DHY 133 - Pharmacology

1. Demonstrate behavior congruent with the American Dental Hygienists? Association Code of Ethics
   1. Demonstrate accountability and responsibility for own professional behavior and development
   2. Demonstrate accountability and responsibility reflecting professional values.
   3. Demonstrate professional behavior by being on time for class.
2. Discuss the history of pharmacology
3. Describe the role of pharmacology in the dental hygiene process of care
4. Define the ways in which drugs are named and the significance of each
   1. Outline the procedures for drug development and evaluation of drug safety
   2. State the purpose of the Nuremburg code and the current Institutional Review Boards
5. Identify the four phases of clinical evaluation in drug approval and the five schedules of drugs
6. Describe the elements of a drug prescription
   1. State the necessities for the dental hygienist?s understanding of the basics of prescription writing.
   2. Name those persons who may write prescriptions
   3. Recognize units of measure for the:
7. Recount reliable sources of information about drugs
   1. Name the three classes of drug action
   2. Identify the log dose-effect curve and distinguish between potency and efficacy
   3. Recognize factors which cause variations of individual response to a drug
8. Compare the differences between pharmacodynamics and pharmacokinetics.
   1. Describe the drug-receptor interaction and types of drug receptors.
   2. Differentiate dose, potency, and efficacy in the context of the actions of drugs
   3. Explain the pharmacologic effect of a drug and factors that cause variations in individual response.
   4. Discuss the major steps in pharmacokinetics: absorption, distribution, metabolism, and excretion
   5. Summarize the various routes of drug administration
   6. Distinguish between a loading dose and a maintenance dose
9. Define an adverse drug reaction and differentiate among the five categories of reactions: cytotoxic, drug-drug, drug-food, drug-disease, and idiosyncratic
   1. Distinguish between local and systemic effects of drug administration
   2. Distinguish between enteral and parenteral routes of drug administration and uses for each
   3. State how the effects of a drug can be recognized
   4. Identify three factors which influence a drug’s passage across cell membranes
   5. Define:
   6. Define absorption and factors influencing drug absorption
   7. Define distribution of drugs through
   8. Recall three mechanisms of drug action
   9. Recognize drug biotransformation and excretion mechanisms
10. Describe actions dental hygienists should take to avoid adverse drug reactions in the patients they treat
    1. Name the factors that alter a drug’s effect
    2. State the most accurate suggestion for determining children’s dosage
11. Review the anatomy and physiology of the nervous system
    1. Describe the neurophysiology of nerve stimulus transmission
    2. Elaborate on the autonomic nervous system, including functional organization and neurotransmitters.
12. Discuss the pharmacologic effects, adverse reactions, contraindications, and dental considerations of cholinergic agents
13. Discuss the pharmacologic effects, adverse reactions, contraindications, and dental considerations of anticholinergic agents
14. Discuss the pharmacologic effects, adverse reactions, contraindications, and dental considerations of adrenergic agents
