Exceptional interaction between pharmacologists and other healthcare providers is main to implementing the best patient care imaginable, and dentists are no different.
While doctors may not be the most common healthcare specialists pharmacologists work with, there are a few areas where collaboration is almost joint.
Alan Tanabe, PharmD, Staff Pharmacist at Meijer in Ann Arbor, MI, observes that dentists and pharmacologists might work well together. “Hardly, I will come across a medicine announced for amoxicillin for a patient with a documented beta-lactam disease, or a direction for ibuprofen for a patient who is previously practicing another NSAID for a distinctive reason, but these problems are normally settled immediately with a call to the prescribing tooth-yanker,” he stated. He discovers that most puzzles are immediately solved as long as the issue is performed politely and supported by evidence-based data if required.
Although it may be hard to balance these acute directions with everything else falling in an employed chain, Tanabe states that “we will triage the requirements of a patient, especially post-procedure.”
In terms of opioid ordering by dentists, Tanabe states that he has witnessed most doctors being very careful about keeping the number of opioids confined to what a patient will need.
Tanabe thinks in the value of “open discussion and team strategy.”
Anne Henriksen, PharmD, pharmacologist, and owner at Malley’s Compounding Pharmacy in Richland, Washington, recognizes that collaboration is crucial. “The business of pharmacy always comes down to connections. Although the range of dentists may be very focused, treatments, and medicines that they command can communicate with other chronic medicines the patient may take.
Pharmacologists are medicine therapy experts. Securing all ordered medicines are reliable and suitable for the patient through many various fields of practice is an indispensable part of the pharmacist’s ability,” she stipulates.
Building connections is necessary: “it is constantly hard to understand another practitioner’s field of practice truly. Dentists who regularly use your drugstore and speak with and have a connection with a pharmacologist will be more likely to be able to demonstrate proper expectations with their patient,” Henriksen speaks.
Henriksen has discerned a shift in directing in recent years. “For opioid-naive patients who are having a single dental procedure, ibuprofen and other NSAIDs have been shown to provide superior pain relief,” she says. “With the enhanced focus on the dependence on prescription opioids, doctors are more traditional with ordering painkillers.”
Meanwhile, a problem occurs with an allergy, drug communication, or any other puzzle, Henriksen sees that most doctors are open to helping with the pharmacologist to ensure safe and proper treatment.
Jason Lizzack, DMD, of Lizzack Family Dentistry in Fair Lawn, NJ, coincides with the teamwork strategy. “I always relish when a pharmacologist calls on a disease or drug interaction. Due to the complexity of patients’ healing histories, I firmly hope the pharmacologist will ask me if there is any battle with my directions,” he states.
With the opioid disaster in the leaders every day, doctors must be careful in keeping up with state laws and developments that happen. Dr. Lizzack constantly monitors the state prescription monitoring schedule (PMP) before ordering, although he insists that he tries to hold narcotic painkiller medicines to a point.
“If I designate an opioid, I completely reveal that this is an addictive material and should only be taken if needed—in addition to having them sign the opioid approval form. I also give patients a non-narcotic pain protocol they can follow that consists of using ibuprofen and acetaminophen together–this seems to work well,” he states.
Commander John Burke is chairman and owner of Pharmaceutical Diversion Education, Inc, and has more than 47 years of law implementation practice. He emphasizes that pharmacologists should not be getting directions from doctors with large amounts of opioids. Commander Burke notes that, usually, patients will fill orders like dental training. The druggists will get to know the dentist’s signature and common prescribing practices. “If it is out of whack, look at the direction closely for change and verify with the prescriber,” he states.
Commander Burke emphasizes that state monitoring applications are a huge deterrent, and “both pharmacologists and doctors should use these plans to the max.” He suggests pharmacologists to automatically control the state PMP for any new patient with a regulated substance formula.
Commander Burke states that patients should be told that opioid painkillers are highly addictive, should only be taken as required and that it is a crime to share with anyone else. Patients must be advised to dispose of medicines correctly if not needed (such as a take-back program at a local law enforcing department), as exposed to letting medications sit in the medicine cabinet.
“Many pain medicines are in cabinets because the patient got them after a dental plan and never used them,” he states. “If the patient chooses to keep painkillers that are not demanded, they should at least be locked up or unless adjusted.”
The American Dental Association (ADA) “raises legal limits on opioid dosage and duration of no more than seven days for the processing of severe pain.” The ADA Center for Professional Success offers a website for doctors as a public service with guides for reliable prescribing, free online continuing training, and other tools and data for dental pain control, particularly for those ones who are at higher risk for drug overdose and addiction.
All In All
In this time of the opioid epidemic, pharmacologists must walk a particular line. We must take care of our patients while also following state and business guidelines about opioids. Because opioid dependence can occur very fast to the most reliable of patients, patients must follow the potential risks that go along with these strong painkillers.
As busy as we are, we have to take the time to take all the required steps, such as reducing the state PMP and negotiating with providers when relevant. Courteously and kindly saying to frustrated patients that this is part of our job to make sure they are harmless, and nine times out of ten, the patient will understand our interest.