Part 1 Drugs commonly prescribed by the dentist



Drugs & Dentistry I

Drugs commonly prescribed by the dentist

March 2002

1. Antimicrobial Drugs

a. Antibiotics

|Drug |Indications |Forms |Usual dose |Trade &price |Comments |

|Amoxicillin | | | | | |

| |-Routine drug of choice in infection.|Cap. 250-500 mg |Adult: |-Amoxil |- 3% of population are |

| |-Prophylaxis regimen for subacute |Sus. 125 mg/5ml |250-500 mg q8h |250 mg = 27 SR |allergic to the drug |

| |bacterial endocarditis |250 mg/5ml |Child: |500 mg = 53 SR | |

| | | |20 mg/kg/day in |-Ultramox | |

| | | |divided doses |500 mg = 25 SR | |

| | | | |-Amoxidar | |

| | | | |250 mg = 7 SR | |

| | | | |500 mg = 13 SR | |

| Co-Amoxiclav. | | | | | |

|“amoxicillin with |-Infections caused by beta-lactamase |Tab. 375-625 mg |Adult: |-Augmentin |Children ( 40kg |

|clavulanic acid” |producing strains. |1g |375-625 mg q8h |375 mg = 48 SR |20-40 mg/kg/day amoxicillin |

| |-Sever dental infections |Sus. 156 mg/5ml |OR |625 mg = 81 SR |with 5-10mg calvulanic acid in |

| |with spreading cellulites. |228 mg/5ml |1 g q12h |156 mg = 22 SR |three |

| | |457 mg/5ml | |-Amoclan |divided doses. |

| | | | | | |

| | | | |375 mg =34 SR | |

| | | | |-Amoclan forte | |

| | | | |625mg = 44 SR | |

| | | | |-Megamox | |

| | | | |375mg =36 SR | |

| | | | |625mg =43 SR | |

| | | | |1g =75 SR | |

| | | | |-Klavox | |

| | | | |375mg = 44 SR | |

| | | | |625 mg =76 SR | |

| | | | |-Julmentin | |

| | | | |375 mg = 40 SR | |

| | | | |-Julmentin Forte | |

| | | | |625 mg = 68 SR | |

|Erythromycin | | | | | |

| |-Routine second choice |Tab. 250-500 mg |250-500 mg q6h |-Erythrocin |-50% of s.auruse is resistant |

| |to amoxicillin in infection or first |Sus. 200 mg/5ml |200 mg/5ml q6h |250mg = 14 SR |-GI intolerance is common |

| |choice if amoxicillin is allergic . | | |500mg = 27 SR | |

| | | | |Sus. = 19 SR | |

| | | | |-Eromycin | |

Tab. for tablet Sus. for suspension

Cap. for capsule q8h = every 8 hours

Syr. for syrup By Dr. KHALID AL - JOHANI

Inj for injection KING ABDULAZIZ UNIVERSITY

SCHOOL OF DENTISTRY

|Drug |Indications |Forms |Usual dose |Trade &price |Comment |

| | | | | |Some pt. is allergic to the drug. |

|Clarithromycin |-Mild to moderate infection. |Tab. 250-500 mg |250-500 mg |-Klacid |-Caution when prescribed for |

| |-Prophylaxis regimen for subacute |Sus. 125 mg/ 5ml |bid | |pregnant or lactating women, |

| |bacterial endo-carditis for pt. |250 mg/100ml | | |hepatic, renal pt. |

| |allergic to amoxicillin. | | | |-It increases effects of |

| | | | | |cyclosporine, warfarinn & decreases|

| | | | | |the effects of clindamycin, |

| | | | | |penicillin &anticholingergic drugs.|

| |-Mild to moderate infection. | |500 mg qid | |-Contraindicated if the pt. is |

| |-Prophylaxis regimen for subacute |Cap. 250 mg |on day1, then 250 mg|-Zithromax |hypersensitive to the drug or to |

|Azithromycin |bacterial endo-carditis for pt. | |qid on days 2-5 | |erythromycin. |

| |allergic to amoxicillin. | | | |-Caution when prescribed for |

| | | | | |pregnant or lactating women, |

| | | | | |hepatic, renal & cardiac pt. or |

| | | | | |with elderly & child < 16 y. |

| | | | | |-It decrease the effects of |

| | | | | |clindamycin & penicillin |

| | | | | |-Pt. instructed to take medication |

| | | | | |at least an hour before meal or 2 |

| | | | | |hours after the meal. |

|Tetracycline |-Second or third choice to | | | | |

| |amoxicillin in routine inf. |Tab. 250-500 mg Sus. |250-500 mg q6h , 1 |-Tetracycline |-Used in bone graft. |

| |-Anaerobic bacterial infections & |125 mg/5ml |hour before or 2 |250 mg = 13 SR |-Cause teeth discolora- tion, so it|

| |periodontitis associated with | |hours after meals | |is not used in child ( 8y & in |

