Slide 1

In The Name Of GOD

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The simplest clinical classification scheme recognizes three basic types of drug interactions:

1- antagonism2- potentiation3- unexpected drug effect4- summation5- synergism

An example of this type of interaction is seen in antibiotic therapy , where the combined use of a drug that acts by inhibiting the synthesis bacterial cell walls .

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The increased neuromuscular blocking activity of succinylcholine occurring in patients receiving a pseudocholinesterase inhibitor .

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Disulfiram inhibits the intermediary metabolism of alcohol, resulting in the accumulation of acetaldehyde if alcohol is ingested by the patient .

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Examples of drugs that summate by acting at identical and at different sites include the opioid analgesics morphine and meperidine .

The combination of chemotherapeutic agents to treat certain infections (e.g., tuberculosis) and neoplastic diseases .

1- pharmaceutical interactions .

2- pharmacokinetic interactions .

3- pharmacodynamic interactions .

Most pharmaceutical interactions of importance to dentistry involve drugs that are given parenterally for intravenous sedation.

Pharmacodynamic interactions represent modifications in the pharmacologic effects of a drug independent of any change in the quantitative disposition of that drug. Such interactions may increase, diminish, or qualitatively alter the therapeutic effect.

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: PABA

65

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: +

:1 3 G6PD

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COMT

HR (MAP)

HR (MAP) : 1

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(MOAIs) --

(TCA) ---

(SSRI) ---

MAOI :

TCA VC

SSRI VC

:Selective--Nonselective--

12 2 1

VC

VC : 200/115 6 CVA 6 CABG 6 CHF : :

OCP CCB BZD :

MAOI : NSAID

Tolerance: Dependance: Addiction:

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NO CO2 Diffusion Hypoxia: 5 100%

Smoking

: Co:

NSAID : COX

NSAID PG COX2

NSAID Cox1 PG COX1 PG PG GFR .PG

Cox2 PG

NSAID

NSAID ( PG) : ACE ( ) 7 8 . NSAID 4 : NSAID 4

NSAID Dry Socket ( diflunisal) ( Reye)

NSAID ( )

NSAID Nsaid COX A2

NSAID COX2: PG COX2 COX1

CELEXIB

PG

NSAID

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Turn Over

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nsaid

Latex Free

NSAID