUCTION | 133 | ||
| MAJOR PSYCHIATRIC DISORDERS | 133 | ||
| Schizophrenia | 133 | ||
| Dopamine hypothesis | 133 | ||
| Other neurotransmitters | 134 | ||
| Affective Disorders | 134 | ||
| Depression | 134 | ||
| Mania and bipolar disorders | 134 | ||
| Monoamine Hypothesis | 135 | ||
| Development of Antipsychotic and Antidepressant Drugs | 135 | ||
| ANTIPSYCHOTIC DRUGS | 136 | ||
| Other receptor actions in antipsychotic drugs | 136 | ||
| Chemistry and Structure–Activity Relationships | 136 | ||
| Phenothiazines and thioxanthenes | 136 | ||
| Butyrophenones | 137 | ||
| Dihydroindolones | 137 | ||
| Dibenzoxazepines | 137 | ||
| Diphenylbutylpiperidines | 137 | ||
| Dibenzodiazepines | 138 | ||
| Thienobenzodiazepines | 138 | ||
| Benzisoxazoles | 138 | ||
| Other drugs expressing atypical antipsychotic activity | 138 | ||
| Benzodiazepines | 138 | ||
| Dopaminergic Pathways as a Basis for the Effects of Antipsychotic Drugs | 138 | ||
| Extrapyramidal effects | 140 | ||
| Sedative actions | 140 | ||
| Seizure threshold | 140 | ||
| Antiemetic action | 141 | ||
| Endocrine system | 141 | ||
| Other central nervous system actions | 141 | ||
| Peripheral Actions of Antipsychotics | 141 | ||
| Autonomic nervous system | 141 | ||
| Cardiovascular system | 141 | ||
| Respiratory effects | 141 | ||
| Absorption, Fate, and Excretion | 141 | ||
| Adverse effects | 142 | ||
| General Therapeutic Uses | 143 | ||
| Implications for Dentistry | 143 | ||
| ANTIDEPRESSANTS | 143 | ||
| Mechanisms of Antidepressant Agents | 143 | ||
| Tricyclic Antidepressants (TCAs) | 144 | ||
| TCA chemistry and structure–activity relationships | 144 | ||
| TCA absorption, fate, and excretion | 145 | ||
| TCA pharmacologic effects | 146 | ||
| . After TCAs have been administered for approximately 2 to 3weeks to depressed patients, they become less confused and have an e... | 146 | ||
| . TCAs are more potent anticholinergics than their phenothiazine analogues, especially with the tertiary amines (See Table 10-2)... | 146 | ||
| . TCAs can cause hypotension and compensatory tachycardia. TCAs affect the heart in a manner similar to the class I antiarrhythm... | 146 | ||
| Adverse effects of TCAs | 146 | ||
| TCA drug interactions | 147 | ||
| Dental consequences of TCAs | 147 | ||
| Tetracyclic Antidepressants and Other Second-Generation Drugs | 147 | ||
| Pharmacology of second-generation drugs | 147 | ||
| Absorption, fate, and excretion | 147 | ||
| Adverse effects of second-generation drugs | 147 | ||
| Dental consequences of second-generation drugs | 149 | ||
| Selective Serotonin Reuptake Inhibitors (SNRIs) | 149 | ||
| Pharmacologic effects of SSRIs | 149 | ||
| Absorption, fate, and excretion of SSRIs | 149 | ||
| Adverse effects of SSRIs | 150 | ||
| SSRI–drug interactions | 150 | ||
| Dental consequences of SSRIs | 150 | ||
| Newer SERT inhibitors with dual action (dual action drugs) | 150 | ||
| Serotonin-norepinephrine reuptake inhibitors (SNRIs) | 150 | ||
| . Venlafaxine and duloxetine are metabolized primarily by CYP2D6. Some are mild inhibitors of CYP2D6. Venlafaxine is metabolized... | 150 | ||
| . Side effects include dry mouth, insomnia, blurred vision, sweating, and constipation. Venlafaxine, more likely than other SNRI... | 150 | ||
| Dental consequences of SNRI drugs | 150 | ||
| Monoamine Oxidase Inhibitors | 151 | ||
| MAOI pharmacologic effects | 151 | ||
| MAOI adverse effects | 151 | ||
| MAOI drug interactions | 151 | ||
| Dental consequences of MAOI | 151 | ||
| St. John’s Wort | 151 | ||
| Dental Implications for Depressed Patients | 152 | ||
| Drugs for Bipolar Disorder | 152 | ||
| Lithium Salts | 152 | ||
| Pharmacologic effects | 152 | ||
| Absorption, fate, and excretion | 152 | ||
| Adverse effects | 152 | ||
| General therapeutic uses | 153 | ||
| Implications for dentistry | 153 | ||
| Other Antimanic Drugs | 153 | ||
| 11 - Sedative-Hypnotics, Antianxiety Drugs, and Centrally Acting Muscle Relaxants* | 156 | ||
| CASE STUDY | 156 | ||
| BENZODIAZEPINES | 157 | ||
| Chemistry and Structure-Activity Relationships | 157 | ||
| Mechanism of Action | 158 | ||
| Pharmacologic Effects | 159 | ||
| Central nervous system | 159 | ||
