Pediatric psychopharmacology and local anesthesia: potential adverse drug reactions with vasoconstrictor use in dental practice.
Pain management is important when dealing with pediatric dental patients. The use of local anesthetics can be especially challenging for children taking psychotropic medications. The purpose of this paper was to identify pertinent information regarding drug interactions between vasoconstrictor/local anesthetic combinations and medications for the management of psychiatric or behavior disorders in children. Many of the reported interactions are controversial, largely theoretical with very limited clinical evidence, and not well defined. However, when considering the potential for significant increased blood pressure when local anesthesia containing a vasoconstrictor is used, a thorough under standing of the pharmacological actions of medications used to treat psychiatric or behavioral disorders and vasoconstrictors can help dental professionals minimize the potential risk of drug interactions in their practice.
Pharmacist in Prentiss, Miss., USA.
Joe
J
Waits
Assistant professor, McWhorter School of Pharmacy, Samford University, Birmingham, Ala., USA.
Erika
E
Cretton-Scott
Professor, McWhorter School of Pharmacy, Samford University, Birmingham, Ala., USA.
Noel K
NK
Childers
Professor, Department of Pediatric Dentistry, School of Dentistry, University of Alabama at Birmingham, Birmingham, Ala., USA. pjsims@samford.edu.
Pamela J
PJ
Sims
D000766:Anesthesia, Dental; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002653:Child Behavior Disorders / Q000188:drug therapy; D004347:Drug Interactions; D006801:Humans; D018377:Neurotransmitter Agents / Q000009:adverse effects / Q000627:therapeutic use; D011596:Psychomotor Disorders / Q000188:drug therapy; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use*; D014662:Vasoconstrictor Agents / Q000009:adverse effects / Q000627:therapeutic use*
D000779:Anesthetics, Local; D018377:Neurotransmitter Agents; D011619:Psychotropic Drugs; D014662:Vasoconstrictor Agents