15. Explain adrenergic and adrenergic-receptor blocking agents
    1. State the necessities for the dental hygienist understanding the basics of prescription writing.
    2. Name those persons who may write prescriptions
    3. Recognize units of measure for the
    4. Recognize and translate common abbreviations used in prescription writing
    5. Identify parts of the prescription
16. Review the anatomy and physiology of the nervous system
    1. Describe the neurophysiology of nerve stimulus transmission
    2. Elaborate upon the autonomic nervous system, including functional organization and neuron-transmitters
17. Describe nociception
18. Explain the differences in mechanism of action of opioid and nonopioid analgesics
    1. Cholinergic agents and their
    2. Anticholinergic agents and their
    3. Adrenergic drugs and their
    4. Adrenergic blocking agents and their
19. Discuss commonly used pharmacologic agents used for the treatment of odontogenic and orofacial pain including
    1. the primary line of treatment
    2. secondary line of treatment
    3. tertiary line of treatment
    4. adverse drug events
20. Understand the concept of bacteriocidal versus bacteriostatic antibacterial drugs.
    1. Three ways in which analgesics work
    2. The classification of nonnarcotic analgesics
    3. The salicylates with regard to
    4. Nonsteroidal anti-inflammatory agents or drugs
    5. Acetaminophen:
    6. Drugs used to treat gout
    7. Narcotic analgesic agents with regard to
    8. Specific agents and their
21. Understand the pharmacodynamics of the following antibacterial drugs
    1. bacterial cell wall inhibitors
    2. inhibitors of DNA synthesis and repair
    3. inhibitors of translation and transcription
22. Discuss bacterial resistance to anitibiotic drug therapy and factors that influence its development
    1. Identify three types of infective dental processes
    2. Explain situations in which the dental hygienist may encounter the use of anti-infective agents
    3. State the goal of chemotherapy of infectious diseases
    4. Define the following
    5. Identify general principles of antimicrobial therapy and considerations for
    6. List indications for antimicrobial agents
    7. Recall general adverse effects
23. Identify antibacterial agent and the dosage regimen for the treatment of odontogenic infections
24. Summarize the concept and practice of antibiotic prophylaxis in dentistry.
    1. Identify indications for and describe the prophylactic antibiotic regimen for TJR patents.
    2. Identify indications for and describe the prophylactic antibiotic regimen to prevent infective endocarditis in susceptible clients
    3. List dental procedures which require and which do not require antibiotic prophylaxis in TJR or IE susceptible clients
25. Name several types of antifungal agents and discuss their indications in dentistry and potential adverse reactions
26. Discuss the treatment of herpes simplex.
    1. List reasons why the management of anxiety is important in the delivery of patient care
    2. Recall the two components of cognitive appraisal according to Lozarus and variables associated with each
    3. Identify “automatic thoughts” and their characteristics
    4. Name fears associated with dental treatment and their sources
    5. Relate techniques and tools utilized in patient anxiety assessment
    6. Relate pain control modalities available for dental patients and their purposes
    7. Distinguish between
    8. Discuss normal sleep patterns, drugs which alter sleep patterns, and side effects from these alterations
    9. Recall benzodiazephines with regard to
    10. Briefly discuss buspirone
    11. Identify barbiturate drugs with regard to
    12. Identify nonbarbiturate sedative-hypnotics and their
    13. Identify centrally acting muscle relaxants and their
    14. Discuss sedative-analgesic combinations with regard to
    15. Review special considerations and cautions when using antianxiety agents
27. Describe the various drugs and drug combinations used to treat acquired immunodeficiency syndrome
    1. State the action of general anesthetics
    2. Define the term balanced anesthesia and
    3. Recall four factors which influence the choice of a drug for anesthesia
    4. Describe preparation of the patient for general anesthetic administration
    5. Name the methods of administering a general anesthetic
    6. Identify the patient responses characteristic of each of the
    7. State the goals of surgical anesthesia
    8. Identify adverse reactions encountered with the administration of general anesthetics
    9. Categorize the classes of general anesthetics
    10. Relate physical factors and the process to achieve inhalation anesthesia
    11. Define minimum alveolar concentration and state its use
    12. Identify pharmacological effects, clinical application, advantages and disadvantages for
    13. Define “dissociative anesthesia” and its
    14. Discuss the use of opioids in conjunction with general anesthesia
    15. Define “neuroleptanalgesia” and its
    16. Recall the role of benzodiazephines in anesthesia
    17. Recall characteristics of an ideal local anesthetic
    18. Classify the local anesthetics chemically
    19. Discuss local anesthetics and vasoconstrictors with regard to
    20. Name the ingredients in a local anesthetic solution
    21. Distinguish between infiltration, field block, and nerve block injections
    22. Identify names, pharmacologic and clinical effects, and duration of action for
    23. Recall suggestions for choosing an anesthetic agent
    24. Identify agents for and application of topical anesthetics
    25. Prepare to administer local anesthesia utilizing the Handbook of Local Anesthesia by Malamed
    26. Practice administration of local anesthesia for the following injections: supraperiosteal, anterior superior alveolar nerve block, infraorbital nerve block, middle superior alveolar nerve block, posterior superior alveolar nerve block, greater palatine ne
    27. Demonstrate proper record keeping on patient chart following administration of local anesthesia
    28. Recall that the local anesthetic must be ordered by the dentist and the administration performed under direct supervision
28. Explain the mechanism of action, pharmacokinetics, pharmacologic effects, and adverse reactions of local anesthetics.
