chapter 9 and 17

Question 1

most toxic drugs in use today, act by killing cancer cells through damaging cell dna or interfering with dna synthesis

Answer 1

antineoplastics

Question 2

what are the 3 most common effects of antineoplastic drugs

Answer 2

nausea and vomiting, candidiasis or oral mucositis, and alopecia(hair loss)

Question 3

other toxic effects include bone marrow suppression(inhibition of blood cell replication in bone marrow) and resulting _____ which is a decrease in neutrophils or wbc’s)

Answer 3

leukopenia

Question 4

leukopenia predisposes patients to serious____ and _____ leading to serious bleeding problems

Answer 4

infection and thrombocytopenia

Question 5

what are some alkylating agents

Answer 5

cytoxan, alkeran, paraplatin, platinol. bicnu

Question 6

what are some antimetabolites(dna synthesis inhibitors)

Answer 6

floxuridine, methotrexate, purinethol

Question 7

what are some antitumor antibiotics

Answer 7

all the ones with hcl

Question 8

what are some plant alkaloids or extracts

Answer 8

vinblastine, taxol

Question 9

what are some hormones and antagonists

Answer 9

lupron, tamoxifen

Question 10

primarily affect cells that are actively multiplying

Answer 10

cell cycle specific antineoplastics ccs

Question 11

kill cells that are actively multiplying or at rest; more toxic to normal cells than the ccs agents, but good for slow-growing neoplasms

Answer 11

cell cyclic nonspecific ccns

Question 12

what is a major cause of cancer treatment failure

Answer 12

drug resistance

Question 13

if your patient is on antineoplastic they would most likely need a

Answer 13

med consult

Question 14

complications of the oral cavity occur in about ____ of patients treated with chemotherapy and all patients receiving radiation

Answer 14

40%

Question 15

involves gingival tissue inflammation as well as ulcerations; pain and burning of the oral mucosa difficult to maintain oral hygiene

Answer 15

oral mucositis

Question 16

what are some rinses to use for oral mucositis

Answer 16

chlorhexidine, saline, viscous lidocaine, nystatin, benzocaine, diphenhydramine elixir with kaopectate

Question 17

results of xerostomia

Answer 17

increased caries, difficult to eat

Question 18

treatment of xerostomia

Answer 18

pallative treatment: sugarless candies, increase water intake, avoid alcohol
saliva substitues: biotene, optimoist, salivart, salix, xerolube, moistir, oral swabsticks, mothkote

systemic: cevimline(evoxac),
pilocarpine(salagan)

Question 19

oral candidiasis results and treatment

Answer 19

increased growth of opportunistic fungi; treatment: topical/systemic antifungal agents: nystatin, clotrimazole, fluconazole

Question 20

oral biofilm accumulation results and treatment

Answer 20

gingival inflammation; treatment: clorhexidine oral rinse as an adjunct to meticulous oral hygiene

Question 21

due to suppression of salivary function; usually not permanent so treatment is usually palliative; uncomfortable bc there is no salivary lub and mucosal tissues get sticky; dry mucosa may also be more prone to bleeding

Answer 21

xerostomia

Question 22

increased incidence of candidiasis and dental/root caries

Answer 22

xerostomia

Question 23

what to use for xerostomia and prevention of caries

Answer 23

neutral sodium fluoride rinse such as prevident rinse

Question 24

what is a direct affect of antimetabolite

Answer 24

mucositis

Question 25

inflammation and ulceration; buccal, labial, and soft palate mucosa along with ventral surface of tongue and floor of mouth

Answer 25

mucositis

Question 26

small areas of ulceration quickly become large areas due to direct toxic effects of the antimetaboites

Answer 26

mucositis

Question 27

resulting from an overgrowth of fungi bc of reduced white blood cell count; may be more important to prevent; anesthetic solutions will help reduce pain

Answer 27

oral candidiasis

Question 28

the primary concern with high bacteria levels is the increased incidence of ____

Answer 28

bacteremia

Question 29

cancer patient should be put on ____ as a prophylaxis for infective endocarditis

Answer 29

antibiotics

Question 30

what oral rinse is helpful to reduce bacterial levels and help with oral hygiene

Answer 30

chlorhexidine gluconate

Question 31

can cancer patients have an alteration of taste when going through treatment?

