CDA Essentials 2018 • Volume 5 • Issue 2

S upporting Y our P ractice 39 Issue 2 | 2018 | Dentists’ Prescribing of Analgesics for Children in British Columbia Analgesics are one of the most prescribed classes of drugs for children. Although dentists are regular prescribers of analgesic medications, data on the frequency as well as duration of analgesic use prescribed by dentists for children is lacking. We sought to address this lack of information by examining the rate of analgesic prescription, both narcotic and non-narcotic, by dentists for children in British Columbia (BC), Canada. Methods We used PharmaNet as the data source for our study. 2 This database captures all prescription drugs dispensed in BC and includes drug dose and day supply information, which was used to quantify duration of use. Day supply is computed by dividing the total quantity of a drug by the number of daily doses. We had access to a dataset of all drugs prescribed to children ≤18 years of age from 1997 to 2013. We used descriptive statistics to analyze patterns in common analgesic medications prescribed by dentists, specifically trends for the following narcotic analgesics: codeine, morphine, hydromorphone, oxycodone, hydrocodone and tramadol. We also examined benzodiazepine prescriptions (lorazepam, clobazam, diazepam, clonezapam) intended for post-operative pain management, as they are used by dentists for their anxiolytic/sedative properties. Tramadol was also included in the list of study drugs. Results Our study group consisted of 268,691 children who had received at least one prescription of the drugs of interest from a dentist. Among all study drugs, the largest number of prescriptions were for codeine and 50% of children ( n = 134,264) received codeine for more than 3 days . The duration of codeine use increased rapidly with age among children ≥12 years, 5 days being the longest duration of use. The use of tramadol increased markedly from 2005 to 2013. Discussion During the study period, codeine was the most prescribed analgesic, with ibuprofen the most commonly prescribed non-narcotic analgesic. For children ≥12 years, a 5-day supply of codeine was commonly prescribed. Codeine is a commonly used narcotic among both children and adults as, unlike morphine, it does not require a triplicate prescription and at lower doses it is available behind the counter in BC pharmacies. However, evidence of pharmacogenomic variation in codeine metabolism and related respiratory depression in children 4 has led to drug label warnings about the use of codeine by children. This article has been condensed and edited. The views expressed are those of the authors and do not necessarily reflect the opinions or official policies of the Canadian Dental Association. Full article available at jcda.ca/h5 More Online Mahyar Etminan PharmD,MSc (Epid) M. Reza Nouri DMD,MSc Mohit Sodhi BSc Bruce C. Carleton BPharm,PharmD etminanm@ mail.ubc.ca The following is based on an Applied Research article originally published on JCDA.ca —CDA’s online, open access scholarly publication that features articles indexed in Medline, Journal Citation Reports and Science Citation Index. Research Summary