Autumn Final: Common Medical Problems + Prescribed Drugs

Question 1

what are the types of names of drugs (Eg, warfarin and coumadin)

Answer 1

generic/non-proprietary; warfarin

trade/brand name; coumadin

pharmacological category; anticoagulant, coumarin derivative, vitamin K antagonist (this ones most important for us)

Question 2

List 6 anticoagulants ; whats the general type of medicine? list each thing it acts on

Answer 2

GENERALLY ANTAGONISTS ; antagonist of

• acetylsalicylic acid (aspirin) : COX1&2
• clopidogrel (plaxiv) - P2Y12 ADP
• coumadin (warfarin) - Vitamin K
• rivaroxaban (xarelto) - Xa
• apixaban (eliquis) - Xa
• dabigatran (pradaxa) - thrombin

Question 3

List 4 antihypertensives (maybe not on test)

Answer 3

• beta 1 blocker (metoprolol/lopressor)
• calcium channel blocker (amlodipine/norvasc)
• ACE inhibitor (lisinopril) or ARB (losartan)
• Diuretics (hydroclorothyazide - HCTZ and furosemide/lasix)

Question 4

list 2 anti anxiety meds (maybe not on test)

Answer 4

• SSRI (sertraline, prozac and sertraline, zoloft)

- benzodiazepines (diazepam, valium and alprazolam, xanax)

Question 5

TOP 10 commonly prescribed drugs

Answer 5

1. atorvastatin (LIPITOR)
2. Lisinopril (prinivil, zestril)
3. Albuterol (accuneb, ventolin, proair, proventil)
4. levothyroxin (sythroid, unithroid, levoxyl, levothyroid)
5. amlodipine (norvasc, amvaz)
6. metoprolol (lopressor, torpol)
7. gabapentin (neurontin)
8. omeprazole (prilosec)
9. metformin (glucophage)
10. losartan (cozaar)

hydrocodone?

Question 6

Lisinopril; (3 brand names, drug use and effect)

Answer 6

brand names; prinivil , zestril, Qbrelis

-ACE inhibitor used for HIGH BLOOD PRESSURE treatment and heart failure prevention

Question 7

atorvastatin (brand name. drug use and effect)

Answer 7

brand name; lipitor

-Treatment to lower low-density lipoprotein (LDL) cholesterol levels and reduce risk of heart attack and stroke

Question 8

Levothyroxine (brand names 4, treatment)

Answer 8

brand names; levo-T, synthroid, euthyrox, levoxyl

-Treatment for hypothyroidism

Question 9

metformin (4 brand names, treatment)

Answer 9

Brand names -glucophage, fortamet, glumetza, riomet

first line med for type TWO diabetes

Question 10

amlodipine (3 brand names, treatment)

Answer 10

• brand names; norvasc, katerzia, amvaz

- treatment for high blood pressure, chest pain and coronary artery disease

Question 11

metoprolol (2 brand names, treatment)

Answer 11

brand names; lopressor, toprol

treatment for high blood pressure and chest pain

Question 12

omeprazole (brand name, treatment)

Answer 12

prilosec

GERD

Question 13

losartan (brand name, treatment)

Answer 13

cozaar

treatment for high blood pressure

Question 14

albuterol (brand names; 4)

Answer 14

proair, accuneb, proventil, ventolin

asthma, COPD, airway tightness

Question 15

gabapentin (3 brand names , treatment)

Answer 15

• brand names; horizant, neurontin, gralise

- treatment used to control seizures resulting from epilepsy

Question 16

what 6 quesitons should always be asked

Answer 16

1. cardiovar diseases?
2. allergies to medicines or latex?
3. bleeding issues?
4. take any medications?
5. other medical problems not asked about?

