Moore P A, Gage T W, Hersh E V, Yagiela J A, Haas D A
University of Pittsburgh, School of Dental Medicine, Department of Dental Public Health, Pa. 15261, USA.
J Am Dent Assoc. 1999 Jan;130(1):47-54. doi: 10.14219/jada.archive.1999.0028.
Rapid progress in dental pharmacotherapeutics requires that clinicians constantly update their knowledge of new drugs, drug interactions and useful therapeutic trends. This article is the first in a five-part series based on a 1998 International Association for Dental Research symposium entitled "Adverse Drug Interactions in Dentistry: Separating the Myths From the Facts." The goal of the series is to identify specific adverse drug interactions that are relevant to the therapeutic agents commonly used in general dental practice: analgesics, antibiotics, sedatives, local anesthetics and vasoconstrictors.
A group of dentist/clinical pharmacologists, with documented expertise in specific areas of dental therapeutics, reviewed the current literature regarding adverse drug interactions in dentistry. This expert panel evaluated the quality of information used to document these drug interactions and assess the severity of these drug reactions with respect to the drugs' use in dental practice.
On the basis of the quality and severity of each reported interaction, the authors summarized the clinical importance of these drug interactions using a Significance Rating for Dental Drug Interactions. The participants presented their recommendations at the above-mentioned IADR symposium.
Although thousands of drug interactions are described in the literature, the authors found many to be poorly documented or of minor importance to dental practitioners. For interactions that they determined to be relevant, the participants provided recommendations and precautions for preventing these potential complications. This article discusses the professional impact of drug interactions on dental practice; the classification and documentation of drug interactions; the determination of causality between drug interactions and adverse effects; risk factors; and unique characteristics of dental therapeutics. Subsequent articles will present specific summary recommendations for drug interactions associated with the use of antibiotics, analgesics, sedatives, and local anesthetics and vasoconstrictors.
Although thousands of drug interactions have been reported in the literature, only a few are significantly associated with dental therapeutic agents. Avoiding these drug interactions will prevent potentially severe reactions in dental practice.
牙科药物治疗学的快速发展要求临床医生不断更新他们关于新药、药物相互作用和有用治疗趋势的知识。本文是一个五部分系列文章中的第一篇，该系列基于1998年国际牙科研究协会的一次研讨会，主题为“牙科中的药物不良反应：区分神话与事实”。该系列的目标是识别与一般牙科实践中常用治疗药物（镇痛药、抗生素、镇静剂、局部麻醉药和血管收缩剂）相关的特定药物不良反应。
一组在牙科治疗特定领域有记录的专业知识的牙医/临床药理学家，回顾了当前关于牙科药物不良反应的文献。这个专家小组评估了用于记录这些药物相互作用的信息质量，并评估了这些药物反应在牙科实践中使用药物方面的严重程度。
根据每个报告的相互作用的质量和严重程度，作者使用牙科药物相互作用的重要性评级总结了这些药物相互作用的临床重要性。参与者在上述国际牙科研究协会研讨会上提出了他们的建议。
尽管文献中描述了数千种药物相互作用，但作者发现其中许多记录不充分或对牙科从业者不太重要。对于他们确定相关的相互作用，参与者提供了预防这些潜在并发症的建议和预防措施。本文讨论了药物相互作用对牙科实践的专业影响；药物相互作用的分类和记录；药物相互作用与不良反应之间因果关系的确定；风险因素；以及牙科治疗的独特特征。后续文章将针对与抗生素、镇痛药、镇静剂、局部麻醉药和血管收缩剂使用相关的药物相互作用提出具体的总结建议。
尽管文献中报道了数千种药物相互作用，但只有少数与牙科治疗药物有显著关联。避免这些药物相互作用将预防牙科实践中潜在的严重反应。
