Farmakologi

7/21/2019 Farmakologi

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DRUGS AND X-RAYS FOR PREGNANT AND BREASTFEEDING WOMEN DURING DENTAL

TREATMENT

1. DENTAL CARE BEFORE PREGNANCY

A dental exa!nat!"n #$"%ld n"t &e 'e(a'ded a# an !#"lated e)!#"de %nde'ta*en d%'!n( )'e(nan+,. P'!"' t"

)'e(nan+, a 'e(%la' )'"('a " dental +a'e &a#ed "n a )'e/ent!/e e)$a#!# #$"%ld $a/e &een

e#ta&l!#$ed. Re(%la' exa!nat!"n# !n+l%d!n( 'ad!"('a)$!+ exa!nat!"n# 0$e'e +l!n!+all, !nd!+ated "'

)a't " t$!# )'"('a and #$"%ld &e +"nt!n%ed t$'"%($"%t )'e(nan+,. T'eatent )lann!n( #$"%ld all"0 "'

t$e )"##!&!l!t, " )'e(nan+,.

. DENTAL CARE DURING PREGNANCY

E#ta&l!#$ed )'e/ent!/e dental )'"('a# and %n+")l!+ated 'e#t"'at!"n "' 'e$a&!l!tat!"n )'"('a# #$"%ld

+"nt!n%e t$'"%($ )'e(nan+, a# needed. S"e +"n+e##!"n# t" t$e )at!ent2# )$,#!+al +""'t a, &e

ne+e##a',.

M"#t dental t'eatent +an &e +a''!ed "%t 0!t$ #aet, d%'!n( )'e(nan+,. W$e'e t$e'e !# a 'ea#"n t" dee'

t'eatent "' !n#tan+e ele+t!/e )'"+ed%'e# 'e3%!'!n( (ene'al anae#t$e#!a t$e#e )'"+ed%'e# #$"%ld &edee''ed %nt!l ate' t$e &!'t$ "' ! ne+e##a', %nt!l t$e )at!ent2# +"nd!t!"n $a# &een +"n4'ed and t$e

#!t%at!"n +an &e a##e##ed.

RADIOGRAPHY: W$en 'ad!"('a)$, " an a'ea 'e"te '" t$e "et%# !# needed a# !n dental'ad!"('a)$, t$!# +an &e %nde'ta*en 0!t$ ne(l!(!&le d"#e t" t$e "et%# at an, t!e d%'!n( )'e(nan+,.W$e'e ne+e##a', "' a##e##ent "' d!a(n"#!# " !ne+t!"n "' t'a%a "' "' t'eatent " t$e#e +"nd!t!"n#t$e'e !# NO 'ea#"n "n 'ad!"l"(!+al ('"%nd# t" dee' 'ad!"('a)$# d%'!n( )'e(nan+,.

In (ene'al ele+t!/e t'eatent !# &e#t )e'"'ed !n t$e nd t'!e#te' " )'e(nan+, 56t$ 7t$ and 8t$ "nt$#9.

Cl!n!+al #e##!"n# "' ele+t!/e t'eatent #$"%ld n"t &e %nd%l, )'"l"n(ed. In t$e t$!'d t'!e#te' t$e "t$e'

#$"%ld &e )"#!t!"ned +""'ta&l, #%+$ t$at t$e "etal a## d"e# n"t )'e## $ea/!l, "n t$e !ne'!"' /ena

+a/a.

INFECTIONS: P'"l"n(ed ele/at!"n " &"d, te)e'at%'e #$"%ld &e a/"!ded a# !t $a# &een #$"0n t" a:e+t

de/el")!n( +ell#. T$e "#t l!*el, '!#e !n &"d, te)e'at%'e "++%''!n( !n dent!#t', !# '" a+%te !ne+t!"n.

T$!# +"%ld &e '" !ne+ted #*!n ;a)# a##"+!ated 0!t$ e'%)t!n( "la'# 5%#%all, <0!#d"= teet$9 '"

a+%te )e'!"d"ntal 5(%= !ne+t!"n# '" a+%te "d"nt"(en!+ !ne+t!"n# 5a&#+e##e#9 "' (ene'al!#ed

#t"at!t!#. T$e )'")t t'eatent " #%+$ !ne+t!"n# !# e##ent!al t" a/"!d !n+'ea#e# !n &"d, te)e'at%'e. In

add!t!"n t" t$e '!#!n( &"d, te)e'at%'e a##"+!ated 0!t$ a+%te !ne+t!"n# an, a+%te "' +$'"n!+ !ne+t!"n#

a, )'"d%+e t"x!n#. T$e e:e+t# " #%+$ t"x!n# "n t$e de/el")!n( +$!ld !# %n*n"0n.

