Adverse drug reactions, a guide for dentists
DOI:
https://doi.org/10.17159/sadj.v78i01.15751Keywords:
Adverse drug reactions, dentists, adverse drug reaction reporting, SAHPRAAbstract
Adverse drug reactions (ADRs) are unintended or harmful effects due to the use of a medicine. Antibiotics and analgesics, which incidentally, are commonly prescribed by dentists, result in most of the ADRs globally. As with most healthcare professionals, dentists do not report on ADRs regularly. Therefore, the aim of the review was to explore the drugs most used in dental practice in South Africa (SA), their associated ADRs and the ADR reporting channels. The study undertook a literature review that focused on studies of adverse drug reactions specifically in dental practices. An electronic search was done on EBSCO host to source articles published from 2000 to 2022. There was a plethora of ADRs that were found to occur with the medicines that are prescribed by dentists that ranged
from minor to serious. Although all medicines have a risk of ADRs, amoxicillin can result in gastrointestinal disturbances and anaphylactic reactions, while clindamycin has a risk of Clostridium difficile infection. Patients need to be alerted to the risk of a disulfiram reaction with metronidazole and alcohol. Hepatic failure can occur with paracetamol use especially in patients with underlying liver disease, an alcoholic or in an overdose. Ibuprofen, caution in patients with underlying ulcers as gastrointestinal bleeding is a risk. Local anesthetics pose a high threat of severe reactions such as tissue necrosis and direct neurotoxicity while anterograde amnesia, respiratory depression and thrombosis can occur with benzodiazepines. Dentists can prevent ADRs by having a good knowledge of their prescribed drugs, monitoring their patients and by being judicious in their prescribing habits.
Downloads
Metrics
References
Shehab N, Patel PR, Srinivasan A, Budnitz DS. Emergency department visits for antibiotic-associated adverse events. Clin Infect Dis. 2008 Sep 15;47(6):735-43. DOI: https://doi.org/10.1086/591126
Howard RL, Avery AJ, Slavenburg S, Royal S, Pipe G, Lucassen P, Pirmohamed M. Which drugs cause preventable admissions to hospital? A systematic review. Br J Clin Pharmacol. 2007 Feb;63(2):136-47. DOI: https://doi.org/10.1111/j.1365-2125.2006.02698.x
Chavez EM, Jacobsen PL. Pharmacology and aging. Textbook of geriatric dentistry, edited by Poul Holm-Perderson, Angus WG Walls, Jonathan A Ship, 3rd ed, John Wiley and Sons Ltd Publishing. 2015 Jun 19:145.
Chari DN, Dave BH, Bargale SS, Deshpande AN, Shah SS, Shah PS. Adverse drug reaction: Knowledge, attitude and practice amongst paediatric dentists in India: An electronic survey. Adv Hum Biol. 2021 May 1;11(2):181. DOI: https://doi.org/10.4103/aihb.aihb_107_20
Yip J, Radford DR, Brown D. How do UK dentists deal with adverse drug reaction reporting?. Br Dent J. 2013 Apr;214(8):E22-.E22. DOI: https://doi.org/10.1038/sj.bdj.2013.426
Khan SA, Goyal C, Tonpay SD. A study of knowledge, attitudes, and practice of dental doctors about adverse drug reaction reporting in a teaching hospital in India. Perspect Clin Res. 2015 Jul;6(3):144. DOI: https://doi.org/10.4103/2229-3485.159938
Schatz S, Weber RJ. Adverse drug reactions. Pharmacy Practice. 2015 Aug 24;1(1).
Khammissa RA, Ballyram R, Wood NH, Lemmer J, Feller L. Glucocorticosteroids in the treatment of immune mediated oral diseases: clinical review. S Afr Dent J. 2016 Mar 1;71(2):62-7.
Poveda Roda R, Bagán JV, Sanchis Bielsa JM, Carbonell Pastor E. Antibiotic use in dental practice: A review. Med Oral Patol Oral Cir Bucal. 2007 May;12(3):186-92.