    1. Recall characteristics of an ideal local anesthetic
    2. Classify the local anesthetics chemically
    3. Discuss local anesthetics and vasoconstrictors with regard to:
    4. Name the ingredients in a local anesthetic solution
    5. Distinguish between infiltration, field block, and nerve block injections.
    6. Identify names, pharmacologic and clinical effects, and duration of action for:
    7. Recall suggestions for choosing an anesthetic agent
    8. Identify agents for and applciation of topical anesthetics
    9. Prepare to administer local anesthesia utilizing the Handbook of Local Anesthesia by Malamed
    10. Practice administration of local anesthesia for the following injections: supraperiosteal, anterior superior alveolar nerve block, infraorbital nerve block, middle superior alveolar nerve block, posterior superior alveolar nerve block, greater palatine ne
    11. Demonstrate proper record keeping on patient chart following administration of local anesthesia
    12. Recall that the local anesthetic must be ordered by the dentist and the administration performed under direct supervision
29. Summarize the history of general anesthetics in dentistry
    1. Discuss the indications and contraindications for use of this conscious sedation modality
    2. Discuss the complications associated with use
    3. Discuss the signs and symptoms of the baseline level of conscious sedation
    4. List safety features associated with gas cylinders and the gas machine
    5. Calculate the percentage of nitrous oxide and the percentage of oxygen from the tidal volume to be recorded on the patient?s dental record
    6. Safely administer nitrous oxide oxygen sedation by using titration to induce the proper level of sedation, monitoring the patient during analgesia, and oxygenating the patient at the completion of the sedation period
    7. Recall that this procedure must be ordered by the dentist and performed under direct supervision
30. Describe how general anesthesia works and the stages involved
    1. Define cardiovascular disease
    2. Discuss implications of cardiovascular disease in the following situations
    3. Define terms describing actions of drugs on the cardiovascular disease
    4. Review pathophysiology of congestive heart failure
    5. Identify cardiac glycosides with regard to
    6. Review the mechanism of cardiac rhythm
    7. Identify antiarrhythmic agents and their
    8. Recall symptoms, cause, and precipitating factors in angina pectoris
    9. Identify antianginal drugs with regard to
    10. Define hypertension and its symptoms
    11. Categorize hypertensive disease
    12. Identify antihypertensive agents and their
    13. Name antihyperlipidemic drugs and their
    14. Review the clotting mechanism
    15. State the purpose of and indications for anticoagulant therapy
    16. Identify action, uses, administration and adverse effects of
    17. Recall measures for dental patients on anticoagulant drug therapy
    18. Relate the term “epilepsies” and etiologies
    19. Review types of epileptic seizures and characteristics of each
    20. Discuss the mechanism of action of anticonvulsant drugs and their general adverse effects
    21. Identify anticonvulsive agents with regard to
    22. List procedures for dental treatment of epileptic patients
31. Name and describe several types of general anesthetics and their adverse effects.
    1. Discuss the role of drug therapy in psychiatric disorders
    2. List factors in assessing a patient’s need for drug therapy
    3. Identify cautions you should use when treating patients with mental disorders
    4. Identify antipsychotic agents with regard to
    5. Classify types of depression
    6. Identify antidepressant drugs and their
    7. Recall MAOIs with regard to
    8. Recall names of atypical antidepressants plus their advantages and disadvantages
    9. Name the drug used in treatment of manic depressive illness and its
    10. State reasons you should be aware of adrenocorticosteroid agents
    11. Review the natural mechanism of release of adrencorticosteroid agents
    12. Classify adrenocorticosteroids
    13. Identify glucocorticoids with regard to
    14. Review pituitary hormones and their functions
    15. Discuss thyroid hormones and
    16. Recall pancreatic hormones and diabetes mellitus
    17. Identify antidiabetic agents
    18. Review female sex hormones and their purposes
    19. Identify oral contraceptives with regard to
    20. Name the male sex hormones and their uses
    21. Identify clomiphene and its
    22. Discuss the use of antineoplastic drugs
    23. Identify mechanisms of action for these agents
    24. Identify the classification of antineoplastic agents, drugs in each category, and their uses
    25. State why adverse effects occur as well as early and principal adverse effects
    26. Outline oral care protocol for patients receiving chemotherapy
    27. Identify diseases associated with the respiratory system
    28. Identify each of the respiratory drug groups with regard to
    29. Relate dental concerns for the patient with respiratory problems
    30. Identify gastrointestinal drugs and their
    31. Discuss the following
    32. State the role of drugs as part of emergency treatment
    33. Recall causes, signs and symptoms, and treatment of potential dental office emergencies
    34. Identify equipment and drugs included in an emergency kit for the dental office
    35. Identify uses and actions for drugs commonly used in an emergency situation
32. Discuss the use of nitrous oxide in dentistry, including how it works, the pharmacological effects, adverse reactions, and contraindications using Clark and Bunnick, Handbook of Nitrous Oxide and Oxygen Sedation as your primary text
    1. Describe pain and anxiety management in dentistry
    2. Recall the physical properties and pharmacokinetics of N2O.
    3. Describe the manufacturing and packaging of N2O/O2.
    4. Describe the delivery systems available for N2O/O2 delivery in the dental office.
    5. Recall the steps from the protocol list necessary for client assessment, preparation, N2O/O2 titration, and complete recovery from analgesia.
