what hsv primarily causes oropharyngeal disease(including intraoral and eye)
hsv1
which hsv causes genital disease, which is considered a sexually transmitted disease
hsv2
when does primary herpes infection (primary herpetic gingivostomatitis) occur
infants/children
symptoms of primary herpes
fever, malaise, nausea, vomiting; painful intraoral vesicles on oral mucosa– form ulcers with red haloes; gen gingivitis
treatment of primary herpes infection
fluids and analgesics(tylenol)– don’t give aspirin to people under 16 could cause reyes
what is recurrent herpes simplex virus infection
hsv1 occurs adults who preveiously had primary herpes(fever blisters)
when will herpes lesions resolve itself
10-14 days
should antibiotics of corticosteriods be used to treat recurrent herpes infection
no
what do antiherpetic drugs end in
-ci/yclovir
what is used to treat herpes labialis
otc analgesic medications– dont actually stop virus
action of antiviral agents
incorporates into the viral DNA within host – premature dna termination – prevents virus from reproducing
use of antiviral agents
treatment initial and recurrent viral infections(hsv1) or herpes labialis
dosage of antiviral agents
tablets 200mg every 4 hours for 10 days initially
topical 1/2 inch ribbon to area every 3 hours
example of antiviral agent
acyclovir
virus attacks the body’s immune system, resulting in many life-threatening infections and cancers
hiv aids
once one has developed aids, the immune system is weakened enough to allow for unusual or prolonged infections
hiv/aids
these drugs chemically are nucleosides and work by inhibiting the viral enzyme reverse ranscriptase
nucleoside reverse transcriptase inhibitors
this class inhibits the catalytic reaction of reverse transcriptase that is independent of nucleotide binding
nonnucleoside reverse transcriptase inhibitors
these drugs suppress viral replication by inhibiting protease, the enzyme responsible for cleaving viral precursor peptides into infective virions
protease inhibitors
this class interferes with the entry of HIV-1 into hosts(lymphocytes) by inhibiting fusion of the virus and cell membranes
fusion inhibitors
antiretroviral drugs used for treatment of HIV/AIDS end in what
VIR
PROTEASE INHIBITORS CAN CAUSE
dental pain and taste changes
HAART
high active antiretroviral therapy
using three drug combinations for initial therapy is termed what
HAART
what are two common oral lesions/conditions associated with hiv infections
candidiasis and angular chelitis
what drugs are used to treat fungal infections
azoles and nystatin
what are some common viral infections associated with hiv
herpes simplex lesions hairy leukoplakia(epstein barr virus infection)
what are some bacterial infections associated with hiv
linear gingival erythema
nug
necrotizing ulcerative periodontitis
other oral conditions with hiv
minor apthous ulcers(canker sores)
oral pain: acute due to oral lesions
chronic neurological pain
xerostomia
what is lidex used for
to treat ulcers for hiv patients
normal flora in gastro and vaginal tracts
candida
causes a localized superficial infection that is kept in check by the body; however, in certain circumstances such as immunocompromised hosts, the infection spreads
candida
three groups of fungal infections
systemic mycosis
superficial or mucotaneous mycoses
subcutaneous mycoses
what causes mucocutaneous mycoses of the mouth
candida albicans
what can candida albican cause
thrush(acute pseudomembranous candidiasis)
chronic atrophic candidiasis(denture sore mouth)
candidal esophagitis
oral mucous membranes present with a creamy, white plaque that easily wipes off with gauze, leaving a raw, red, bleeding connective tissue surface
thrush
nystatin also called
mycostatin troches suspension
topical or oral suspension indicated for treatment of susceptible cutaneous, mucocutaneous oral cavity fungal infections normally caused by the candida species
indications for nystatin
mechanism of action of nysatin
binds to phospholipids in fungal cell mem, altering cell wall permeability, resulting in loss of essential intracellular nutrients
clotrimazole also called
mycelex troches
topical cream for treatment of susceptible fungal infections including oropharyngeal candidiasis. to prevent oropharyngeal candidiasis in immunocompromised patients(chemo/radiation)
clotrimazole
mechanism of action of clotrimazole
binds to phospholipids in fungal cell mem, altering cell wall perm
under max denture; palatal tissue appears as small, asymptomatic(not painful) red spots; treatment with high sugar content in suspension, pastilles, and troches; line denture with cream(azole)
denture sore mouth
used for thrush
clotrimazole; a troche that is slowly dissolved in mouth; patients with high caries index should not be given troches because they contain sugar
severe and extensive oropharyngeal candidiasis can be treated with
fluconazole 100 -200 mg orally twice a day
______ is good for candida suppression in hiv disease
prophylactic fluconazole
commissures of lips
angular cheilosis
what are the causes of angular cheilosis
fungal infection caused by candida albicans
b complex deficiency
drooing/overclosure(moisture)
treatment of angular cheilosis
azole topical
which of the following agents is used to treat fungal infection in oral cavity?
a. metronidazole(flagyl)
b. tetracycline
c. azythromicin(z pak)
d. clotrimazole(mycelex)
d
which of the following is used to treat cold sores
a. flagyl
b. tetracycline
c. acyclovir
d. clotrimazole
c
causes of thrush
broad spectrum antibiotics, inhalation corticosteroids, immunosuppressive drugs suppress immune system and encourage fungi to overgrow