Almeida VD, Azevedo J, Leal HF, Queiroz AT, da Silva Filho HP, Reis JN. Bacterial diversity and prevalence of antibiotic resistance genes in the oral microbiome. PLOS One. 2020 Sep 29;15(9):e0239664. DOI: https://doi.org/10.1371/journal.pone.0239664
Siqueira Jr JF, Rôças IN. Microbiology and treatment of acute apical abscesses. Clin Microbiol Rev. 2013 Apr;26(2):255-73. DOI: https://doi.org/10.1128/CMR.00082-12
Kuriyama T, Williams DW, Yanagisawa M, Iwahara K, Shimizu C, Nakagawa K, Yamamoto E, Karasawa T. Antimicrobial susceptibility of 800 anaerobic isolates from patients with dentoalveolar infection to 13 oral antibiotics. Oral Microbiol Immunol. 2007 Aug;22(4):285-8. DOI: https://doi.org/10.1111/j.1399-302X.2007.00365.x
Mthethwa SR, Matjila SA. Antibiotic prescribing practices of dentists at Medunsa Oral Health Centre. South African Dental Journal. 2018 Sep;73(8):520-6. DOI: https://doi.org/10.17159/2519-0105/2018/v73no8a6
Lalloo R, Solanki G, Ramphoma K, Myburgh NG. Endodontic treatmentrelated antibiotic prescribing patterns of South African oral health professionals. International endodontic journal. 2017 Nov;50(11):1027-33 DOI: https://doi.org/10.1111/iej.12731
Singh VP, Nayak SU, Nettemu SK, Nettem S, Lee YH, Verma MB. Azithromycin in periodontal therapy: beyond the antibiotics. J Periodontol Oral Implant. 2018 Dec 31;2(2):61-6. DOI: https://doi.org/10.3126/jnspoi.v2i2.23616
Buset SL, Zitzmann NU, Weiger R, Walter C. Non-surgical periodontal therapy supplemented with systemically administered azithromycin: a systematic review of RCTs. Clin Oral Investig. 2015 Nov;19(8):1763-75. DOI: https://doi.org/10.1007/s00784-015-1499-z
Rossiter, Dawn. South African Medicines Formulary. Ed. Dawn Rossiter. 13th ed. Rondebosch, South Africa: Health and Medical Pub. Group of the South African Medical Association, 2016. Print.
Akhavan BJ, Khanna NR, Vijhani P. Amoxicillin. InStatPearls [Internet] 2021 Aug 17. StatPearls Publishing.
Thornhill MH, Dayer MJ, Durkin MJ, Lockhart PB, Baddour LM. Oral antibiotic prescribing by NHS dentists in England 2010-2017. Br Dent J. 2019 Dec;227(12):1044-50. DOI: https://doi.org/10.1038/s41415-019-1002-3
Robertson D, Smith AJ. The microbiology of the acute dental abscess. J Med Microbiol. 2009 Feb 1;58(2):155-62. DOI: https://doi.org/10.1099/jmm.0.003517-0
Dabija-Wolter G, Al-Zubaydi SS, Mohammed MM, Bakken V, Bolstad AI. The effect of metronidazole plus amoxicillin or metronidazole plus penicillin V on periodontal pathogens in an in vitro biofilm model. Clin Exp Dent Res. 2018 Feb;4(1):6-12. DOI: https://doi.org/10.1002/cre2.96
Dar-Odeh NS, Abu-Hammad OA, Al-Omiri MK, Khraisat AS, Shehabi AA. Antibiotic prescribing practices by dentists: a review. Ther Clin Risk Manag. 2010;6:301. DOI: https://doi.org/10.2147/TCRM.S9736
Leffler DA, Lamont JT. Clostridium difficile infection. New England Journal of Medicine. 2015 Apr 16;372(16):1539-48. DOI: https://doi.org/10.1056/NEJMra1403772
Czepiel J, Drózdz M, Pituch H, Kuijper EJ, Perucki W, Mielimonka A, Goldman S, Wultanska D, Garlicki A, Biesiada G. Clostridium difficile infection. European Journal of Clinical Microbiology & Infectious Diseases. 2019 Jul;38(7):1211-21. DOI: https://doi.org/10.1007/s10096-019-03539-6
Kirkwood KL. Update on antibiotics used to treat orofacial infections. The Alpha omegan. 2003 Dec 1;96(4):28-34.
Vardakas KZ, Trigkidis KK, Boukouvala E, Falagas ME. Clostridium difficile infection following systemic antibiotic administration in randomised controlled trials: a systematic review and meta-analysis. Int J Antimicrob Agents. 2016 Jul 1;48(1):1-0. DOI: https://doi.org/10.1016/j.ijantimicag.2016.03.008
Mohsen S, Dickinson JA, Somayaji R. Update on the adverse effects of antimicrobial therapies in community practice. Can Fam Physician. 2020 Sep 1;66(9):651-9.
Blondeau JM. What have we learned about antimicrobial use and the risks for Clostridium difficile-associated diarrhoea? J Antimicrob Chemother. 2009 Feb 1;63(2):238-42. DOI: https://doi.org/10.1093/jac/dkn477
Shenoy ES, Macy E, Rowe T, Blumenthal KG. Evaluation and management of penicillin allergy: a review. Jama. 2019 Jan 15;321(2):188-99. DOI: https://doi.org/10.1001/jama.2018.19283
Mirakian R, Leech SC, Krishna MT, Richter AG, Huber PA, Farooque S, Khan N, Pirmohamed M, Clark AT, Nasser SM. Management of allergy to penicillins and other beta-lactams. Clin. Exp. Allergy. 2015 Feb;45(2):300-27. DOI: https://doi.org/10.1111/cea.12468
Karamanakos PN, Pappas P, Boumba VA, Thomas C, Malamas M, Vougiouklakis T, Marselos M. Pharmaceutical agents known to produce disulfiram-like reaction: effects on hepatic ethanol metabolism and brain monoamines. Int J Toxicol. 2007 Sep;26(5):423-32. DOI: https://doi.org/10.1080/10915810701583010
Murphy PB, Bistas KG, Le JK. Clindamycin. In StatPearls [Internet] 2018. StatPearls Publishing.
