Drug History

It is practical to think of drugs as falling into two groups. Those prescribed (administered) by oral healthcare providers and those prescribed by other clinicians. Of those agents prescribed by oral healthcare providers, minimum competency assumes knowledge in the following seven areas: (1) drug name (brand/generic), (2) mechanisms of action, (3) drug kinetics, (4) indication, (5) dosing, (6) adverse effects/monitoring parameters, and (7) contraindications.

In relation to those drugs prescribed by other healthcare providers, minimum competency by dental practitioners assumes knowledge in the following five areas: (1) recognition of those drugs most commonly taken by patients by name (brand/generic); (2) indications for their use, i.e., why a patient is taking the drug; (3) in some instances dosages, e.g., thyroid medications, corticosteroids; (4) relevant adverse effect; and (5) the use of informational resources.

In identifying and stratifying patient-specific risk factors for major endocrine and metabolic events, the drugs taken by patients provide invaluable insight. In the United States, there are approximately 500 active ingredients that are dispensed in a variety of different dosage forms and salts. The 200 most common drugs (40% of 500) represent 90% of all prescriptions filled and the 300 most common drugs (60% of 500) represent an astounding 97%.17

ClinCalc DrugStats provides prescription drug utilization data estimates based on the Medical Expenditure Panel Survey (MEPS) conducted annually in the United States. The 2017 Top 200 Drugs, based on more than 3 billion out-patient prescriptions, reflect data collected in 2014. Of the top 200 drugs, endocrine and metabolic agents represent the fifth highest volume of prescription medications dispensed by U.S. community pharmacies (Table 3).17

Table 3. Top 200 Prescription Drugs Dispensed by U.S. Community Pharmacies.17
Major Drug Categories Rank
Cardiovascular 1
Analgesics 2
Antimicrobial 4
Endocrine/metabolic 5
Respiratory 6
Gastrointestinal 7
Genitourinary 8