Dental Newsletters

Clinical Articles Brought to You by Lexicomp and Dr. Richard L. Wynn

The purpose of this column is to keep professionals informed of recent reports regarding drugs and other events which may influence dental treatment. These reports will be gleaned from scientific journals, screened for dissemination, and presented on a timely basis and with great accuracy.

It is hoped the dental professional will reap significant benefit from this information, and it will contribute to superior patient care.

Trends in Prescription Opioid Drug Abuse, 2002-2013

Date: 
10/19/2015

After a steady rise, trends show a decline starting in 2011. There has been an epidemic of prescription opioid abuse over the last two decades. A 2015 New England Journal of Medicine study authored by drug abuse experts from multiple substance abuse centers revealed a substantial increase in the rates of opioid diversion and abuse from 2002 to 2011. But then the rates flattened or decreased from 2011 through 2013. The rate of opioid-related deaths rose and fell in a similar pattern.

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Medical Marijuana and Chronic Pain: Considerations for Use within States That Have Laws in Place

Date: 
09/10/2015

As of March 2015, 23 states and the District of Columbia had medical marijuana laws in place. A recent published study in the Journal of the American Medical Association (JAMA) by Kevin P Hill, MD, of Harvard Medical School reviewed the pharmacology, indications and laws related to medical marijuana use, with emphasis on its use in treating chronic pain

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Medical Marijuana: An Extensive Review of Clinical Benefits and Adverse Effects

Date: 
08/21/2015

A recent study by Whiting, et al, (JAMA 2015) performed an extensive literature review using 28 databases and provided assessment of the indications, benefits and adverse effects of medical marijuana and cannabinoids. Using a rating scale to score the quality of evidence, the authors described evidence of moderate quality to support the use of marijuana in treating chronic pain syndromes and spasticity from multiple sclerosis.

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Non-aspirin Nonsteriodal Anti-inflammatory Drug (NSAID) Safety Concerns Regarding Potential Cardiovascular Events

Date: 
07/27/2015

By R.L. Wynn

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Perioperative Management of Patients Taking Dabigatran (Pradaxa): Published Experiences

Date: 
06/17/2015

Dabigatran (Pradaxa) is a member of a group of new oral anticoagulants which include rivoraxaban (Xarelto), apixaban (Eliquis) and edoxaban (Savaysa). At the present time, there are no evidence-based guidelines for dental periprocedural protocols for these new oral anticoagulants.

A recent medical report and five reports in dental literature describing clinicians’ experiences and observations provide some insight in managing dental patients taking dabigatran.

Published experiences managing patients taking dabigatran

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A Recent Meta-analysis on Azithromycin and the Risk of Cardiotoxicity

Date: 
05/11/2015

By R.L. Wynn

In a review of 12 randomized, placebo-controlled trials, no significant association was found between azithromycin therapy and the risk for death or hospitalization from cardiovascular causes. This report, by authors from the University of Cincinnati Academic Health Center, is the first meta-analysis of the cardiac safety of azithromycin in randomized clinical trials.

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Examining Emergency Department Visits for Adverse Drug Events in Older Adults

Date: 
12/01/2014

By R.L. Wynn

Adverse drug events pose a distinct threat to older adult patients. Three recent studies examine the most frequent causes of emergency visits and hospitalizations due to adverse drug events.

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Post-discharge smoking intervention study methods

Date: 
11/01/2014

Rigotti, N.A., et al. “Sustained care intervention and post-discharge smoking cessation among hospitalized adults: A randomized clinical trial.” JAMA 2014; 312(7): 719-728. 

The lead author is from Massachusetts General Hospital in Boston.

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Study on the relationship between medical cannabis laws and opioid analgesic overdose deaths

Date: 
10/01/2014

Bachhuber, M.A., et al. “Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999-2010.” JAMA Intern Med doi: 10.1001/jamainternmed.2014.4005. Published online August 25, 2014. 

The study, funded by NIH grants, was conducted by authors from Philadelphia VA Medical Center; University of Pennsylvania; Albert Einstein College of Medicine and Montefiore Medical Center, New York; and Johns Hopkins Bloomberg School of Public Health, Baltimore.

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The new cross reactivity study

Date: 
09/01/2014

Campagna, J.D., et al. “The use of cephalosporins in penicillin-allergic patients: A literature review.” J Emergency Medicine, 2012; 42:612-20.

This latest study was out of the University of Maryland Medical Center, Department of Emergency Medicine and the Department of Pharmacy, and the Department of Emergency Medicine, Howard County General Hospital, Johns Hopkins University, Baltimore, Maryland.

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