prophylactic (ward off disease) measure to prevent
infective endocarditis (or IE) and in other medical
conditions. Patients having history of infective
endocarditis, rheumatic heart disease, artificial heart
valves, and some heart murmurs are at high risk when
involved in dental procedures that are likely to cause
bleeding. They are prescribed a large dose of
antibiotics before treatment and a smaller dose 6
hours after the initial dose. In all cases the dental
officer will review the patients health history and will
prescribe an antibiotic if needed. Many types of
antibiotics are available; listed are a few groups that
Penicillin is one of the most important of the
antibiotics. It is derived from a number of Peni-
cillium molds commonly found on breads and fruits.
It is one of the most effective and least toxic of the
antimicrobial agents used in dentistry.
Cephalosporins are a group of antibiotics that are
structurally and pharmacologically related to the
penicillin. Because the cephalosporins are structurally
similar to pencillians, some patients who are allergic to
penicillin may be allergic to a cephalosporin drug. So,
special caution is necessary when taking cepha-
OPIUM AND ALKALOIDS
The tetracyclines, introduced in 1948, were the
first truly broad-spectrum antibiotics. Administration
to children and pregnant women is not indicated
because it may produce discoloration of the teeth and
slow bone marrow growth.
Alkaloid-based compound names end in -ine.
Examples include atropine, caffeine, and nicotine.
The most important alkaloids of opium are morphine
and codeine. All of the opiate derivative drugs are very
addictive and require strict control.
Erythromycin has a bitter taste and is destroyed by
gastric acids, and usually comes in the form of a coated
tablet. Erythromycin is one of the drugs of choice
when penicillin is contraindicated. Many patients
cannot tolerate the nausea and stomach upset
commonly associated with erythromycin, so the
dentist may have to prescribe an alternate drug.
NON-NARCOTIC ANALGESICS AND
Analgesics are drugs that relieve pain without
producing unconsciousness or impairing mental
capacities. Many of these drugs also have an
antipyretic and/or an anti-inflammatory effect.
Antipyretics are drugs that lower increased body
temperatures. Analgesics can be used to relieve pain
from toothache, or can be prescribed for dental
postoperative pain relief.
Aspirin is an economical analgesic, antipyretic,
and anti-inflammatory agent used for mild to moderate
pain. It is contraindicated in peptic ulcer disease. It
acts as a gastric mucosal irritant and has an
anticoagulant (inhibits blood clotting) effect.
This drug is similar to aspirin, but has no
anti-inflammatory action. It is available as tablets,
elixir, drops, or capsules and is useful for patients who
are sensitive to aspirin.
Ibuprofen is indicated for the relief of mild to
moderate pain. It is used as an anti-inflammatory agent
for dental pain associated from post surgical or
operative procedures. It is not to be given to patients in
the third trimester of pregnancy or anyone with a
history of gastrointestinal bleeding.
Morphine sulfate is a drug indicated for the relief
of severe pain and used preoperatively to sedate
patients, treat myocardial infarctions, and is used in
casualty care. It is contraindicated in patients with
head injuries, acute alcoholism, or convulsive
Codeine sulfate is like morphine, but has one-sixth
of the analgesic power and one-fourth of the
respiratory depressant of morphine. It is used as a pain
reliever in dentistry for moderate to severe dental pain.