An, *n"0n te'at"(en!+ #%&#tan+e# 5+a%#!n( &!'t$ dee+t#9 #$"%ld n"t &e %#ed "' )'e#+'!&ed d%'!n(

)'e(nan+,. T$e e:e+t# " an, t$e'a)e%t!+ #%&#tan+e #$"%ld al0a,# &e +"n#!de'ed a(a!n#t t$e )"##!&le

ad/e'#e e:e+t# "n t$e de/el")!n( +$!ld. T$e A%#t'al!an D'%( E/al%at!"n C"!ttee $a# 'e/!e0ed and+ate("'!#ed t$e '!#*# " d'%(# %#ed !n )'e(nan+, and !n"'at!"n 'ele/ant t" d'%(# %#ed !n dent!#t', !# #et

"%t &el"0.

A)a't '" t$!# lea;et !n"'at!"n "n ed!+at!"n# +an al#" &e #"%($t '">

• Tele)$"ne 1300 MEDICINE 51?@@ 8??6 68?9 W$en ,"% +all ,"% 0!ll #)ea* 0!t$ an ex)e'!en+ed

'e(!#te'ed n%'#e. Y"%' 3%e#t!"n a, &e an#0e'ed "n t$e #)"t "' ,"% a, &e 'ee''ed t" ,"%' GP "')$a'a+!#t "' t" an"t$e' $ealt$ )'"e##!"nal. I ,"% $a/e a +")lex en3%!', ,"% a, &e )%tt$'"%($ t" an NPS )$a'a+!#t.

• Tele)$"ne MOTHERSAFE "n 9382 6539 at t$e R",al "#)!tal "' W"en Rand0!+*.

?. CONSIDERATIONS ABOUT TE CATEGORISATION OF DRUGS

• T$!# +ate("'!#at!"n $a# #"e l!!tat!"n# t$at %#t &e a##e##ed &, t$e )'e#+'!&e'>

• It !)l!e# t$at t$e'e !# a $!e'a'+$!+al '!#* 0!t$ Cate("', C &e!n( <0"'#e= t$an Cate("', B. T$!# !# t"" #!)l!#t!+.

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• It d"e# n"t (!/e +l!n!+al +"ntext t" t$e '!#*# and d"e#n2t d!:e'ent!ate &et0een d'%(# "' "'e "' le##

#!(n!4+ant +"nd!t!"n#.

• Med!+!ne# 0!t$!n t$e #ae Cate("', d" n"t al0a,# +a'', a #!!la' '!#*.

• T$e Cate("'!e# d" n"t +"n#!de' t$e #ta(e " )'e(nan+,.

• T$e Cate("'!e# d" n"0 ta*e t$e d"#e "' '"%te " ad!n!#t'at!"n !nt" a++"%nt.

• T$e'e !# a d!:e'ent +la##!4+at!"n #,#te "' &'ea#teed!n(.

In t$e a&#en+e " +")ell!n( +!'+%#tan+e# dent!#t# #$"%ld 'e#t'!+t t$e!' %#e " d'%(# "' )'e(nant

)at!ent# t" Cate("'!e# A B and B1 and 0$e'e a&#"l%tel, ne+e##a', B B? C and D. D'%(# !n Cate("',

X #$"%ld n"t &e %#ed at all. T$e dent!#t %#t al0a,# 0e!($ %) t$e *n"0n ad/anta(e# "' t$e )at!ent

a(a!n#t an, )"##!&le ad/e'#e e:e+t# 0$!+$ a, "++%' t" e!t$e' t$e "t$e' "' t$e +$!ld.

Cate("',

A

D'%(# 0$!+$ $a/e &een ta*en &, a large n%&e' " )'e(nant 0"en and 0"en "

+$!ld&ea'!n( a(e 0!t$"%t an, )'"/en !n+'ea#e !n t$e '!#* " al"'at!"n# "' "t$e' d!'e+t "'

!nd!'e+t $a'%l e:e+t# "n t$e "et%# &e!n( "&#e'/ed.Cate("',

B

D'%(# 0$!+$ $a/e &een ta*en &, a limited n%&e' " )'e(nant 0"en and 0"en "

+$!ld&ea'!n( a(e 0!t$"%t an, )'"/en !n+'ea#e !n t$e '!#* " al"'at!"n# "' "t$e' d!'e+t "'

!nd!'e+t $a'%l e:e+t# "n t$e "et%# &e!n( "&#e'/ed.

Cate("',B1

D'%(# 0$e'e an!al #t%d!e# $a/e n"t #$"0n e/!den+e " an !n+'ea#ed "++%''en+e " "etaldaa(e.

Cate("',

B

D'%(# 0$e'e an!al #t%d!e# a'e !nade3%ate "' a, &e la+*!n( &%t a/a!la&le data #$"0 n"

e/!den+e " an !n+'ea#ed "++%''en+e " "etal daa(e.Cate("',

B?

