Lecture Summary: Pharmacology of Pain Management and Related Topics

Introduction

• Overview of drugs for pain management
• Two categories: NSAIDs and Opioids

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

• Aspirin (Salicylic Acid):
  • Over-the-counter, blood thinner, antipyretic, analgesic, anti-inflammatory
  • Used for pain, arthritis, cardiovascular disease
  • Contraindicated with warfarin
• Ibuprofen (Advil, Motrin):
  • Antipyretic, analgesic, anti-inflammatory
• Naproxen (Aleve):
  • Same functions as ibuprofen
• Acetaminophen (Tylenol):
  • Analgesic, antipyretic, NOT anti-inflammatory

Opioids

• Prescription required
• Common opioids:
  • Codeine: often prescribed in dentistry
  • Morphine, Oxycodone: strong pain relievers
• Mechanism: Bind to mu, kappa, delta receptors; depress central nervous system
• Risks: High addiction potential, respiratory depression

Mechanism of Non-Opioids

• Block COX enzymes, reduce prostaglandin synthesis

Pharmacological Comparisons

• NSAIDs reduce fever but not all are anti-inflammatory (e.g., acetaminophen)

Drug Interactions and Contraindications

• Aspirin and warfarin contraindicated (both blood thinners)

Antibiotics and Infections

• Bactericidal vs. Bacteriostatic Antibiotics:
  • Bactericidal: Cephalosporins, Metrozidazole, Penicillin
  • Bacteriostatic: Clindamycin, Tetracycline
• Penicillin for pre-medication; alternatives for allergies

Viral and Fungal Infections

• Antiviral drugs:
  • Acyclovir, Docosanol (for HSV)
• Antifungal drugs:
  • Nystatin (for thrush), Imidazoles (end in azole)

Gastrointestinal Diseases

• GERD Treatments:
  • Histamine-2 blockers (end in -dine), Proton pump inhibitors (end in -azole)
• Antacids: Tums

Brain Disorders

• Antidepressants:
  • SSRIs & SNRIs: Block reuptake of serotonin/norepinephrine
• Anti-Anxiety:
  • Benzodiazepines: End in -zepam or -zolam
• Anti-Convulsants:
  • Phenytoin: Causes gingival enlargement

Respiratory Disorders

• Asthma and COPD treatments:
  • Short-acting beta-2 agonists: Albuterol (quick relief)
  • Long-acting beta-2 agonists: Salmeterol (slow release)
  • Corticosteroids: For recovery, not acute relief

Local Anesthesia

• Types: Esters vs. Amides (Amides have an 'i' before -caine)
• Cardiac considerations: Limit epinephrine in cardiac patients

Nitrous Oxide

• Used for sedation, not a strong anesthetic
• Contraindicated in respiratory issues, pregnancy

Immunosuppressants

• Cyclosporine: Causes gingival enlargement, used for transplant acceptance

Bisphosphonates

• Used for osteoporosis, can cause osteonecrosis of the jaw

Diabetes Management

• Type 1: Insulin injections essential
• Type 2: Metformin common medication
• Monitoring: HbA1c test for glycemic control

Conclusion

• Reminder to review additional resources for further details on pharmacology topics.