Pharmacology for Dentistry

Non-Narcotic Analgesics (NSAID’s) 87

iv. To prevent intracellular potassium loss,

potassium is given along with sodium

bicarbonate.

v. For ketoacidosis and hypoglycemia,

glucose may be given.

vi. In severe intoxication, dialysis (perito-

neal dialysis and haemodialysis) may

be used.

Therapeutic Uses

1. In Dentistry: The NSAID’s are the
   most important drugs for the manage-
   ment of acute dental pain. The particu-
   lar drug may be selected on the basis
   of severity of pain and presence of
   other related symptoms e.g. for mild
   to modrate pain, paracetamol is gen-
   erally recommended and in accute
   pain diclofenac alone or combined
   with paracetamol is generally pre-
   ferred. But care must be taken when
   given to patient who is having peptic
   ulcer, asthama or any hypersensitivty
   history.


2. As analgesic-antipyretic: Salicylates
   are effective in the treatment of mild
   to moderate types of pain. They are
   used in the treatment of headache,
   bodyache, arthralgias, neuralgias and
   dysmenorrhoea. They are also effective
   in fever of any origin.


3. As an antiinflammatory: Salicylates
   are commonly used in the treatment of
   various inflammatory conditions such
   as arthritis and fibromyositis.


4. As antirheumatic: Salicylates are the
   drug of choice in the treatment of rheu-
   matoid arthritis. In larger dose they
   suppress the swelling, immobility and
   redness of the joints involved. They are
   also useful in the acute rheumatic fe-
   ver. They produce relief in pain, swell-

ing and morning stiffness in the rheu-

matoid arthritis patients.

5. Treatment of gout: In large dose, aspi-
   rin is effective in the treatment of gout.


6. As antiplatelet agent: By inhibiting
   platelet aggregation aspirin may lower
   the incidence of reinfarction. It has been
   used to prevent the formation of plate-
   let-fibrin thrombus in ischemic heart
   disease patients.

PYRAZOLONE DERIVATIVES

PHENYLBUTAZONE

It is a potent antiinflammatory agent. It has

poor analgesic and antipyretic action.

Mechanism of action is similar to other

NSAIDs.

It is readily absorbed from the GI tract

with peak plasma concentration occurring

two hours after ingestion. It is 98% bound

to plasma proteins and it is extensively

metabolised in the liver by oxidation and by

conjugation with glucuronic acid.

Adverse effects include nausea, epigas-

tric distress, aplastic anaemia, vomiting, di-

arrhoea, peptic ulcer, depression, neutrope-

nia, hypothyroidism, skin rash and urticaria.

It is indicated in ankylosing spondyli-

tis, rheumatoid arthritis, rheumatic fever,

osteoarthritis, after blunt injuries, frac-

tures, tooth extraction, vasectomy and

acute gout.

OXYPHENBUTAZONE

It is a metabolite of phenylbutazone and

having similar pharmacodynamic and phar-

macokinetic properties and similar thera-

peutic uses.