| Cardiovascular system | 160 | ||
| Respiratory system | 160 | ||
| Absorption, Fate, and Excretion | 160 | ||
| Adverse Effects and Drug Interactions | 161 | ||
| Antagonists | 162 | ||
| General Therapeutic Uses | 163 | ||
| BENZODIAZEPINE-LIKE SEDATIVE-HYPNOTICS | 164 | ||
| MELATONIN RECEPTOR AGONISTS | 165 | ||
| OREXIN RECEPTOR ANTAGONIST | 165 | ||
| BARBITURATES | 165 | ||
| Chemistry and Structure-Activity Relationships | 165 | ||
| Mechanism of Action | 165 | ||
| Pharmacologic Effects | 165 | ||
| Central nervous system | 165 | ||
| Cardiovascular system | 166 | ||
| Respiratory system | 166 | ||
| Absorption, Fate, and Excretion | 166 | ||
| III - Special Subjects in Pharmacology and Therapeutics | 563 | ||
| 37 - Medications for Management of Chronic, Non-Odontogenic Pain | 564 | ||
| CASE STUDY | 564 | ||
| INTRODUCTION TO PHARMACOLOGIC MANAGEMENT OF CHRONIC PAIN | 564 | ||
| Classification of Orofacial Pain | 564 | ||
| The Trigeminal Nerve and Its Role in Orofacial Pain | 564 | ||
| DRUGS FOR THE TREATMENT OF MUSCULOSKELETAL PAIN | 565 | ||
| Muscle Relaxant Drugs | 565 | ||
| Nonsteroidal Antiinflammatory Drugs (NSAIDs) | 565 | ||
| Ketorolac | 565 | ||
| Diclofenac potassium | 566 | ||
| Naproxen sodium | 566 | ||
| Adrenocorticosteroids | 567 | ||
| DRUGS FOR NEUROPATHIC PAIN | 567 | ||
| Antiseizure Drugs | 567 | ||
| Carbamazepine | 567 | ||
| Oxcarbazepine | 567 | ||
| Gabapentin | 567 | ||
| Valproic acid | 567 | ||
| Lamotrigine | 567 | ||
| Topiramate | 568 | ||
| Phenytoin | 568 | ||
| Pregabalin | 568 | ||
| Tiagabine | 568 | ||
| Levetiracetam | 568 | ||
| Zonisamide | 568 | ||
| Antidepressants | 568 | ||
| Adrenocorticosteroids | 568 | ||
| Other Medications | 568 | ||
| N-methyl-d-aspartate receptor antagonists | 568 | ||
| Drugs that act at α-adrenergic receptors | 569 | ||
| Other drug targets | 569 | ||
| Diagnostic Criteria | 569 | ||
| TREATMENT OF HEADACHE PAIN | 570 | ||
| Tension-Type Headache | 570 | ||
| Migraine | 570 | ||
| Cluster Headaches | 570 | ||
| TOPICAL AGENTS | 570 | ||
| IMPLICATIONS FOR DENTISTRY | 573 | ||
| Case Discussion | 573 | ||
| 38 - Management of Fear and Anxiety | 575 | ||
| CASE STUDY\r | 575 | ||
| BACKGROUND | 575 | ||
| GENERAL PRINCIPLES | 575 | ||
| Indications for Use | 575 | ||
| Treatment Planning | 575 | ||
| Patient Selection | 576 | ||
| PHARMACOLOGIC APPROACHES | 576 | ||
| MINIMAL AND MODERATE SEDATION | 578 | ||
| Inhalation Sedation | 578 | ||
| Advantages | 578 | ||
| Disadvantages | 578 | ||
| 1 - Protein Biopharmaceuticals | 641 | ||
| 2 - USE OF HERBS AND HERBAL DIETARY\rSUPPLEMENTS IN DENTISTRY* | 642 | ||
| REGULATIONS AND QUALITY CONTROL | 642 | ||
| TYPES OF HERBAL DIETARY SUPPLEMENTS AND RELATED BOTANICAL PRODUCTS | 643 | ||
| INTEGRATED HEALTH CARE AND DENTISTRY | 643 | ||
| Patient Evaluation | 643 | ||
| Modifications of Dental Treatment | 643 | ||
| Herbal Therapies for Oral Conditions | 645 | ||
| WEB-BASED SOURCES OF INFORMATION ON HERBAL MEDICINE AND HERBAL DIETARY SUPPLEMENTS | 647 | ||
| 3 - Antiseptics and Disinfectants | 648 | ||
| GENERAL REFERENCES | 649 | ||
| 4 - DRUG INTERACTIONS IN CLINICAL DENTISTRY | 650 | ||
| CLASSIFICATION OF DRUG INTERACTIONS | 650 | ||
| MECHANISMS OF DRUG INTERACTIONS | 650 | ||
| FACTORS INFLUENCING DRUG INTERACTIONS | 650 | ||
| DRUG INTERACTIONS USED IN PHARMACOTHERAPEUTICS | 650 | ||
| 5 - Drugs Used in the Treatment of Glaucoma | 656 | ||
| 6 - PRESCRIPTION WRITING\r | 657 | ||
| COMPONENT PARTS OF THE PRESCRIPTION | 657 | ||
| PRESCRIPTION FORMAT AND PAD FORMS | 658 | ||
| 7 - Controlled Substance Laws and Drug Schedules | 661 | ||
| 8 - Regulations and Drug Prescribing | 663 | ||
| HISTORICAL DEVELOPMENT OF DRUG LEGISLATION | 663 | ||
| 9 - Glossary of Abbreviations* | 667 | ||
| Index | 675 | ||
| A | 675 | ||
| B | 680 | ||
| C | 682 | ||
| D | 686 | ||
| E | 689 | ||
| F | 690 | ||
| G | 691 | ||
| H | 693 | ||
| I | 694 | ||
| J | 696 | ||
| K | 696 | ||
| L | 697 | ||
| M | 698 | ||
| N | 700 | ||
| O | 702 | ||
| P | 703 | ||
| Q | 707 | ||
| R | 707 | ||
| S | 708 | ||
| T | 710 | ||
| U | 712 | ||
| V | 712 | ||
| W | 713 | ||
| X | 713 | ||
| Y | 713 | ||
| Z | 713 |