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BDS4 Oral Medicine > Medicines and Therapeutics in Oral Medicine > Flashcards

Medicines and Therapeutics in Oral Medicine Flashcards

1
Q

What are the main medicines used in Oral Med?

A
  • Anti-microbial
  • Topical steroids
  • Dry mouth medications
  • Others like immunosuppresive
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2
Q

What types of Antimicrobials can be used in the Oral medicine?

A
  • Anti-viral
  • Anti-fungal
  • Antibiotics
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3
Q

What Topical steroids can be used in Oral med?

A
  • Inhaled steroids
  • Steroid mouthwash
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4
Q

What other medicines can be used in oral med, not antimicrobials or Topical steroids?

A
  • Benzdamine mouthwash
  • Carbamazepine
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5
Q

What are the 5 classifications of Medicines?

A
  • General sales
  • Pharmacy medicines
  • Controlled drugs
  • Medical devices
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6
Q

What is meant by medical devices in oral med?

A
  • i.e. saliva substitute
  • Not technically a medicine but used to aid txt
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7
Q

What is the definition of Licenced Medicines?

A
  • A medicine that has been proven in evidence to MHRA to have efficacy and safety at defined doses in a child and/or adult population when treating specified medical conditions
  • Clinical trial data provided by the manufacturer
  • Post licence surveillance via MHRA is also done to ensure truth in the data
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8
Q

What is the definition of Unlicensed Medicines?

A
  • Medicines that have not had evidence of efficacy submitted for the condition under txt
  • They will be licenced medicines but for another condition
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8
Q

What are some conditions that Unlicensed Medicines have to meet before pt can take them?

A
  • ‘Off licence’ or ‘off-label’ use is at discretion of treating physician
  • Pt must be informed it is off-licence
  • Pt must be given PIL (patient information leaflet) specific to condition under txt
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9
Q

What is the Antiviral Aciclovir used to treat?

A
  • Primary herpetic gingivostomatitis
  • Recurrent herpetic lesions
  • Shingles (recurrent herpes zoster)
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10
Q

What are the Antifungals Miconazole, Fluconazole and Nystatin used to treat?

A
  • Acute pseudomembranous candidiasis
  • Acute erythematous candidiasis
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11
Q

What are some Unlicensed topical steroids and what are they used for?

A
  • Betamethasone mouthwash
  • Beclomethasone metered dose inhaler
  • Both used to treat aphthous ulcers and Lichen planus
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12
Q

What should be on the specific Inhaled steroid PIL for metered dose inhaler (MDI) when used for oral ulcers?

A
  • What the condition is
  • What are the causes
  • Is it hereditary
  • Symptoms
  • What does it look like
  • How is it diagnosed
  • Can it be cured
  • Is it life threatening
  • How can be treated
  • How do i use the inhlaer
  • How often and what tiime of day
  • Can i eat or drink after it
  • Potential risks and side effects
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13
Q

What are some medical devices that can be used to txt ‘Dry mouth’?

A
  • Salivix pastilles
  • Saliva orthana
  • Biotene oral balance
  • Artificial saliva DPF
  • Glandosane
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14
Q

What are some medicines that can be prescribed by an Oral Medicine Specialist in a practice, not a primary care dentist?

A
  • Tricyclic antidepressants to reduce pain transmission for orofacial pain
  • Gabapentin/Pregabalin for neuropathic pain
  • Azathioprine *
  • Mycophenolate *
  • Hydroxychloroquine *
  • Colchicine - *used to treat inflammatory mucosal conditions where other simple txt have failed
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15
Q

What needs to be considered when thinking about using medicines?

A
  • Clinical indication
  • Licenced or unlicensed for this use
  • Dose and route of administration
  • Important warnings for the pt
  • Drug interactions and cautions
  • Txt duration and monitoring
15
Q

What information is required when filling out pt Prescription?

A
  • Pt name, address, Age if under 18
  • Pt identifier - DoB or CHI no.
  • Number of days of txt
  • Drug to be prescribed
  • Drug formulation and dosage
  • Instructions on quantity to be dispensed
  • Instructions to be given to pt
  • Signed - identifier of prescriber
16
Q

How long is a prescription validity?

A
  • Six months from date issued
  • Useful if more than one item on script
  • Useful if more than one repeated dispensing occasion e.g. recurrent herpetic lesions
17
Q

What are the requirements when writing prescriptions?

A
  • Must be legible
  • AVOID abbreviations - write full instructions in INK
  • Only legal requirement is for dentist to sign the prescription - confirms all info is correct
18
Q

What are some advantages for written instructions for the pt?

A
  • Stressed pt may not remember instructions
  • Language issues may prevent proper understanding (multilingual options available, large print options)
  • Contact numbers for pt issues
  • Legal protection if post-txt course questioned
19
Q

What are some advice for pt when prescribing meds?

A
  • Take drugs at correct time and finish course
  • Unexpected reactions - stop and contact prescriber
  • Known side-effects should be discussed e.g. metronidazole and alcohol
  • Keep medicines stored safely, esp from children
20
Q

What are some non-steroidal topical txt of Oral Mucosal Lesions?

A
  • Chlorhexidine mouthwash (dilute 50% with water if needed)
  • Benzdamine mouthwash or spray (useful topical anaesthetic/pain relief)
  • OTC remedies such as Igloo, Listerine, Bonjela
21
Q

What are some Steroid based topical txt or oral mucosal lesions?

A
  • Hydrocortusone mucoadhesive pellet
  • Betamethasone mouthwash
  • Beclomethasone Metered Dose inhaler (MDI/puffer)
  • CFC-free preparations e.g. Clenil modulite
22
Q

What is the Tailored info leaflet for Betamethasone mouthwash for treating mouth ulcers (unlicensed)?

A
  • Use Betnesol tabs 0.5mg
  • 1mg 2 tablets
  • 10mls water (2 teaspoons)
  • 2 mins rinsing
  • twice daily
  • Refrain from eating/drinking for 30 min after use
  • Do not swallow (avoids systemic steroid effects like diabetes, osteoporosis, adrenal suppression)
  • Do not rinse after use
23
Q

What is the tailored PIL for Beclomethasone MDI?

A
  • This is an accepted and proven effective txt for oral condition
  • Licensed for other medical conditions like asthma and COPD
  • Dental prescribing 50cmg/puff device
  • Position device correctly - exit vent directly over ulcer area
  • 2 puffs
  • 2-4 times daily
  • Dont rinse after use or effect will be lost
  • Must be a pressurised device not a breath activated device
  • Small oral candida risk
24
Q
A

BDS4 Oral Medicine (22 decks)

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