| |presence of AA (Actinobacillus | | | |pregnant women. |

| |actino-mycetemcomitans). | | | | |

| |-ANUG | | | | |

|Doxycycline | | | | |-Some patients are |

| |-Periodontitis associated with |Tab. 100 mg |100 mg q12h |-Doxydar |hypersensitive to the drug. |

| |presence of AA |Cap. 100 mg | |-Vibramycin |-It cause candidiasis,teeth & |

| |(Actinobacillus actino- | | |100 mg=26 SR |tongue discoloration & dry mouth. |

| |mycetemcomitans). | | | |-It is not prescribed for child ( |

| |-ANUG | | | |8y &for pregnant women. |

| |-Syphilis | | | | |

| | | | | | |

|Drug |Indications |Forms |Usual dose |Trade &price |Comment |

| |Alternative to amoxicillin in | |Adult | |Cramps & diarrhea in 20% of |

|Clindamycin |prophylaxis regimen for subacute |Tab. 150-300 mg |150-450 mg q6h |-Dalacin-C |patients after oral administration.|

| |bacterial endocarditis if |Inj. 300-600 |Child |150 mg=21 SR |-Contraindicated if pt. is |

| |amoxicillin is allergic. |900 mg |8 -25 mg/kg in |300 mg=37 SR |hypersensitive to the drug or had |

| |-Chronic osteomyelitis. | |3-4 divided doses. | |developed pseudo-membranous |

| | | | | |colitis. |

| | | | |-Flagyl |-Caution when the pt. complain of |

| |-Protozoal & anaerobic bacterial |Tab. 250-500 mg |250-500 mg q8h |250 mg =13SR |neutropenia, |

| |infections. | | |500 mg =15SR |hepatic disease, active CNS |

|Metronidazole |-Refractory adult peridontits. | | |-Nidazol |disease, or if the pt. on |

| |Combined with penicillin in serious| | |-Elyzol |warfarin . |

| |Odontogenic infection, especially | | |-Flazol |-Contraindicated if pt. is |

| |in compromised patients. | | | |hypersensitive to the drug |

| | | | | |or in the first trimester. |

|Cephalexin |Alternative to amoxicillin in the |Cap. 250-500 mg |Adult: |-Keflex |10-15% cross reaction |

| |tretment of orofacial infections | |250-500 mg |250mg = 29 SR |sensitivity in pt. allergic to |

| |&in the prevention of SAB |Syr. 125 mg/5ml |q6h |500mg = 42 SR |penicillin |

| |endocarditis except if the pt. had | |Child: |-Cefrin | |

| |an immediate anaphylactic allergic | |6.5-50 mg/kg/ day in| | |

| |reaction to amoxicillin. | |4 doses | | |

|Cefuroxime |Skin, soft tissue & bone |Tab. 125-250 mg |Adult: |-Zinnat |10-15% cross reaction |

| |infections. |Sus. 125 mg/5ml | |250 mg =87 SR |sensitivity in pt. allergic to |

| | |250 mg/5ml |1-2tab q12h |500 mg =95 SR |penicillin |

| | | |Child: | | |

| | | |125mg q12h | | |

1. The Antibiotics may decrease the activity of oral contraceptive. So the pt. should be instructed to use additional method of contraception during the antibiotic course.

2. If the infection not improved within 3days, change the drug and do sensitivity test.

3. Recommended antibiotics during pregnancy : Penicillin & Cephalosporine.

4. Recommended antibiotics for lactating mother : Cephalosporine & Erythromycin.

|Drug |Indications |Forms |Usual dose |Trade &price |Comment |

| | | |Herpes zoter: | |-It is contraindicated in patients |

| |-Viral infections of: |Tab. 400- 800 mg |800 mg q4h for 7-10 |-Zovirax |with known hypersensitivity to the |

| |-Herpes zoster. |Cap. 200 mg |days |200 mg=149SR |drug. |

| |-Herpes simplex. |Cream 2 g |Chickenpox: |400 mg=697SR |-It should be used with caution |

|Acyclovir |-Chickenpox. | |20 mg/kg qid for 5|Cream =23 SR |in-patient with renal impairment. |

| |-Prevention of recurrence of | |days |-Clovir |-It used in the tengling stage in |

| |the viral infections. | | | |the management of HSV before |

| | | | | |development of the lesion “vesicles|

| | | | | |“ |

| | | | | |-It could cause glossitis. |

| | | | | |-Postpone dental treatment when |

| | | | | |oral herpetic lesions are present. |

b. Antifungal

|Drug |Indications |Forms |Usual dose |Trade &price |Comment |

| | | |Adult |Daktarin |Oral gel |

| |Treatment of candidal |Tab. 250 mg |600-1800 mg in 3 |Oral gel =17 SR |Apply twice / day up to 1 month.|

