Acyclovir (Aciclovir, Zovirax)

An Anti-Viral drug
INDICATIONS:For treatment of Herpes simplex, Varicella Zoster infections
AVAILABLE AS:

• 200 mg, 400 mg, 800 mg tablets
• 200 mg, 400 mg, 800 mg dispersible tablets
• Oral suspensions – 200 mg/5 mL, 400 mg/5 mL
• 5% cream
• 250 mg powder (for reconstitution and IV administration)

ACIVIR (Cipla) - DisperTab - 200 mg, 400 mg, 800 mg, Vial 25 mg x 10 ml, Cream - 5% x 5 gm

CYCLOVIR (Zydus) - Tab 200 mg, Cream 5%

HERPEX (Torrent) - Tab 200 mg, DisperTab 800 mg, Cream 5%

OKAVIR (Cipla) - DisperTab 200 mg, 400 mg, Skin Cream 5%

DOSE:
Adults:

• For Primary HSV Infections: 200-400 mg 5 times daily (or topical application on the lesion, 5 times daily) for 5-10 days
• For suppression of Recurrent HSV Infection: 200 mg Q.I.D. or 400 mg B.I.D. (i.e. 800 mg/day)
• For Prevention of HSV in immunocompromised patients: 200 mg q.i.d. 
• For Herpes Zoster: 800 mg 5 times per day for 7-10 days
• For Varicella Zoster: 800 mg 4 times per day for 5 days.
• For skin infections: 5% cream applied 5 times per day for 5-10 days.

Children under 2 years: half the adult dose.

ADMINISTRATION: With or without food

CONTRAINDICATIONS:  Hypersensitivity
PRECAUTIONS:

• Renal disease
• Pregnancy
• Breastfeeding
• Maintainence of adequate fluid intake is mandatory when high doses are administered.

SIDE EFFECTS:

• Stinging sensation at site of application
• Altered taste
• GI upset
• Renal failure
• Bone Marrow depression
• Tremors
• Convulsions
• Lichenoid reactions
• Rashes
• Urticaria

DRUG INTERACTIONS:

• Reduces the efficacy of anticonvulsant drugs (phenytoin and sodium valproate)
• increases the toxicity of pethidine

Acetylsalicylic Acid (Aspirin)

ACETYLSALICYLIC ACID (ASPIRIN)
It is a peripherally acting NSAID, not a very safe drug in pregnancy (Cat C), Cat D in the 3rd trimester (i.e. not to be used in 3rd trimester)
Indications-

• Pain with a significant inflammatory component (e.g. pain after a dental extraction)
• Musculoskeletal pain
• Dysmennorhoea
• As an anti-pyretic
• Anti-platelet action (prophylaxis for Cerebrovascular disease or MI)

Available as-

• 300 mg tablets
• 300 mg dispersible tablets
• 75 mg tablet (specific for antiplatelet action)

Tab. ASPENT (Ranbaxy) 60 mg

Tab. ASPIN 100 Enteric Coated (Cipla) 100 mg

Dose-

• Analgesia and Antipyresis - 325-650 mg QID (Max. 4 gm per day)
• Antiplatelet - 75 to 300 mg per day

Administration- should be taken WITH FOOD

Contraindications-

• Bronchial asthma (risk of precipitation of bronchoconstriction)
• Children under 12 yrs (risk of Reye's Syndrome)
• H/O Peptic Ulcers (aspirin is ulcerogenic)
• Uncontrolled Hypertension
• Patients suffering from gout (aspirin is uricosuric, i.e. causes uric acid to appear in the urine)
• Patients with hemostatic disorders (aspirin decreases platelet aggregation due to its anti-platelet action, and hence increases bleeding time)
• Patients with known hypersensitivity to the drug.
• Patients with renal/hepatic compromise.

Precautions-

• Pregnant patients
• Breastfeeding mothers

Side Effects-

• Aspirin is highly ulcerogenic, and can cause an "Aspirin burn" if kept pressed against the oral mucosa for a long time.
• Causes bleeding time to increase, and hence hemostatic problems
• Uricosuric, so can precipitate an attack of gout
• In high doses, can cause tinnitus due to an increase in the labyrinthine pressure.

Drug Interactions-

• Should not be prescribed to patients on anticoagulant therapy, since it would lead to a more fragile hemostatic state (due to its antiplatelet effect)
• Enhances the effects of antiepileptic drugs (phenytoin sodium and sodium valproate)
• Aspirin and corticosteroid, both are ulcerogenic, so should be avoided in patients giving history of peptic ulceration.
• Should not be used along with Oral hypoglycemic agents, as it can precipitate hypoglycemia.

Aceclofenac (NSAID)

ACECLOFENAC
Aceclofenac is a peripherally acting NSAID.
Indication-
Pain and inflammation associated with musculoskeletal disorders
Aceclofenac + paracetamol is also used for pain and inflammation
Oral Effect-
Aceclofenac > inhibits prostaglandin synthesis > less periodontal breakdown.
Prostaglandins are major inflammatory mediators and contribute to the periodontal breakdown, so anything which inhibits their synthesis, will inhibit periodontal breakdown. So, patients on long term NSAID therapy like aceclofenac, are more resistant to periodontal breakdown.
Dosage-
Adult: 100 mg BD (Aceclofenac)
1 tab morning, 1 tab night (max. 2 tabs) (Aceclofenac + Paracetamol)


Tab. ACE-PROXYVON (Wockhardt) - Aceclo 100 mg + PCM 500 mg + Rabeprazole Sod. 10 mg. (Aceclo+PCM)
Tab. ACEROC-P (Wockhardt) (Film coated tab.) - Aceclo 100 mg, PCM 500 mg
Tab. FLOZEN-AA (Mankind) - Aceclo 100 mg, PCM 500 mg, Serratiopeptidase 15 mg 
Tab. MOVEXX (Cipla) (Film coated)
Tab. MOVEXX PLUS (Cipla) - Aceclo 100 mg, PCM 500 mg. 


Rare Side Effects-
Angioedema
Thrombocytopenia
Drug interactions-
Ibuprofen and Aspirin should be avoided since side effects are aggravated esp. GI ulceration, renal and liver damage etc. 

CareDental - Introduction to the blog

Hi guys,

Welcome to the Care Dental's Blog.
This is a blog, meant for dentists, practitioners as well as the general public. Here, i'll be sharing the technical know-how of things related to the daily chores in dentistry as well as patient education and awareness tools. Do subscribe to our blog and keep yourself updated. All posts are open for your valuable comments and criticism, so please do not hesitate. Thank you and happy reading !!!