Three Serious Drug Interactions that Every Dentist Should Know About.
Identifieur interne : 000173 ( Main/Exploration ); précédent : 000172; suivant : 000174Three Serious Drug Interactions that Every Dentist Should Know About.
Auteurs : Elliot V. Hersh [États-Unis] ; Paul A. Moore [États-Unis]Source :
- Compendium of continuing education in dentistry (Jamesburg, N.J. : 1995) [ 2158-1797 ] ; 2015.
Descripteurs français
- KwdFr :
- Antagonistes bêta-adrénergiques (effets indésirables), Antagonistes bêta-adrénergiques (pharmacologie), Anti-inflammatoires non stéroïdiens (effets indésirables), Anti-inflammatoires non stéroïdiens (pharmacologie), Bradycardie (induit chimiquement), Cytochrome P-450 CYP2C9 (effets des médicaments et des substances chimiques), Fluconazole (effets indésirables), Fluconazole (pharmacologie), Humains (MeSH), Hémorragie (induit chimiquement), Interactions médicamenteuses (MeSH), Lithium (effets indésirables), Lithium (pharmacologie), Métronidazole (effets indésirables), Métronidazole (pharmacologie), Propranolol (effets indésirables), Propranolol (pharmacologie), Rapport international normalisé (MeSH), Soins dentaires (MeSH), Warfarine (effets indésirables), Warfarine (pharmacologie), Épinéphrine (effets indésirables), Épinéphrine (pharmacologie).
- MESH :
- effets des médicaments et des substances chimiques : Cytochrome P-450 CYP2C9.
- effets indésirables : Antagonistes bêta-adrénergiques, Anti-inflammatoires non stéroïdiens, Fluconazole, Lithium, Métronidazole, Propranolol, Warfarine, Épinéphrine.
- induit chimiquement : Bradycardie, Hémorragie.
- pharmacologie : Antagonistes bêta-adrénergiques, Anti-inflammatoires non stéroïdiens, Fluconazole, Lithium, Métronidazole, Propranolol, Warfarine, Épinéphrine.
- Humains, Interactions médicamenteuses, Rapport international normalisé, Soins dentaires.
English descriptors
- KwdEn :
- Adrenergic beta-Antagonists (adverse effects), Adrenergic beta-Antagonists (pharmacology), Anti-Inflammatory Agents, Non-Steroidal (adverse effects), Anti-Inflammatory Agents, Non-Steroidal (pharmacology), Bradycardia (chemically induced), Cytochrome P-450 CYP2C9 (drug effects), Dental Care (MeSH), Drug Interactions (MeSH), Epinephrine (adverse effects), Epinephrine (pharmacology), Fluconazole (adverse effects), Fluconazole (pharmacology), Hemorrhage (chemically induced), Humans (MeSH), International Normalized Ratio (MeSH), Lithium (adverse effects), Lithium (pharmacology), Metronidazole (adverse effects), Metronidazole (pharmacology), Propranolol (adverse effects), Propranolol (pharmacology), Warfarin (adverse effects), Warfarin (pharmacology).
- MESH :
- chemical , adverse effects : Adrenergic beta-Antagonists, Anti-Inflammatory Agents, Non-Steroidal, Epinephrine, Fluconazole, Lithium, Metronidazole, Propranolol, Warfarin.
- chemical , drug effects : Cytochrome P-450 CYP2C9.
- chemical , pharmacology : Adrenergic beta-Antagonists, Anti-Inflammatory Agents, Non-Steroidal, Epinephrine, Fluconazole, Lithium, Metronidazole, Propranolol, Warfarin.
- chemically induced : Bradycardia, Hemorrhage.
- Dental Care, Drug Interactions, Humans, International Normalized Ratio.
Abstract
Patients with complex medical and drug histories are becoming more commonplace in dental practice. This article reviews three serious adverse drug interactions that are well supported by the literature and can impact dental practice. Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit the renal excretion of lithium and lead to lithium toxicity. Metronidazole and fluconazole inhibit the metabolism of warfarin by blocking cytochrome P-450 2C9 (CYP-2C9), the major metabolic pathway of warfarin, with the end result being dramatic increases in patients' international normalized ratios (INRs) and potentially fatal bleeding. Propranolol and other nonselective beta-adrenergic blocking agents can inhibit the vasodilatory effect of epinephrine in dental local anesthetic solutions, leading to hypertensive reactions and a concomitant reflex bradycardia. It is important for clinicians to recognize and avoid these serious drug interactions. By doing so, they will provide the safest and best treatment for their patients.