| |infections |Oral gel. 25 mg/ml |divided doses daily | | |

|Miconazole | | |for 3-20 weeks | | |

| | | |Children (1 y | | |

| | | |20-45mg/kg/day | | |

| | | |in 3 divided doses.| | |

| | | |Adult: | |-Contraindicated in patients with |

| |-Systemic & cutaneous fungal |Tab. 200 mg |200-400 mg |-Nizoral |previous hypersensitivity. |

|Ketoconazol |infections. | |qid | |-Used cautiously in patients with |

| | | |Children (2 y | |impaired hepatic & or adrenal |

| | | |3.5-6.6 mg/kg/ day | |reserve. |

| | | |in a single dose. | | |

| | | |Adult: | |Contraindicated with pt. has known |

| |-Intestinal candidiasis. |Suspention 100000 inter. |Sus. 400000-600000 |-Mycostatin |hypersensitivity. |

| |-Skin candidiasis. |unit " iu " for oral use.|iu qid Children (3|-Nilstat |-Oral use can cause nausea, |

| |-Oral candidiasis | |months |-Nystan |vomiting and diarrhea. |

|Nystatin | | |250000-500000 iu |-Rianest |- To prevent reinoculation of |

| | | |qid |-Mikostat |candidal infection pt. is |

| | | |Newborn | |instructed to dispose the tooth |

| | | |100000 iu qid | |brush or other contaminated oral |

| | | | | |hygiene devices used during period |

| | | | | |of infection |

| | | | | | |

2. Analgesics

|Drug |Indications |Forms |Usual dose |Trade &price |Comment |

| Acetaminophen | | |Adult |-Adol |-Caution with hepatic |

| |-Mild to moderate |Tab. 325-500 mg |0.5-l g every |-Panadol |disease pt. |

| |pain & fever | |4-6 hours to |-Tylenol |-Contraindicated if the pt. is |

| | |Syrup 120 mg/5ml |max.4gm daily |-Fevadol |hypersensitive to acetaminophen or |

| | |125 mg/5ml |Children: |-Dafalgan |complain of Glucose 6-Phosphate |

| | | |1 year: 60-120mg |-Panacetamol |Dehydrogenase Deficiency. |

| | | |1-5y 120-150mg |syrup | |

| | | |6-12y 250-500mg |-Tempra | |

| |-Pain |Tab. 200-400 |400 mg every |-Brufen |It is contraindicated in: |

| |-Fever |600 mg |4-6 hours for |400mg=12 SR |-Hypersensitivity |

|Ibuprofen |-Inflammatory diseases | |mild-moderat pain |600mg=20 SR |-Nasal polyp |

| |-Rheumatoid disorders |Syrup 100 mg/5ml | |-Ibofen |-Angio-edema |

| |-Gout | | |-Profinal |-Bronchospastic reactivity |

| | | | |600 mg=13 SR |to aspirin or other |

| | | | |-Sapofen |NSAID’s. |

| | | | |400 mg=10 SR |-Caution if the pt. on |

| | | | |600 mg=10 SR |anticoagulant. |

| | | | | |-Taken after food |

| Mefenamic acid | | |Adult: | | |

| | |Tab. 500 mg |500mg initially |-Ponstan |-Avoid prescribing for dental pain |

| | |Cap. 250 mg |then 250 mg every 6 |500 mg=13 SR |in last trimester of pregnancy. |

| |-Mild to moderate pain |Syrup 50 mg/5ml |hours with food |-Fendol |-Caution if the pt. on |

| | | |children( 6 months :|500 mg= 7 SR |anticoagulant. |

| | | |25 mg/kg daily |-Mafepain | |

| | | |in divided doses |500 mg= 9 SR | |

|Diclofenac Sodium | | | |-Voltaren | |

| |-Mild to moderate pain |Tab. 25-50-100 mg |150-200mg/ day in | |-It can cause dry mouth & |

| |-Pain of rhematoid arthritis & |Inj. 75 mg/ampoule |2-4 divided doses. |50 mg =38 SR |stomatitis. |

| |osteoarthri- tis. | | |-Olfen |-Avoid prescribing for dental |

| |-Gout & Ankylosing spondylitis | | |50 mg =21 SR |pain in last trimester of |

| | | | |-Rofinac |pregnancy. |

| | | | |50 mg = 32 SR | |

| | | | |-Diclogesic | |

| | | | |50 mg = 17 SR | |

| | | | |-Vortex | |

| | | | | | |

| | | | |50 mg =10 SR | |

| | | | |-Colfen | |

| | | | |50 mg = 9 SR | |

| Paracetamol 500 mg |Mild to moderate pain |________ |2 tab. Every 4 hours|-Solpadeine |-Do not give if the pt. has allergy|

|with Caffeine 30 mg | | |to max. 8 tab. | |to propyphenazone |

|& Codeine | | |daily. |= 9 SR -Fevadol |-Not recommended for pregnant, |

| | | | |plus |breast-feeding women & for |

| | | | |= 8 SR |children ................
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