Drug classifications, mechanisms, dental drugs
Esters = metabolized by pseudocholinesterase. Amides = liver metabolized. Lidocaine (amide) = gold standard. Onset order: Fastest → Articaine > Lidocaine > Bupivacaine. pKa determines onset (lower pKa = faster onset).
Ibuprofen = most commonly prescribed NSAID in dentistry. Ketorolac = most potent NSAID analgesic. COX-2 selective = Celecoxib. Diclofenac = most prescribed worldwide. Paracetamol = safest for pregnancy.
Amoxicillin = first-line for dental infections. Amoxicillin + Clavulanic acid = resistant cases. Metronidazole = anaerobes. Clindamycin = penicillin allergy. IE prophylaxis = Amoxicillin 2g, 1hr before.
Warfarin + NSAIDs = bleeding risk. Erythromycin + Warfarin = increased anticoagulation. Epinephrine + TCAs = hypertensive crisis. Metronidazole + Alcohol = disulfiram-like reaction.
Triamcinolone acetonide = most used topical steroid in oral lesions. Nystatin = topical antifungal of choice. Fluconazole = systemic antifungal of choice. Oral candidiasis in steroid inhaler users = rinse mouth after use.
Anaphylaxis = Epinephrine IM (first drug). Syncope = most common emergency in dental office. Angina = Nitroglycerin sublingual. Hypoglycemia = oral glucose/juice. Epileptic seizure = Midazolam.