D'%(# 0$e'e an!al #t%d!e# $a/e #$"0n an !n+'ea#ed "++%''en+e " "etal daa(e t$e

#!(n!4+an+e " 0$!+$ !# %n*n"0n !n $%an#.Cate("',

C

D'%(# 0$!+$ &e+a%#e " t$e!' )$a'a+"l"(!+al e:e+t# $a/e +a%#ed "' a, &e #%#)e+ted t"

+a%#e $a'%l e:e+t# "n t$e $%an "et%# "' ne"nate 0!t$"%t +a%#!n( al"'at!"n#. T$e#e

e:e+t# a, &e 'e/e'#!&le.

Cate("',

D

D'%(# 0$!+$ &e+a%#e " t$e!' )$a'a+"l"(!+al e:e+t# $a/e +a%#ed "' a, &e #%#)e+ted t"

+a%#e an !n+'ea#ed !n+!den+e " $%an "etal al"'at!"n# "' !''e/e'#!&le daa(e. T$e#e

d'%(# a, al#" $a/e ad/e'#eCate("',

X

D'%(# t$at $a/e #%+$ a $!($ '!#* " +a%#!n( )e'anent daa(e t" t$e "et%# t$at t$e, #$"%ld

ne/e' &e %#ed !n )'e(nan+, "' 0$e'e t$e'e !# a )"##!&!l!t, " )'e(nan+,.

6. DRUGS AND BREAST MIL

D%'!n( la+tat!"n d'%(# +an &e ex+'eted !n !l* and !n #"e +a#e# a'e " ade3%ate +"n+ent'at!"n t" a:e+t

t$e n%'#!n( !nant. T$e +"n+ent'at!"n )'e#ent !n !l* !# %#%all, !n t$e #ae "'de' a# t$e #e'%

+"n+ent'at!"n " t$e "t$e' &%t t$e'e a'e ex+e)t!"n# 0$e'e t$e d'%( !# +"n+ent'ated !n t$e !l*.

O++a#!"nall, #!n(le d"#e# "' #e/e'al d"#e# 0!t$!n a 6 $"%' )e'!"d " a d'%( 0$!+$ a, $a/e an e:e+t "n

a n%'#!n( !nant a'e e##ent!al "' t$e "t$e'2# $ealt$ "' t'eatent. T$e )'e#en+e " t$e d'%( !n !l* +an &e!n!!#ed ! ex)'e##ed &'ea#t !l* !# #t"'ed 5!n a 'e'!(e'at"'9 "' #e/e'al da,# &e"'e t$e )'"+ed%'e and

%#ed t" eed t$e +$!ld d%'!n( and ate' t$e )'"+ed%'e %#%all, "' a )e'!"d " 6 - 6 $"%'#.

D'%(# ex+'eted !n t$e !l* +an a:e+t a n%'#!n( !nant !n an, " t$e#e 6 0a,#>

1. T$e, a, $a/e a d!'e+t e:e+t "n t$e !nant e.(. #edat!/e# a, +a%#e d'"0#!ne##. T$e !nant2# #%+*!n( 'e;ex a, &e !n$!&!ted?. T$e ta#te " t$e !l* a, &e alte'ed6. E/en #all a"%nt# " t$e d'%( ex+'eted !n t$e !l* a, +a%#e an alle'(, "' d'%( $,)e'#en#!t!/!t,.

Cate("',

1

e', l"0 +"n+ent'at!"n# !n !l* n" ad/e'#e e:e+t# "n

!nant *n"0n.Cate("',

Ad/e'#e e:e+t# a, "++%'

Cate("',

?

Ad/e'#e e:e+t "n !nant $a/e &een 'e+"'ded.

of 5 C")!led &, D' Matt W$!te @16 ?@181



Refere!e":

1. AUSTRALIAN RADIATION AND NUCLEAR SAFETY AGENCY (ARPANSA)

Rad!at!"n P'"te+t!"n !n Dent!#t',> Rad!at!"n P'"te+t!"n Se'!e# N". 1@ @@7.. NATIONAL HEALTH AND MEDICAL RESEARCH COUNCIL (NHMRC)

G%!del!ne# "' Dental T'eatent !n dent!#t', @@?. THERAPEUTIC GOODS ADMINISTRATION (TGA)

A%#t'al!an Cate("'!#at!"n #,#te "' )'e#+'!&!n( ed!+!ne# !n )'e(nan+, @11000.t(a.("/.a%H$)Hed!+!ne#-)'e(nan+,-+ate("'!#at!"n.$t

6. Cla""if#ig Dr$g" i Deti"tr#

A%#t'al!an P'e#+'!&e' ?>6 ?-6@7. %I%S& 'a 2(1)

Page * of 5 C")!led &, D' Matt W$!te @16 ?@181

http://www.tga.gov.au/hp/medicines-pregnancy-categorisation.htm

http://www.tga.gov.au/hp/medicines-pregnancy-categorisation.htm



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