RESUMO
Effective acute pain management is an essential but sometimes challenging component of dental practice. Numerous studies have examined the efficacy of various analgesic agents in dental postoperative models. This article combines an evaluation of the available evidence with current prescribing patterns to provide dental practitioners prescribing recommendations for acute pain, based on the anticipated severity of post-procedural pain. An important consideration when prescribing analgesics is to determine for whom opioid analgesics are necessary and appropriate, and if so, the dose and quantity that should be prescribed. This is partly because of the prevalence of substance and alcohol abuse that can be expected to be encountered within the dental patient population, and because substance abusers in the community frequently obtain prescription drugs from friends and family for misuse.
Assuntos
Analgésicos/uso terapêutico , Prescrições de Medicamentos , Procedimentos Cirúrgicos Bucais/efeitos adversos , Dor Pós-Operatória/tratamento farmacológico , Acetaminofen/efeitos adversos , Acetaminofen/uso terapêutico , Doença Aguda , Anestésicos Locais/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Dor Facial/tratamento farmacológico , Humanos , Hidrocodona/uso terapêutico , Transtornos Relacionados ao Uso de Opioides/prevenção & controleRESUMO
Tapentadol HCI is an opioid (narcotic) analgesic, which also inhibits norepinephrine reuptake. While it appears to display a somewhat lower incidence of nausea and constipation than oxycodone 10 mg to 15 mg, its analgesic efficacy in acute postsurgical dental pain is inferior to ibuprofen 400 mg. Like other single-entity opioids, tapentadol should not be used as a first-line agent for postsurgical dental pain but can be employed as an add-on drug for breakthrough pain in patients already using a regimen of a non-steroidal anti-inflammatory drug and/or acetaminophen.