PubMed: 26053779
Affiliations:
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(pharmacologie)</term><term>Propranolol (effets indésirables)</term><term>Propranolol (pharmacologie)</term><term>Rapport international normalisé (MeSH)</term><term>Soins dentaires (MeSH)</term><term>Warfarine (effets indésirables)</term><term>Warfarine (pharmacologie)</term><term>Épinéphrine (effets indésirables)</term><term>Épinéphrine (pharmacologie)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Adrenergic beta-Antagonists</term><term>Anti-Inflammatory Agents, Non-Steroidal</term><term>Epinephrine</term><term>Fluconazole</term><term>Lithium</term><term>Metronidazole</term><term>Propranolol</term><term>Warfarin</term></keywords><keywords scheme="MESH" type="chemical" qualifier="drug effects" xml:lang="en"><term>Cytochrome P-450 CYP2C9</term></keywords><keywords scheme="MESH" type="chemical" qualifier="pharmacology" xml:lang="en"><term>Adrenergic beta-Antagonists</term><term>Anti-Inflammatory Agents, 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bêta-adrénergiques</term><term>Anti-inflammatoires non stéroïdiens</term><term>Fluconazole</term><term>Lithium</term><term>Métronidazole</term><term>Propranolol</term><term>Warfarine</term><term>Épinéphrine</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Dental Care</term><term>Drug Interactions</term><term>Humans</term><term>International Normalized Ratio</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Humains</term><term>Interactions médicamenteuses</term><term>Rapport international normalisé</term><term>Soins dentaires</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Patients with complex medical and drug histories are becoming more commonplace in dental practice. This article reviews three serious adverse drug interactions that are well supported by the literature and can impact dental practice. Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit the renal excretion of lithium and lead to lithium toxicity. Metronidazole and fluconazole inhibit the metabolism of warfarin by blocking cytochrome P-450 2C9 (CYP-2C9), the major metabolic pathway of warfarin, with the end result being dramatic increases in patients' international normalized ratios (INRs) and potentially fatal bleeding. Propranolol and other nonselective beta-adrenergic blocking agents can inhibit the vasodilatory effect of epinephrine in dental local anesthetic solutions, leading to hypertensive reactions and a concomitant reflex bradycardia. It is important for clinicians to recognize and avoid these serious drug interactions. By doing so, they will provide the safest and best treatment for their patients. </div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26053779</PMID><DateCompleted><Year>2017</Year><Month>03</Month><Day>07</Day></DateCompleted><DateRevised><Year>2017</Year><Month>03</Month><Day>07</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">2158-1797</ISSN><JournalIssue CitedMedium="Internet"><Volume>36</Volume><Issue>6</Issue><PubDate><Year>2015</Year><Month>Jun</Month></PubDate></JournalIssue><Title>Compendium of continuing education in dentistry (Jamesburg, N.J. : 1995)</Title><ISOAbbreviation>Compend Contin Educ Dent</ISOAbbreviation></Journal><ArticleTitle>Three Serious Drug Interactions that Every Dentist Should Know About.</ArticleTitle><Pagination><MedlinePgn>408-13; quiz 414, 416</MedlinePgn></Pagination><Abstract><AbstractText>Patients with complex medical and drug histories are becoming more commonplace in dental practice. This article reviews three serious adverse drug interactions that are well supported by the literature and can impact dental practice. Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit the renal excretion of lithium and lead to lithium toxicity. Metronidazole and fluconazole inhibit the metabolism of warfarin by blocking cytochrome P-450 2C9 (CYP-2C9), the major metabolic pathway of warfarin, with the end result being dramatic increases in patients' international normalized ratios (INRs) and potentially fatal bleeding. Propranolol and other nonselective beta-adrenergic blocking agents can inhibit the vasodilatory effect of epinephrine in dental local anesthetic solutions, leading to hypertensive reactions and a concomitant reflex bradycardia. It is important for clinicians to recognize and avoid these serious drug interactions. By doing so, they will provide the safest and best treatment for their patients. </AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Hersh</LastName><ForeName>Elliot V</ForeName><Initials>EV</Initials><AffiliationInfo><Affiliation>Professor, Pharmacology, Department of Oral Surgery and Pharmacology, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Moore</LastName><ForeName>Paul A</ForeName><Initials>PA</Initials><AffiliationInfo><Affiliation>Professor, Pharmacology and Dental Public Health, Departments of Dental Anesthesiology and Dental Public Health, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Compend Contin Educ Dent</MedlineTA><NlmUniqueID>9600713</NlmUniqueID><ISSNLinking>1548-8578</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000319">Adrenergic beta-Antagonists</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000894">Anti-Inflammatory Agents, Non-Steroidal</NameOfSubstance></Chemical><Chemical><RegistryNumber>140QMO216E</RegistryNumber><NameOfSubstance UI="D008795">Metronidazole</NameOfSubstance></Chemical><Chemical><RegistryNumber>5Q7ZVV76EI</RegistryNumber><NameOfSubstance UI="D014859">Warfarin</NameOfSubstance></Chemical><Chemical><RegistryNumber>8VZV102JFY</RegistryNumber><NameOfSubstance UI="D015725">Fluconazole</NameOfSubstance></Chemical><Chemical><RegistryNumber>9FN79X2M3F</RegistryNumber><NameOfSubstance 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Non-Steroidal</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName><QualifierName UI="Q000494" MajorTopicYN="N">pharmacology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001919" MajorTopicYN="N">Bradycardia</DescriptorName><QualifierName UI="Q000139" MajorTopicYN="N">chemically induced</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D065729" MajorTopicYN="N">Cytochrome P-450 CYP2C9</DescriptorName><QualifierName UI="Q000187" MajorTopicYN="N">drug effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003729" MajorTopicYN="Y">Dental Care</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004347" MajorTopicYN="Y">Drug Interactions</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004837" MajorTopicYN="N">Epinephrine</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName><QualifierName UI="Q000494" 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