Luchian I, Goriuc A, Martu MA, Covasa M. Clindamycin as an alternative option in optimizing periodontal therapy. Antibiotics. 2021 Jul 4;10(7):814. DOI: https://doi.org/10.3390/antibiotics10070814
Hansen MP, Scott AM, McCullough A, Thorning S, Aronson JK, Beller EM, Glasziou PP, Hoffmann TC, Clark J, Del Mar CB. Adverse events in people taking macrolide antibiotics versus placebo for any indication. Cochrane Database Syst Rev. 2019(1). DOI: https://doi.org/10.1002/14651858.CD011825.pub2
Roberts E, Nunes VD, Buckner S, Latchem S, Constanti M, Miller P, Doherty M, Zhang W, Birrell F, Porcheret M, Dziedzic K. Paracetamol: not as safe as we thought? A systematic literature review of observational studies. Ann Rheum Dis. 2016 Mar 1;75(3):552-9. DOI: https://doi.org/10.1136/annrheumdis-2014-206914
Turkoski BB. Acetaminophen: old friend—new rules. Orthop Nurs. 2010 Jan 1;29(1):41-3. DOI: https://doi.org/10.1097/NOR.0b013e3181c8cd75
Food and Drug Administration. FDA Acetaminophen Dosage Announcement. Available from: chromeextension:// efaidnbmnnnibpcajp cglclefindmkaj/https://www.medicaid.nv.gov/Downloads/provider/web_announcement_468_20120425.pdf. (2012, Accessed 5 August, 2022).
Ong CK, Seymour RA, Lirk P, Merry AF. Combining paracetamol (acetaminophen) with nonsteroidal antiinflammatory drugs: a qualitative systematic review of analgesic efficacy for acute postoperative pain. Anesth Analg. 2010 Apr 1;110(4):1170-9. DOI: https://doi.org/10.1213/ANE.0b013e3181cf9281
Malmstrom K, Sapre A, Couglin H, Agrawal NG, Mazenko RS, Fricke Jr JR. Etoricoxib in acute pain associated with dental surgery: a randomized, double blind, placebo-and active comparator-controlled dose-ranging study. Clin Ther. 2004 May 1;26(5):667-79. DOI: https://doi.org/10.1016/S0149-2918(04)90067-7
Hunt RH, Harper S, Callegari P, Yu C, Quan H, Evans J, James C, Bowen B, Rashid F. Complementary studies of the gastrointestinal safety of the cyclooxygenase-2-selective inhibitor etoricoxib. Aliment Pharmacol Ther. 2003 Jan;17(2):201-10. DOI: https://doi.org/10.1046/j.1365-2036.2003.01407.x
Krasniqi S, Daci A. Analgesics use in dentistry. Pharmacology, Toxicology and Pharmaceutical Science-Pain Relief-From Analgesics to Alternative Therapies. 2017 May 24:111-39. DOI: https://doi.org/10.5772/66600
Balakrishnan R, Ebenezer V. Contraindications of vasoconstrictors in dentistry. Biomed Pharmacol J. 2013 Dec;6(2):409-14. DOI: https://doi.org/10.13005/bpj/435
Becker DE, Reed KL. Essentials of local anesthetic pharmacology. Anesth Prog. 2006;53(3):98-109. DOI: https://doi.org/10.2344/0003-3006(2006)53[98:EOLAP]2.0.CO;2
Dillane D, Finucane BT. Local anesthetic systemic toxicity. Can J Anesth. 2010 Apr;57(4):368-80. DOI: https://doi.org/10.1007/s12630-010-9275-7
Dalal R, Grujic D. Epinephrine. InStatPearls [Internet] 2022 May 8. StatPearls Publishing.
Bounds CG, Nelson VL. Benzodiazepines. In StatPearls [Internet]. 2020. StatPearls Publishing.
Laporta ML, Sprung J, Weingarten TN. Respiratory depression in the postanesthesia care unit: Mayo Clinic experience. Bosn J Basic Med Sci. 2021 Apr;21(2):221. DOI: https://doi.org/10.17305/bjbms.2020.4816
Veselis RA, Reinsel RA, Feshchenko VA. Drug-induced amnesia is a separate phenomenon from sedation: electrophysiologic evidence. Anesthesiology. 2001 Oct 1;95(4):896-907. DOI: https://doi.org/10.1097/00000542-200110000-00018
Stachnik J. Inhaled anesthetic agents. Am J Health Syst Pharm. 2006 Apr 1;63(7):623-34. DOI: https://doi.org/10.2146/ajhp050460
Glassick A, Hamilton T, Shetty K. Management of Dental Patients on Steroid Therapy and Steroid Therapy for Patients in a Dental Practice. New Year, New Changes. 2010 Jan 1:27.
South African Health Products Regulatory Authority. Post-marketing reporting of adverse drug reactions to human medicines in South Africa. Available from: www.sahpra.org.za/wpcontent/uploads/2020/03/2.33_ADR_Reporting_
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
.png){kind=spacer}