Question 17

list diagnostic tests for :
- bleeding issues secondary to liver disease
-aspirin/non steroidal anti inflammatory agents
-thrombocytopenia
-anticoagulant warfarin
anticoagulant plavix and newer agents

Answer 17

• bleeding issues assoc w liver; INR (international normalized ratios)– liver disease may cause reduction in synthetic capabilities of factors they cant clot–
• aspirin/non steoridal anti inflamm agents (bleeding time)
• thrombocytopenia (CBC with a differential - gives platelet count) and bleeding time test
• anticoag warfarin; INR
• anticoag plavix and newer agents : NO RELIABLE TESTS

Question 18

whats prophylactic antibiotics

Answer 18

preoperative antibiotics required (know about it before procedures)

Question 19

what is an issue with a joint replacement

Answer 19

may be called bilateral tka/tkr (total knee arthroplasty/reconstruction)

• -want to know about inflammatory problems/immunosuppression problems (diabetes?)
• also could be rheumatoid arthritis, traumatic/war related

-consult orthopedic surgery; recommendation from ada is we dont prescribe prophylactic antibiotics for patients with a joint replacement, not recommended. UNLESS the patient has had previous infections in the past or an orthopedic surgeon that suggests it.

Question 20

list contraindications to elective dental treatment

Answer 20

-myoacardial infarction within 6 months
-stroke within 6 months
-blood pressure above 180/110
-hiv/aids with CD4<50 and or platelet count <60,000
-INR>3.5 with need for invasive treatment
-undiagnosed and/or untreated chest pain
-undiagnosed , untreated, or non-compliant diabetes or other endocrine diseases
-

Question 21

Describe ASA classifications I-VI

Answer 21

I: normal/healthy (healthy, non smoking, minimal alcohol)

II: Mild systemic disease (Mild diseases only without substantive functional limitations (current smoker, alcohol drinker, pregnancy, obesity, well controlled DM/HTN , mild lung disease)

III: Severe systemic disease (substantive functional limits; one or more moderate to severe diseases. Like poor controlled DM/HTN, copd, obesity, active hepatitis, alcohol dependence or abuse, pacemaker, moderate reduction of ejection fraction, ESRD undergoing regularly scheduled dialysis, premature infant, PCA<60 weeks, history NOT recent.. more than 3 months ago of Myocardial infraction, CVA-stroke, TIA- mini stroke, or CAD/stents- coronary artery disease)

IV: Severe systemic disease that is a constant threat to life (recent MI, CVA–stroke, TIA-mini stroke, or CAD/stents=coronary artery disease, ongoing cardiac ischema or severe valve disfunction, severe reduction of ejection fraction, sepsis, DIC, ARD or ESRD, not undergoing regularly scheduled dialysis

V: moribund patient, not expected to survive without the operation (ruptured abdominal/thoracic aneurysm, massive trauma, intracranial bleed with mass effect, ischemic bowel in face of significant cardiac pathology or multiple organ/system dysfunction)

VI: declared brain dead patient, organs being removed

cerebrovascular accident= stroke (CVA)

Question 22

what are diagnostic tests for kidneys

Answer 22

• BUN (blood, urea, nitrogen)

- creatine clearance rate

Question 23

what type of diagnostic tests may be used with immunosupression

Answer 23

CBC with differential (plateley for surgery especiall)

• t supressor cell count for HIV
• viral load for HIV

Question 24

liver diagnostic tests

Answer 24

• SMA20 (SGOT, AST, ALT)
• PT & PTT
• INR

Question 25

LIST diagnostic diabetes tests

Answer 25

-fasting blood sugar (>126 mg/dL)
-random plasma glucose (>200 mg/dL with symptoms (polyurina, polydispia, unexplained weight loss)
3. 2 hour plasma glucose >200 mg/dL following 75 g glucose load
-fructosamine tests (reflects average control over last 2-3 weeks)
glycated hemoglobin (HbA1c- past 6-8 weeks (>7% is an issue)

Question 26

hiv diagnostic tests

Answer 26

-t cell count, vital load, CBC with differential for platelet

Question 27

which ASA classifications require consultation (relevant for dentistry)

Answer 27

3 and 4! medically complex.