Unit 4: Administrative Operations
Administrative Operations

Section 6. Inventory Management

Stocking a Formulary

Many of the patients served by the clinic may not have the financial resources to purchase needed medications from a commercial pharmacy or may need them immediately after their treatment. Failure to obtain and properly use needed medications can compromise the success of certain procedures and the patient's health. Clinic administrators will need to decide whether the clinic will stock and maintain a formulary of medications deemed necessary for the proper care of the clinic's patients.

If the clinic does choose to maintain a formulary, special consideration must be given to stocking and dispensing narcotic analgesics and other controlled substances, especially in light of the recent opiate epidemic. The U.S. Drug Enforcement Agency enforces federal laws, rules, and guidelines covering the purchasing, stocking, prescribing, and dispensing of controlled substances. [[Link “U.S. Drug Enforcement Agency” to: https://www.deadiversion.usdoj.gov/schedules/index.html]] 

Failure to follow these rules and regulations can lead to civil and criminal prosecution. Local dental, medical, or pharmacy boards may have additional rules about prescribing or dispensing narcotics, such as entry into a prescription database. Additionally, the presence of such drugs in the clinic can increase security concerns.

Formulary Suggestions

  • Acetaminophen, in both adult and child formulations and dosages, for pain.
  • Non-steroidal anti-inflammatory analgesic, such as ibuprofen, in both adult and child formulations and dosages, for pain and inflammation.
  • Penicillin VK, in both adult and child dosages and formulations, for odontogenic infections.
  • Amoxicillin, in adult and child formulations and dosages for cardiac prophylaxis, per American Heart Association guidelines.
  • Clindamycin, in adult and child formulations for infections and for cardiac prophylaxis for patients allergic to amoxicillin, and for severe infections that do not respond to penicillin.
  • Chlorhexidine mouthrinse for periodontal patients.
  • Prescription fluoride gel for high-risk caries patients.
  • Doxycycline for periodontal patients.

In addition, every office must carry essential emergency drugs that include:

  • Oxygen
  • Epinephrine
  • Nitroglycerin
  • Injectable antihistamine
  • Albuterol
  • Aspirin
  • Oral carbohydrate

Source: Haas, DA. 2006. Management of medical emergencies in the dental office: Conditions in each country, the extent of treatment by the dentist. Anesthetic Progress. 53(1):20–24.