Term
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Definition
Indications:
Local Vasoconstriction
Hypotension and Shock
Bronchodilation
Allergy
Mechanism:
Direct stimulation of α and β adrenergic receptors
Uses in Dentistry:
Vasoconstriction—less bleeding and makes the analgesia last longer
Cardiac: β1 stimulation increases the work of the heart and decreases cardiac efficiency
• Cerebrovascular disease: Use with caution in patients with cerebrovascular disease
• Diabetes: Increases in circulating blood glucose from
stimulation of liver glycogenolysis and glucagon secretion Inhibition of insulin secretion
• Parkinson's disease: may cause temporary worsening of symptoms.
• Thyroid disease: Use with caution in patients with thyroid disease |
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Definition
MOA: α 1 agonist, inhibitor of dopamine reuptake
Indication: narcolepsy, shift work disorder
Adverse Effects: mania, delusions, hallucinations, suicidal ideation and aggression, persistent sleepiness
Not approved for children (risk of Stevens-Johnson Syndrome) |
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Definition
Used in hypertension
Mechanism: a2 Inverse Agonist--Binds to α2 medullary receptors in the brain which inhibit sympathetic outflow to the body and α receptors in blood vessels are inhibited
Dental Adverse Effects: Dry mouth, orthostatic hypotension |
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Term
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Definition
β2 Sympathetic Agonist
Mechanism: Stimulation of β2 receptors in lungs to cause bronchodilation
Use: Asthma, COPD
Dental Adverse Effects: unusual taste, and drying or irritation of the oropharynx
Dosage Form: Albuterol Inhalation Aerosol |
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Definition
α Sympathetic Antagonist
Mechanism: α1 receptor blockade, leading to smooth muscle relaxation
Uses: HTN and benign prostatic hyperplasia |
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Definition
α Sympathetic Antagonist
Mechanism: Blockade of α1A and α1D adrenergic receptor subtypes found only in prostate gland |
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Term
| Pharmacological Effects of β Blockers |
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Definition
↓ the force and rate of myocardial contraction
↓ O2 consumption of the heart
↓ of blood pressure in hypertensive patients
CO decreases
HR decreases
Reduction in plasma renin activity
Decrease CNS sympathetic outflow
Alteration in baroreceptor responsiveness |
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Term
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Definition
Nonselective
beta blocker
Mechanism: Non-selective competitive inhibitor of beta receptors
Uses: Cardiovascular Disease, Stage fright, Tremor, Migraine headache
may enhance the pressor response to epinephrine
hypertension and bradycardia |
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Term
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Definition
Selective for β1
Mechanism: Competitive inhibitors of epinephrine and norepi at β1
Orthostatic hypotension |
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Term
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Definition
beta antagonist
Mechanism: Antagonist at β1 and α1 receptors
Effects: Decrease heart rate and contractility and decrease blood pressure through alpha blockade
Use: CHF (congestive heart failure) |
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Term
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Definition
SLUD Response:
Salivation
Lacrimation
Urination
Defecation
Bradycardia
Vasodilation
Bronchoconstriction
Relaxation of urinary sphincter
Increase GI secretions
Sweating
Contraction of iris |
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Term
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Definition
Pilocarpine (Salagen)
Cevimeline (Evoxac)
Agonist at muscarinic receptors
Doses are individualized for desired effects until adverse reactions become intolerable.
Contraindicated in asthma, cardiovascular disease, and ulcer
Use with caution in patients with COPD, Parkinson’s disease |
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Term
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Definition
Bronchodilation: Asthma and COPD:
Ipratropium (Atrovent)
Tiotropium (Spiriva)
Urinary: antispasmodics
Tolterodine (Detrol)
Darifenacin (Enablex |
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Term
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Definition
α4β2 neuronal nicotinic acetylcholine receptors
produces agonist activity, while simultaneously preventing nicotine binding to α4β2 receptors
stimulates receptor-mediated activity, but at a significantly lower level than nicotine
Adverse Effect: Nightmares and psychosis |
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Term
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Definition
Class: typical antipsychotic
Mechanism: Binds to receptors in all central dopamine pathways
Use: Alleviate positive symptoms of Schizophrenia, hallucinations, delusions. No effect on negative symptoms:
adverse effect: Dystonia-dyskinetic movements due to disordered tonicity of muscle
Akinisia-absence or poverty of movement |
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Term
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Definition
Atypical Antipsychotic
MOA: Binds to receptors in mesolimbic and mesocortical dopaminergic pathways– more selective than older drugs
Use: alleviates pos and neg symptoms
Adverse effects: hyperglycemia |
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Term
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Definition
atypical antipsychotic
Partial agonist activity at dopamine and serotonin 5-HT 1A receptors and antagonist activity at 5-HT2A receptors
Indicated for schizophrenia, bi-polar disorder, and depression |
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Definition
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Definition
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Definition
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Definition
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Definition
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Definition
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Definition
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Term
| selective serotonin reuptake inhibitor |
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Definition
SSRI
MOA: block serotonin reuptake transporter
indications: Indications include depression, bulimia, obsessive-compulsive disorder, social anxiety disorder, panic disorder, posttraumatic stress disorder
There’s bruxism and xerostomia. There may be some effects on platelet aggregation that would be exacerbated with aspirin and NSAIDs.
