Pharmacology in Dental Hygiene Flashcards

Which analgesic should be avoided in a patient with aspirin-exacerbated respiratory disease (AERD/Samter's triad)?

Answer: Ibuprofen and all NSAIDs (including aspirin)

Patients with AERD (Samter's triad: asthma, nasal polyps, aspirin sensitivity) experience bronchospasm with all NSAIDs that inhibit COX-1, including ibuprofen; acetaminophen is generally safe.

The opioid analgesic codeine exerts its analgesic effect by being converted to:

Answer: Morphine via hepatic CYP2D6 enzyme

Codeine is a prodrug that undergoes O-demethylation by hepatic CYP2D6 to morphine (about 10% conversion), which provides most of its analgesic effect.

A patient is taking warfarin (Coumadin) for atrial fibrillation. If the dental hygienist recommends ibuprofen for post-procedural pain, what is the primary drug interaction concern?

Answer: NSAIDs inhibit platelet aggregation and may displace warfarin from plasma proteins, increasing bleeding risk

NSAIDs inhibit platelet function (GI mucosal protection) and may compete with warfarin for protein binding sites, potentially raising free warfarin levels and increasing hemorrhagic risk.

Which antihypertensive drug class is MOST likely to cause gingival enlargement?

Answer: Calcium channel blockers (particularly nifedipine)

Calcium channel blockers, especially nifedipine (and to a lesser extent amlodipine and diltiazem), are well-known causes of drug-influenced gingival enlargement.

Nitrous oxide-oxygen sedation (N2O/O2) used in dental hygiene is classified as which level of sedation?

Answer: Minimal sedation (anxiolysis) — patient fully conscious and responsive

At the concentrations used in dentistry (up to 50% N2O), nitrous oxide provides minimal sedation (anxiolysis) only — the patient remains fully conscious, maintains their own airway, and responds normally to verbal communication.

A patient taking selective serotonin reuptake inhibitors (SSRIs) for depression is at increased risk for which dental treatment complication?

Answer: Increased bleeding tendency due to impaired platelet serotonin uptake and aggregation

SSRIs block serotonin reuptake in platelets (which rely on serotonin for activation), impairing platelet aggregation and increasing bleeding tendency, particularly when combined with NSAIDs.