Dentistry
A common oral side effect of many CNS drugs.
Xerostomia
Most benzodiazepines are classified under which controlled substance schedule.
Schedule IV
alprazolam (Xanax)
diazepam (Valium)
lorazepam (Ativan)
clonazepam (Klonopin)
Benzodiazepines
This benzodiazepine can be used indirectly as a muscle relaxant
Diazepam (Valium)
This neurotransmitter is enhanced by both benzodiazepines and barbiturates
GABA (gamma-aminobutyric acid)
This must be obtained before administering sedation.
Informed consent
Most benzodiazepines fall under this pregnancy risk category.
Category D (and some are in Category X)
Citalopram (Celexa)
Escitalopram (Lexapro)
Fluoxetine (Prozac)
Paroxetine (Paxil)
Sertraline (Zoloft)
Selective Serotonin Reuptake Inhibitors (SSRIs)
Analgesic-Sedative Combination of Butalbital + acetaminophen + caffeine
Fioricet
Decreased neuron firing when chloride enters the cell results in this condition
hyperpolarization
This reflex may be suppressed during benzodiazepine sedation.
Gag reflex
Black box warning on ALL antidepressants
increased risk of suicide
Venlafaxine (Effexor)
Duloxetine (Cymbalta)
Atomoxetine (Stattera) - ADHD
Levomilnacipran (Fetzima)
Desvenlafaxine (Pristiq)
Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
Serotonin antagonist and reuptake inhibitor (SARI) used to treat depression and off label for insomnia
Trazodone (Desyrel)
Selectively block the reabsorption of 5-HT (serotonin), so that more serotonin is available to bind to synaptic receptors.
SSRIs (selective serotonin reputake inhibitors)
This medication may be used in dentistry if the patient is having difficulty falling asleep the night before a dental appointment
Zolpidem (Ambien)
Barbiturates
Amitriptyline (Elavil)
Nortriptyline (Pamelor, Aventyl)
Desipramine (Norpramin, Pertofrane)
Imipramine (Tofranil)
Tricyclic Antidepressants
NDRI (norepinephrine-dopamine reuptake inhibitor) used to treat depression and used as a smoking cessation aid
Bupropion (Wellbutrin)
These medications block the reabsorption of BOTH serotonin and norepinephrine
SNRIs (serotonin-norepinephrine reuptake inhibitors)
Benzodiazepine used for IV sedation in dentistry.
Midazolam
This group of medications have MANY drug and food interactions including cheese, wine, and fish!! --> can result in hypertensive crisis
Monoamine Oxidase Inhibitors (MAOIs)
Eszopiclone (Lunesta)
Zaleplon (Sonata)
Zolpidem (Ambien)
Z-Drugs (non-benzodiazepine sedative-hypnotics) used in the treatment of insomnia
Antidepressant that acts as both an SSRI and a 5-HT (serotonin) receptor partial agonist
Vilazodone (Viibryd)
Class of medications that inhibit the breakdown of monoamines like serotonin, NE, and dopamine
Monoamine Oxidase Inhibitors (MAOIs)
Benzodiazepines such as Diazepam and Midazolam cause this condition, which is a therapeutic advantage in unpleasant dental procedures.
anterograde amnesia
Examples include Parkinsonism, acute dystonia, and tardive dyskinesia.
Extrapyramidal effects
Baclofen (Lioresal)
Tizanidine (Zanaflex)
Dantrolene (Dantrium)
Muscle Relaxants (used in the treatment of multiple sclerosis (MS), cerebral palsy, and spinal cord injuries)
Benzisothiazol derivative used to treat bipolar and schizophrenia
Lurasidone hydrochloride (Latuda)
These medications act as CNS depressants by increase the frequency of chloride (Cl-) channel opening by binding to GABA receptors resulting in decreased neuron firing (hyperpolarization)
Benzodiazepines
CAUTIOUS administration of local anesthesia is required when patients are taking which anti-depressant medications
TCAs (use epinephrine with caution)
MAOIs (epinephrine is contraindicated)
This antidote reverses benzodiazepine overdose.
flumazenil (Romazicon)
Diphenhydramine (Benadryl)
Doxylamin (Unisom)
Antihistamines that induce sedation (non-benzodiazepine, non-barbituate sedative-hypnotics) can be obtained OTC (over-the-counter)
Name a 2nd generation antipsychotic drug that is FDA-approved as adjunctive treatments for major depressive disorder when the response to an antidepressant is not adequate.
Quetiapine (Seroquel)
Aripiprazole (Abilify)
Category of medications that inhibit the reuptake of serotonin (5-HT) and norepinephrine, but also acts as an antagonist on histamine, muscarinic, and alpha-adrenergic receptors
Tricyclic Antidepressants