The aim of this essay is to discuss therapeutic agents used in dentistry. It wills discus codeine and ibuprofen in terms of class, nomenclature, indication for use, phrmacodynamic, phrmacokinetcs, drug interaction and side effects. It will also provide knowledge regarding principle of prescription writing. It will brief regarding definition of pharmacopeia, legend drug, therapeutic index, and biologic equivalence. It will brief regarding scenarios for the dentist in drug prescription.
The nomenclature of ibuprofen is (RS)-2-(4-(2-methylpropyl) phenyl) propanoic acid
Ibuprofen belongs to non steroidal anti inflammatory drugs
Indication for use
Ibuprofen is actually used in cases of inflammation to control mild to moderate. It is given in fever, dental pain, osteoarthritis is, kidney stones and pain of other origins. Almost 60% of the people show response to ibuprofen.
Route of administration
It can be administered via multiple routes like mouth, rectal, topical, and intravenous routes. It is metabolized in the liver. The onset of action occurs in 30 minutes, and its half-life is 1.5 to 3 hours. 95% of the excretion occurs via urine.
Ibuprofen works via inhibition of cyclooxygenase (COX) enzymes. Cyclooxygenase (COX) enzymes are the enzyme which converts arachidonic acid to prostaglandin H2 (PGH2). Prostaglandin H2 (PGH2) is converted into other products which regulate inflammation, pain and fever and thromoboxane A2. Thromoboacne A2 stimulates binding of platelets helping in clotting of blood.
Ibuprofen is administered at an initial dose of 400 mg (with a dose of about 5.7 mg/kg) repeated every 12 hours. The sustained release is given as 200 mg tablet repeated 12 hourly (Devarakonda et al., 2015).
There are certain adverse effects associated with the administration of ibuprofen. These include nausea, Diarrhea, dyspepsia, constipation, gastrointestinal bleeding, ulceration, rash, dizziness, headache and salt and water retention.
Taking ibuprofen with alcohol may increase risk of GI bleeding.
- Codeine is an opiate
- Indication for use
Codeine is the drug which is actually used to treat pain and cough. It is also used to treat diarrhea.
Route of administration
It is administered orally, rectally, intravenously, via intramuscularly or subcutaneously.
Codeine is an opiate so it affects the receptor is in brain thus modulating the ability of the brain to perceive pain sensation.
It is metabolized in the liver. Its biological half-life is 2.5 to 3 hours. Its duration of action is 4 hours.
Codeine is given as 15 to 60 mg almost four to six times depending on the need. Maximum dose can be increased up to 350 mg per day.
Codeine also persist some of the drug interactions. It is found to show drug interaction with isocarboxazid, Linezolid, phenelzine, methylene blue, tranylcypromine, naltrexone, and procarbazine.
The main side effect with the use of codeine includes drowsiness and constipation. Other side effects include nausea, vomiting, diarrhea, dry mouth, miosis, euphoria, dysphoria, orthostatic hypotension and urinary retention.
It is the ratio between the safe dose of the drug to therapeutic its toxic dose. It measures dose of the drug which can be safely administered without side effects. The more the therapeutic Index the more safe the drug is. Index is also known as therapeutic ratio.
Pharmacopeia is form of a book which is published by the authorities from government. It contain all the information regarding a drug from its name, nomenclature, class, mechanism of action, indications, contraindications, side effects to method of preparation.
It’s like encyclopedia of drugs.
Legend drug mean a list of drugs which are under approval by the U.S. Food and Drug Administration (FDA). The U.S. Food and Drug Administration (FDA) make sure it to be prescribed by particularly licensed physician or pharmacist for the use of specific patients only.
These drugs can be from narcotics or non narcotics category.
Biologic equivalence measures the ability of two different drugs having identical active ingredient shows same bioavailability and same physiological effects on the site of action.
General principles of prescription writing
Prescription writing is one of the basic techniques which every physician should know
All the relevant information regarding the patient should be on the prescription so that there is clear knowledge regarding to whom the drug is prescribed
All information regarding doctor who is prescribing the drug should be mentioned
The reason for prescription with proper diagnosis should be mentioned
Correct date and time should be mentioned.
Drug allergies if present in the patient should be mentioned
Write in clear words the name of the drug, its dose, frequency and duration. Explain the patient the regimen and write in the language which the patient can understand.
The prescription label
A prescription label should have Product Names and Date of Initial U.S. Approval, Recent Major Changes, Drug Interactions, Dosage Forms & Strengths, Indications and Usage, Dosage & Administration, Contraindications, Boxed Warning, Adverse Reactions, Use in Specific Populations Patient Counseling Information
The strategy in my clinic is done as one of the assistant checks the prescription before a person leaves
My principle for avoiding self medication is with the aid of proper counseling in clinics, meetings, pamphlets, seminars and discussions. I will try to talk to the patient in a friendly manner and will give complete knowledge regarding drug overdose. I will also counsel the patient that whom they can contact in case of any illness or any drug overuse.
Noncompliance regarding therapeutic medications
these include demographic factors like age, gender, education etc, psychological factors, patient knowledge, patient physician relationship, use of abusive drugs, memory, treatment complexity, rout of administration, side effects of drugs, taste, validity of drug in stores, long waiting hours and financial issues (Li, 2008).
Some of the drugs used in dentistry are codeine and ibuprofen usually to control pain. A drug prescription should be neat and clean having all the necessary information in it. The dentist should counsel the patient regarding drug overdose and make sure the prescription is complete before the patient leaves the clinic.