    6. Identify the signs and symptoms of appropriate minimal sedation and oversedation
    7. Identify potential biohazards for healthcare personnel associated with chronic exposure to N2O.
    8. Identify ethical and legal considerations regarding N2O administration.
    9. Identify all components of the DMACC nitrous-oxide-oxygen equipment.
    10. Demonstrate proper documentation of nitrous oxide-oxygen delivery to a DMACC client
33. Describe anticaries, antigingivitis, and desensitizing agents used in dentistry and their application.
    1. Define the types of drug interactions and the best means for preventing problems of this nature
    2. Discuss mechanisms of drug interactions, including
    3. Identify dental drug interactions in the following areas
34. Review common oral mucous membrane lesions and conditions including signs, symptoms and treatments
35. Compare the indications and effects of the available drugs used to treat diabetes mellitus.
    1. Explain the management of diabetic dental clients
    2. Describe the various drug-drug interactions of diabetic medications
    3. dental treatment of the alcoholic patient
    4. dental treatment of the cocaine-addicted patient
    5. recognizing drug -shoppers
    6. reporting the drug impaired dental health care worker
36. State the uses for glucoccorticosteriods and the management of clients on these drugs.
37. List drugs taken for thyroid disorders and state the management of clients taking these drugs
38. Summarize the components of oral contraceptives and dental concerns.
39. Summarize the components of hormone replacement therapies and dental concerns.
40. Chose from a list all drugs that are contraindicated during pregnancy.
41. Describe the etiology and treatment of gastroesophageal reflux disorder and peptic ulcer disease
    1. Explain the differences in treatment between GERD and PUD.
    2. Discuss any contraindications or precautions in dental clients with GI disorders.
42. Discuss the treatments for constipation and diarrhea
43. Define the term antiemetic and be able to give examples of them
44. Briefly define the terms asthma and chronic obstructive pulmonary disease.
45. Briefly review the classification of asthma
46. List the different types of medications available to treat the different types of cough.
47. Define the terms antitussive, expectorant, and decongestant.
48. Discuss the pathophysiology, prevalence and risk factors associated with asthma and COPD.
49. Review the different classes of medications used to treat asthma including mechanism of action, adverse reactions, and drug interactions
50. Discuss the dental concerns associated with cardiovascular disease and how metabolic equivalents can be used to assess risks.
51. Describe hypertension and the stepped-up approach to treating it.
52. List the different classes of antihypertensive medications including pharmacologic effects and adverse reactions
53. Define the term angina and review the classes of medications used to treat it
54. Describe the factors that may place one at risk for hyperlipidemic disorders.
55. List the categories of drugs used to treat high cholesterol including pharmacologic effects and adverse reactions
56. Define the term arrhythmia and list its causes
57. Describe the four classifications of antiarrhythmics and the ADEs and drug interactions associated with them
58. Briefly review the coagulation process and drugs used to treat coagulopathies.
59. Describe congestive heart failure and the pharmacologic effects and adverse reactions of cardiac glycosides
60. List other drugs used to treat congestive heart failure.
61. Discuss the dental concerns associated with the drugs used to treat cardiovascular disorders
62. Describe the mechanism of action, interactions, and dental relevance of the benzodiazepines barbiturates, nonbarbituate sedatives and antihistamines used as anxiolytics or sleep aids.
63. Summarize the mechanism of action, pharmacologic effects, adverse reactions, drug interactions, and management considerations of the antidepressants.
64. Summarize the mechanism of action, pharmacologic effects, adverse reactions, drug interactions, and management considerations of the antipsychotics
65. Summarize the mechanism of action, pharmacologic effects, adverse reactions, drug interactions, and management considerations of the drugs used to treat Parkinson Disease
66. Describe the two categories of seizures and give a brief description of the different classifications of seizure disorders
67. Summarize the mechanism of action, pharmacologic effects, adverse reactions, drug interactions, and management considerations of the drugs used to treat seizure disorders
68. Review and council patients on the dental concerns associated with all antiseizure medications
69. Discuss why people choose herbal products over traditional medicine.
70. Discuss the federal legislation governing herbal and dietary products.
71. List several reliable sources of information on supplements
72. Discuss good manufacturing practices and the standardization of herbal products
73. Discuss herbal products used in dentistry as well as common alternative dental products and their efficacy
74. Define antineoplastic agents and discuss their use and adverse drug effects.
    1. Summarize the use, mechanisms of action, and classification of antineoplastic agents
    2. Describe several adverse drug effects associated with antineoplastic agents.
    3. Discuss the dental implications of clients planning to take or actively taking antineoplastic drugs
75. Define several types of inflammatory arthropathies and gout
    1. Summarize the use, mechanisms of action, and classifications of drugs used to treat arthropathies and gout
    2. Describe considerations in the dental hygiene management of clients with arthropathy
76. Define addiction, dependence, tolerance, and abstinence syndrome in relation to drug abuse.
77. Identify several types of central nervous system depressants and stimulants that are commonly abused.
78. Describe the three stages of substance abuse treatment
79. Describe dental hygiene management for the substance-abusing client.
80. Discuss ways in which the dental health care worker can identify clients or colleagues who may be abusing drugs