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Quick Reference: Parkinson’s Disease Drugs in Dentistry
| Drug Class | Example Drugs (Brand Name) | Key Dental ADRs | Dental Management & Considerations |
|---|---|---|---|
| Dopamine Agonists | • Apomorphine (Movapo) • Pramipexole (Sifrol) • Bromocriptine (Parlodel) | • Orthostatic hypotension • Dyskinesia (involuntary movements) • Impulse control disorders (e.g., binge eating, compulsive spending) • Drowsiness | • Reposition the dental chair slowly to prevent fainting. • Be aware that binge eating can increase caries risk. • Interactions with CYP3A4 inhibitors (e.g., erythromycin, fluconazole) may increase ADRs or prolong QT interval. |
| Anticholinergics | • Benzatropine (Benztrop) • Trihexyphenidyl (Artane) | • Dry mouth (Xerostomia) • Orthostatic hypotension • Dyskinesia • Drowsiness | • Manage dry mouth to reduce the risk of caries and mucosal irritation. • Reposition the patient slowly. • No significant dental drug interactions are noted. |
| MAO-B Inhibitors | • Rasagiline (Azilect) • Selegiline (Eldepryl) | • Orthostatic hypotension • Dyskinesia (can make it hard for patients to remain still) | • Reposition the patient slowly. • Involuntary movements may complicate procedures; consider shorter appointments. • No significant dental drug interactions are noted. |
| Other PD Drugs | • Levodopa/carbidopa (Kinson) • Entacapone (Comtan) • Amantadine (Symmetrel) | • Dry mouth (Amantadine, Entacapone, Opicapone) • Orthostatic hypotension • Dyskinesia • Impulse control disorder (Levodopa combos) | • Manage dry mouth as a priority. • Advise patients to take Levodopa 1 hour before the procedure to minimize tremor and rigidity. • Caution with Adrenaline: Entacapone may increase the risk of tachycardia; use proper LA technique. |
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