Dan Lindenmeyer, RPhPharmacy Mgr. - Dillons

6 main categories◦ Hypertension◦ Antidepressants◦ Pain meds◦ Cholesterol Reducers◦ Antibiotics◦ Antacids-Acid Reducers

Company has exclusive rights to market drug for 17 years after a patent has been approved◦ Most of the time patents are obtained while trials

are being run◦ By the time drug hits the market only 8 to 10

years are left on patent AB rated generics must be therapeutically

equal◦ The med must dissolve in the body at the same

rate and produce equivalent levels

Cardiology Hypertension Cholesterol reducers Antibiotics Diabetes Weight Loss Depression and Alzheimer’s Acid Reducers-antacids Herbal Supplements

Strong Narcotics◦ Percocet, Oxycontin, Percodan, Demerol

Mid-Level Narcotics◦ Lortab, Lorcet

Non-Narcotic Controlled◦ Darvocet

NSAIDS◦ Ibuprofen, naproxen, diclofenac, etodolac,

indomethacin, tramadol COX-II Inhibitors

◦ Celebrex◦ Mobic

Anti-arrhythmics Calcium Channel Blockers Ace Inhibitors Angiotensin receptor blockers Beta blockers Diuretics

Lanoxin---Antiarrhythmic

Pacerone—Antiarrhythmic

Mexilitine—Antiarrhythmic

Nitroglycerin—angina agent

Pressure on arterial walls ◦ Blood pressure meds work by blocking

receptors in arterial wall and relaxing the artery

◦ Diuretics remove fluids to decrease fluid volume of the body to lower blood pressure.

Beta blockers◦ Atenolol, metoprolol, propranolol

ACE Inhibitors◦ Lisinopril, enalapril, benazapril

Calcium channel blockers◦ Amlodipine, diltiazem

Angiotensin receptor blockers◦ Cozaar, Hyzaar, Micardis

Diuretics◦ Furosemide, triamterene/HCTZ,

hydrochlorothiazide

Previously d/c blood thinners 10 days before dental extraction or scaling and root planing

Rebound effect after antiplatelet interruption can result in stroke or MI

Minor surgical procedures can be carried out safely without altering antiplatelet therapy◦ Simple extractions <3 teeth

Additional visits for more than 3 teeth◦ Gingival surgery◦ Crowns and bridges◦ Scaling and surgical removal of teeth

Beta lactam antibiotics◦ Penicillins◦ Cephalosporins

Macrolide◦ Erythromycins◦ Zithromax

Quinolones◦ Levaquin◦ Ciprofloxacin

Sulfonamides Tetracyclines

Statins◦ No Generics

Lipitor Zetia Tricor Vytorin(combo of Zetia and Simvastatin)

◦ Generics Mevacor-Lovastatin Zocor-Simvastatin Pravachol-Pravastatin

Niacin

Injectable Insulins◦ Humalog--Novolog◦ Lantus◦ Humulin—N,R,U,70/30

Increase Insulins effect◦ Alcohol, anabolic steroids, beta blockers, MAO

inhibitors, tetracyclines, salicylates

Decrease Insulins effect◦ Oral contrceptives, corticosteroids, niacin,

smoking, thiazide diuretics, thyroid hormones

Metformin

Glyburide and glipizide

Glimepiride

Avandia

Actos

Phentermine

Xenical---Alli

Natural Supplements

How it works: Chemical in brain called serotonin is at higher cellular levels

Most antidepressants block re-uptake of serotonin to produce their effects

Very common condition

Tricyclic◦ Amitriptyline, nortryptyline, imipramine

Tetracyclic◦ Remeron

SSRI◦ Prozac, Zoloft, Lexapro, Celexa

SSRI & Norepinephrine◦ Effexor and Cymbalta

MAO-Inhibitors◦ Parnate, Nardil

H2 antagonists◦ Zantac◦ Tagamet Available OTC and Rx◦ Axid

PPI’s◦ Prevacid◦ Protonix ◦ Aciphex◦ Nexium◦ Prilosec –only one available as an OTC

Namenda

Aricept

Non-Sedating◦ Zyrtec◦ Allegra◦ Clarinex◦ Claritin—OTC

OTC◦ Benadryl◦ Chlorpheniramine◦ Clemastine

Not regulated by FDA◦ No proof of effectiveness◦ Take at own risk◦ Products have been proven safe at

recommended doses Very popular alternative to getting

prescriptions

Resources:◦ Drug information handbook for dentistry-7th

Edition◦ Clinical pharmacology