No significant toxixity with overdose (advantage over TCAs) |
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Term
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Definition
Serotonin-Norepinephrine Reuptake Inhibitor
Blocks both serotonin and norepi reuptake
Vasoconstrictor administered with caution
May impair platelet aggregation
Aspirin and NSAIDs |
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Term
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Definition
Serotonin-Norepinephrine Reuptake Inhibitor
Blocks both serotonin and norepi reuptake
Indications: Depression and Neuropathic Pain
Dental adverse effect: Dry mouth
Vasoconstrictor administered with caution
May impair platelet aggregation
Aspirin and NSAIDs |
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Term
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Definition
Serotonin-Norepinephrine Reuptake Inhibitor
Block norepi and dopamine reuptake
Weakly blocks serotonin reuptake
Indications: Depression, Nicotine Withdrawal
Dental adverse effect: Dry mouth
Vasoconstrictor administered with caution
May impair platelet aggregation
Aspirin and NSAIDs |
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Term
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Definition
| Serotonin antagonist/reuptake inhibitor (SARI) |
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Term
| Serotonin antagonist/reuptake inhibitor (SARI) |
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Definition
Used for depression that causes sleep disturbances
Orthostatic hypotension |
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Term
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Definition
| Monoamine Oxidase Inhibitor |
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Term
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Definition
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Term
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Definition
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Definition
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Definition
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Definition
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Term
| Mono amine oxidase inhibitors |
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Definition
For parkinsons
prevent the degradation of dopamine to dopac. |
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Term
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Definition
| catecholamine methyl transferase reduces the amount of dopamine by converting it to 3-methyoxytyramine. Inhibition will increase amount of dopamine. |
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Term
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Definition
Sinemet - Parkinsons
Unlabeled use of Sinemet is restless leg syndrome
Side effect: Abnormal involuntary movements of the orofacial muscles, Abnormal mouth movements, Protrusion and retraction of the tongue, Chewing motions, Facial grimacing
Oral problems: inflammation, damage to oral structures, movement of anterior teeth and difficulty wearing dentures.
Dry mouth |
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Term
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Definition
Dopamine receptor agonist
Potent D2,3 receptor agonist
Adverse effects include abnormal involuntary movements, confusion, psychosis and dry mouth
Compulsive behavior ?? Spending sprees, gambling |
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Term
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Definition
Dopamine receptor agonist
Potent D3, 2, 4 receptor agonist
Adverse effects include abnormal involuntary movements, orthostatic hypertension, nausea, sedation/somnolence, dry mouth
Compulsive behavior ?? Spending sprees, gambling |
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Term
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Definition
Mechanism: NE and serotonin reuptake inhibitors
Also block muscarinic receptors and α1 adrenergic receptors
Adverse Effects: dry mouth, orthostatic hypotension
Indications: Depression, anxiety, obsessive-compulsive disorder (OCD)
IUSD Clinics-epi with TCA used “with restraint and caution”
Drugs take 3 weeks to have an effect
Overdose leads to cardiotoxicity--arrhythmias, MIs |
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Term
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Definition
GABAb receptor agoinist
Multiple Sclerosis
Spinal cord injuries
Patients who have had strokes
spasticity
flexor spasms and concomitant pain
muscular rigidity
Adverse Effect: sedation |
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Term
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Definition
Indications: Anxiolytic, sedative-hypnotic, amnesic, anticonvulsant, skeletal muscle relaxant, alcohol withdrawal
Inappropriate anxiety exists independently of a perceived threat and involves autonomic symptoms.
Examples:
Generalized anxiety disorder
Panic disorder
Obsessive compulsive disorder
Phobias
Adverse effects:
Drowsiness, sedation, respiratory depression
Psychological dependence—Schedule 4
Overdose does not cause death (wide therapeutic window) unless combined with other CNS depressant, usually alcohol
Metabolized by CYP liver enzymes lots of drug interactions
Erythromycin, clarithromycin and azole antifungals—inhibit hepatic metabolism of benzos |
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Term
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Definition
benzo
Mechanism: Agonist at central benzo sites on the GABA receptor
Drug of choice for sedation in pregnant women |
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Term
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Definition
benzo
Interaction with GABA receptor close to benzo receptor
Drug Interactions:
not to be used with other benzodiazepines
Ketoconazole, itraconazole, clarithromycin Lunesta |
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Definition
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Definition
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Term
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Definition
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Term
| sodium channel inhibitors |
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Definition
Indications: Seizure disorders, bi-polar, neuralgias, migraines
Adverse effects: sedation |
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