Medication Summary
Drugs used to treat dental fractures are generally nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics, anxiolytics, and proper antibiotics.
Antibiotics
Class Summary
Therapy must cover all likely pathogens in the context of the clinical setting. Current recommendations by the American Heart Association 2007 for dental, oral, respiratory tract, or esophageal procedures, indicate prophylaxis if the patient has one of the following conditions: [7]
- Prosthetic cardiac valve
- Previous infective endocarditis
- Congenital heart disease (CHD)
- Unrepaired cyanotic CHD, including palliative shunts and conduits
- Completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first 6 months after the procedure
- Repaired CHD with residual defects at the site or adjacent to the site of a prosthetic patch or prosthetic device (which inhibit endothelialization)
- Cardiac transplantation recipients who develop cardiac valvulopathy
Penicillin VK (Veetids)
Inhibits biosynthesis of cell wall mucopeptide and is effective during active replication. Inadequate concentrations may produce only bacteriostatic effects.
Erythromycin (EES, E-Mycin, Ery-Tab)
An alternative for patients allergic to penicillin. Because of possible GI irritation, advise patients to take this medication with food or milk if GI upset is noted.
Amoxicillin (Amoxil, Polymox, Trimox)
Interferes with the synthesis of cell wall mucopeptide during active replication, resulting in a bactericidal activity against susceptible bacteria.
Analgesics
Class Summary
Pain control is essential to quality patient care. Analgesics ensure patient comfort, promote pulmonary toilet, and enable physical therapy regimens. Many analgesics have sedating properties that benefit patients in pain.
Fentanyl citrate (Duragesic, Sublimaze)
A more potent narcotic analgesic with a much shorter half-life than morphine sulfate. DOC for conscious sedation analgesia.
With short duration (30-60 min) that is easy to titrate, an excellent choice for pain management and sedation. Easily and quickly reversed by naloxone.
After the initial dose, do not titrate subsequent doses more frequently than q3h or q6h thereafter.
Meperidine (Demerol)
Narcotic analgesic with multiple actions similar to those of morphine. May produce less constipation, smooth muscle spasm, and depression of the cough reflex than similar analgesic doses of morphine.
Oxycodone and acetaminophen (Percocet)
Drug combination indicated for relief of moderate to severe pain. DOC for patients who are hypersensitive to aspirin.
Hydrocodone bitartrate and acetaminophen (Vicodin ES)
Drug combination indicated for relief of moderate to severe pain.
Acetaminophen (Tylenol, Panadol, Aspirin Free Anacin)
DOC for the treatment of pain in patients with documented hypersensitivity to aspirin or NSAIDs, in those with upper GI disease, or in those who are taking oral anticoagulants.
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Cross section of an Ellis III dental fracture.
