Adverse drug interactions in dental practice: interactions associated with local anesthetics, sedatives and anxiolytics. Part IV of a series.
BACKGROUND
This article is the fourth 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 symposium evaluated the significance of various drug interactions associated with dental therapeutics.


METHODS
Local anesthesia and preoperative oral sedative/anxiolytic therapy often are indicated for routine oral surgery and restorative dentistry. The author conducted a literature review of the drug interactions associated with the use of local anesthetics and sedatives. The quality of the information used to document these interactions and the severity of the possible adverse outcome were assessed using a significance rating scale for dental drug interactions.


RESULTS
Many of the frequently described drug interactions were found to be poorly documented in the dental and medical literature. Others were determined not to be relevant to current dental practice. The use of local anesthetics, sedatives or anxiolytic agents in combination with other central nervous system depressant agents or in combination with drugs that inhibit their metabolism was associated with a few serious adverse drug interactions or complications.


CONCLUSIONS
The adverse drug interactions associated with the use of local anesthetics and oral sedative/anxiolytic agents in general practice vary in significance. An understanding of possible adverse drug interactions in dentistry may help practitioners avoid and prevent these complications.
Moore
P A
PA
University of Pittsburgh, School of Dental Medicine, Department of Dental Public Health, Pa. 15261, USA.
D000368:Aged; D000779:Anesthetics, Local / Q000009:adverse effects*; D014151:Anti-Anxiety Agents / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000037:antagonists & inhibitors; D001682:Biological Availability; D003729:Dental Care; D016321:Dental Care for Aged; D017742:Dental Care for Chronically Ill; D004336:Drug Antagonism; D004347:Drug Interactions; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D008099:Liver / Q000187:drug effects / Q000378:metabolism; D008657:Metabolic Clearance Rate / Q000187:drug effects; D008708:Methemoglobinemia / Q000139:chemically induced; D013449:Sulfonamides / Q000037:antagonists & inhibitors
D000779:Anesthetics, Local; D014151:Anti-Anxiety Agents; D000900:Anti-Bacterial Agents; D006993:Hypnotics and Sedatives; D013449:Sulfonamides