Types of Drugs

• Drug: Aspirin

  • Type of drug: NSAID (peripherally-acting)
  • Other examples: Ibuprofen, Naproxen, Diclofenac
  • Relevance to dentistry/relevant drug interactions:
  • Do not prescribe to children due to risk of Reye's syndrome
  • Can increase bleeding time
• Drug: Alendronic acid

  • Type of drug: Bisphosphonate
  • Other examples: Risedronate sodium, Zolendronic acid
  • Relevance to dentistry/relevant drug interactions:
  • Can cause delayed healing of bone following dental extractions (BRONJ/MRONJ)
• Drug: Ciclosporin

  • Type of drug: Immunosuppressant
  • Other examples: Tacrolimus
  • Relevance to dentistry/relevant drug interactions:
  • Gingival overgrowth
  • Pt more susceptible to infections
• Drug: Citalopram

  • Type of drug: SSRI anti-depressant
  • Other examples: Fluozetine, paroxetine, sertraline
  • Relevance to dentistry/relevant drug interactions:
  • Xerostomia
  • Postural hypotension
• Drug: Clopidogrel

  • Type of drug: Antiplatelet
  • Other examples: Dipyridamole
  • Relevance to dentistry/relevant drug interactions:
  • Risk of bleeding following extractions
  • Pack and suture sockets
• Drug: Dabigatran

  • Type of drug: Novel oral anticoagulant/direct oral anticoagulant (NOAC or DOAC)
  • Other examples: Apixaban, rivaroxaban
  • Relevance to dentistry/relevant drug interactions:
  • New anticoagulant medications
  • No reversal agent
  • Risk of bleeding following dental extraction (and otherwise invasive dental treatment)
• Drug: Gliclazide

  • Type of drug: Sulphonylurea oral anti-diabetic
  • Other examples: glipizide, tolbutamide
  • Relevance to dentistry/relevant drug interactions:
  • Pt will have Type 2 diabetes, risk of hypoglycaemia and other diabetes-related dental problems
• Drug: Lansoprazole

  • Type of drug: Proton-pump inhibitor
  • Other examples: omeprazole
  • Relevance to dentistry/relevant drug interactions:
  • Xerostomia
  • The pt will have an underlying GI disorder related to acid reflux, this can cause tooth surface loss due to (intrinsic) erosion
• Drug: Lisinopril

  • Type of drug: ACE inhibitor (anti-hypertensive)
  • Other examples: Captopril, perindopril, ramipril
  • Relevance to dentistry/relevant drug interactions: xerostomia
• Drug: methotrexate

  • Type of drug: anti-metabolite
  • Other examples: azathioprine
  • Relevance to dentistry/relevant drug interactions:
  • Can cause bone marrow suppression
  • Pts may have bloods monitored for this
• Drug: metronidazole

  • Type of drug: nitroimidazole antimicrobial (antibiotic)
  • Other examples: tinidazole
  • Relevance to dentistry/relevant drug interactions:
  • Often prescribed by dentists for orofacial infections (bacterial)
  • Pt MUST avoid alcohol whilst taking - disulfram reaction
  • Do not prescribe for pts taking warfarin
• Drug: miconazole

  • Type of drug: imidazole antifungal
  • Other examples: ketoconazole
  • Relevance to dentistry/relevant drug interactions:
  • Can be prescribed by dentists for fungal infections
  • Several drug interactions
  • Do not prescribe to pts on warfarin, even in its topical preparation
• Drug: nicorandil

  • Type of drug: potassium channel activator
  • Relevance to dentistry/relevant drug interactions: oral ulceration can be a side effect
• Drug: nifedipine

  • Type of drug: calcium channel blocker
  • Other examples: amlodipine, verapamil
  • Relevance to dentistry/relevant drug interactions: gingival overgrowth
• Drug: prednisolone

  • Type of drug: corticosteroid
  • Relevance to dentistry/relevant drug interactions:
  • Pts at risk of adrenal crisis if taking at high dose for long period of time may require BP monitoring and/or steroid cover for treatment
  • Increased susceptibility to opportunistic infections
• Drug: Propanolol

  • Type of drug: beta-blocker
  • Other examples: atenolol
  • Relevance to dentistry/relevant drug interactions:
  • Xerostomia
  • Postural hypotension
  • Limit adrenaline-containing LA to 2-3 cartridges
• Drug: salbutamol

  • Type of drug: beta-2 adrenoceptor stimulator (inhaler)
  • Other examples: terbutaline
  • Relevance to dentistry/relevant drug interactions:
  • Xerostomia
  • Pt will have underlying respiratory problem eg asthma and associated dental risks
• Drug: warfarin

  • Type of drug: coumarin anticoagulant
  • Relevance to dentistry/relevant drug interactions:
  • Risk of bleeding, pt will need INR check before invasive dental procedures, and must be below 4
  • Pack and suture sockets
  • Drug interactions +++ always check the BNF before prescribing