Clinically Relevant Drug Interactions Associated with the Use of Analgesics in Dentistry
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 2
Abstract
An increasing number of patients on polypharmacy present to the dentist today for treatment. Analgesics are frequently prescribed. In addition to this, patients may also be taking over-the-counter medications for various reasons. Several drug interactions have been reported with analgesics prescribed for dental pain and other medications that the patient may be concomitantly on. However, not all of these drug interactions may be clinically relevant, especially in the dental setting where analgesic administration is only of a short duration, usually of 4-5 days. NSAIDs should be avoided in the elderly, in patients with renal impairment, in patients with severe congestive heart failure and over a long term. They may reduce the hypotensive effects of some antihypertensives. Preferably they should not be prescribed for patients on lithium, methotrexate, and digoxin. When used along with anticoagulants and selective serotonin reuptake inhibitors, they may potentiate gastrointestinal hemorrhage. Aspirin should be avoided in patients on sulfonylureas, valproic acid and carbonic anhydrase inhibitors. Ibuprofen should not be prescribed for high risk patients on aspirin. Paracetamol will result in increased hepatotoxic metabolites if taken by the patient who has stopped alcohol after chronic ingestion. Opioids and alcohol have a complex relationship and should be avoided. Merperidine and monoamine oxidase inhibitors can cause a significant adverse clinical interaction.
Authors and Affiliations
Ruth Lourenco, Lois James Samuel
Keywords
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