Generic name against brand name
A prescription carries the generic name — the international non-proprietary name — while the box in the pharmacy shows a brand name. The confusion starts where a drug has two generic names:
- paracetamol in the UK and most of the world, acetaminophen in the US — one substance
- adrenaline and epinephrine — the same situation
- lignocaine and lidocaine — likewise
Brand names change by country, so naming the generic is safer: do you have ibuprofen? works anywhere.
Over-the-counter means available without a prescription, which covers most analgesics. Everything else needs a prescription.
The four classes a dentist prescribes
Analgesics: analgesic as the class, painkiller in speech, and within it paracetamol, ibuprofen, aspirin, naproxen, diclofenac, and the opioids codeine, co-codamol, tramadol. Ibuprofen and its relatives are NSAIDs — non-steroidal anti-inflammatory drugs.
Antibiotics: amoxicillin and co-amoxiclav, penicillin and phenoxymethylpenicillin, metronidazole, clindamycin, azithromycin, erythromycin, doxycycline, cephalexin. Plus the concepts antibiotic prophylaxis, antibiotic resistance and broad-spectrum antibiotic. One warning is always given: metronidazole and alcohol do not mix.
Antifungals and antivirals: nystatin, fluconazole, miconazole; aciclovir, valaciclovir.
Antiseptics and topicals: chlorhexidine, povidone-iodine, hydrogen peroxide, benzydamine, the corticosteroids triamcinolone and hydrocortisone, in the forms topical gel, oral gel, lozenge, oral spray, ointment.
Others: potassium nitrate and strontium chloride for sensitivity, saliva substitute and artificial saliva for dryness, tranexamic acid for bleeding.
How a regimen is written
The structure is the same across English-speaking countries: dosage is the regimen, dose the single amount, frequency how often, course of treatment how long, and route of administration how it goes in — usually oral administration.
Forms: tablet, capsule, suspension. Unwanted effects: side effect, or more formally adverse reaction.
What must be said before anything is prescribed
The safety-critical block of this topic:
- drug allergy, and specifically penicillin allergy — which sends the prescription to clindamycin
- contraindication and drug interaction
- anticoagulant and warfarin — bleeding risk at extraction
- bisphosphonate — risk of bone complications after extraction
- immunosuppressant
- medication history — everything currently taken — and a medical alert flag on the record
Two sentences worth memorising: I'm allergic to penicillin and I'm on warfarin. Without them treatment is planned on wrong assumptions.
The pharmacy side: pharmacy, pharmacist, over-the-counter.
Naming conventions that trip people up
- Drug is neutral in English and covers all medicines — it does not imply anything illicit
- Medication and medicine are interchangeable; medicament is rare and sounds archaic
- Dosage is the schedule, dose the individual amount — they are not synonyms
- Prescription is the document; prescribe the act; script the informal word for it
- Co-codamol and co-amoxiclav use co- for fixed combinations, a British naming habit
- Patient information leaflet is the phrase for what many languages name in one word
