Adverse drug reactions, a guide for dentists

Abstract

Adverse drug reactions (ADRs) are unintended or harmful effects due to the use of a medicine. Antibiotics and analgesics, which incidentally, are commonly prescribed by dentists, result in most of the ADRs globally. As with most healthcare professionals, dentists do not report on ADRs regularly. Therefore, the aim of the review was to explore the drugs most used in dental practice in South Africa (SA), their associated ADRs and the ADR reporting channels. The study undertook a literature review that focused on studies of adverse drug reactions specifically in dental practices. An electronic search was done on EBSCO host to source articles published from 2000 to 2022. There was a plethora of ADRs that were found to occur with the medicines that are prescribed by dentists that ranged from minor to serious. Although all medicines have a risk of ADRs, amoxicillin can result in gastrointestinal disturbances and anaphylactic reactions, while clindamycin has a risk of Clostridium difficile infection. Patients need to be alerted to the risk of a disulfiram reaction with metronidazole and alcohol. Hepatic failure can occur with paracetamol use especially in patients with underlying liver disease, an alcoholic or in an overdose. Ibuprofen, caution in patients with underlying ulcers as gastrointestinal bleeding is a risk. Local anesthetics pose a high threat of severe reactions such as tissue necrosis and direct neurotoxicity while anterograde amnesia, respiratory depression and thrombosis can occur with benzodiazepines. Dentists can prevent ADRs by having a good knowledge of their prescribed drugs, monitoring their patients and by being judicious in their prescribing habits.