Answer 31

yes, drugs affect certain taste buds

Question 32

what drugs are used in organ transplant patients to prevent rejection of organ

Answer 32

immunosuppressant drugs

Question 33

these drugs are usually given together with glucocorticosteriods

Answer 33

immunosuppressant

Question 34

immunosuppressant drugs include

Answer 34

azathioprine, cyclosporine, and tacrolimus

Question 35

patients taking immunosuppressant will most likely develop ____and subsequently will also be taking antihypertensive drugs such as calcium channel blocker, which can cause gingival enlargement

Answer 35

hypertension

Question 36

nifedipine =

Answer 36

can cause gingival enlargment; calcium channel blockers

Question 37

critical part of the patient; evaluated for dental infections before being placed on the transplant list

Answer 37

pretransplant dentistry

Question 38

a prodrug that must be metabolized in the liver into an active form that will enter the bloodstream

Answer 38

azathioprine

Question 39

used in vesicular bullous/ulcerative autoimmune diseases such as bullous pemphigoid and lupus erythematous and also in rheumatoid arthritis

Answer 39

azathioprine

Question 40

what is the drug of choice for organ transplant donors

Answer 40

cyclosporine

Question 41

causes gingival enlargement; can be controlled by frequent gingivectomy/gingivoplasty procedures and meticulous oral home care

Answer 41

cyclosporine

Question 42

another name for asathioprine

Answer 42

imuran

Question 43

another name for cyclosporine

Answer 43

sandimmune, neoral

Question 44

another name for tacrolimus

Answer 44

prograf

Question 45

bisphosphonates end in

Answer 45

dronate

Question 46

medicated related osteonecrosis of the jaw

Answer 46

bisphosphonates

Question 47

iv bisphosphonates have been seen to cause ___

Answer 47

osteoradionecrosis of jaw

Question 48

supplement; masticatory stimulant; oral leukoplakia, stained teeth and gingiva, bronchoconstriction; may interact with antipsychotics, causing bradykinesia and jaw tremor

Answer 48

betel nut(areca catechu)

Question 49

supplement; decrease cholesterol levels, lowers bp and is anticoagulant; can have bleeding; cause appearance of chemical burn;

Answer 49

garlic

Question 50

supplement;anti-emetic, vertigo;bleeding

Answer 50

ginger

Question 51

supplement;improvement of cognitive functioning in alzheimers disease(dementia); also used for sexual dysfunctioin caused by selective serotonin reuptake inhibitors

Answer 51

ginkgo

Question 52

supplement;increases vitality, elevates energy levels; bleeding, hypoglycemia, hypertension

Answer 52

ginseng

Question 53

all supplements with g have what adverse effect

Answer 53

bleeding

Question 54

which supplement has adverse effect of hypoglycemia and hypertension

Answer 54

ginseng

Question 55

drug interactions with garlic, ginger, ginkgo

Answer 55

aspirin, nsaids, warfarin

Question 56

supplement;drug interactions with digoxin

Answer 56

ginseng

Question 57

supplement;drug interaction with insulin: additive hypoglycemic effect reduces saquinavir(fortovase) serum levels

Answer 57

garlic

Question 58

supplement; drug interactions: diuretics-increased duresis | insulin and oral hypoglycemics: increased hypoglycemic effect

Answer 58

ginseng

Question 59

supplement;for osteoarthritis; can cause bleeding; interactions with anticoags and nsaids; dont take if allergic to shellfish

Answer 59

glucosamine and chondroitin

Question 60

supplementprevents cancer, causes weight loss; can cause caffeine-related irritability, irregular heartbeat, diarrhea, vomiting and headache; interaction with atropine

Answer 60

green tea

Question 61

supplement; treatment of anxiety, insomnia, and muscle tension; processes antipyretic and local anesthetics increase effects of that

Answer 61

kava kava

Question 62

what supplement interferes with blood clotting, sedation, oral and lingual dyskinsea, rash, painful twisting movement of trunk, liver problems

Answer 62

kava kava

Question 63

used to treat mild to moderate depression; can cause xerostomia, gi upset, allergic reactions, fatigue, dizziness, confusion, photosensitivity, BLEEDING

Answer 63

st johns wort

Question 64

supplement for aphthous ulcers

Answer 64

aloe vera, red raspberry

Question 65

supplement for oral fungal infections(thrush)

Answer 65

tea tree oil, cinnamon

Question 66

supplement for perio disease

Answer 66

coenzyme q10, sanguinaria, goldseal

Question 67

supplement for caries

Answer 67

licorice root(glycyrrhiza glabra)

Question 68

supplement for oral inflammation(mucositis) in cancer patients

Answer 68

chamomile, vitamin E