oral hygiene Flashcards
(39 cards)
main component of dentrifices
cpf
hw
bp
fsc
cleansing +polishing agent 10-40%
foaming agents 1-3%
humectant 20-70%
water 5-30%
binder/gelling agent 1-2%
preservative 2-%
flavoring2%, sweeteners 2-3%
coloring 2-3%
CAT vs S. +p04
cleaning vs polishing agents made of what ?
CAT- Ca2+, Al3, Sn[Tin] cleaning agent
polishing - silica; phosphate
foaming agents
SLS sodium lauryl sulfate - antibacterial
Binders/gelling agent
natural gums - thickening agent
or
seaweed extracts- stabilizers
Humectant
sorbitol and mannitol -maintain moisture and prevent evaporation
type of dentifrices
anti caries F 100-1450/ 5000 prescription based
desensitizing agents
=eg ACP, Knitrate-reduce nerve excitability, SnF2 [stannous fluoride] ; arginine
antigingivitis ; antiplaque - stannous fluoride; triclosan - historical value
Type of F
NaF 0.22% at 1000 ppm
Na MFP monofluorophosphate 0.76% at 1000ppm
NaF 5000ppm - prescription based
active ingredient of oral antiseptic m/w
CHX
EO -essential oils
CPC- cetylpyridinium chloride
CHX adv what? so what?
2adv//mechanism and 3how long it works?
1 most effective antiplaque and antiging->gold standard of therapeutic m/w
2antibacterial via disruption of cell membrane, increase premeability, cell lysis and death
3superior substantivity - 8-12hr bind to oral tissue
chx disadv [4x esp if prolonged usage]
tooth, filling, denture and tongue brownish stains; increased calculus formation;
taste changes and is unpleasant to taste
chx instructions- eg
CHX gluconate 0.12% solution: Rinse bid 15 mL;30 sec 2/52.
chx digluconate 0.2% bid 10mL 60 sec 2 wks
= rinse and spit
30 mins btw rinsing and brushing avoid interaction with SLS which deactivates CHX// eat/drink then only rinse - periogard, peridex
EO moaction
contain phenolic compounds that destroy microorg by compromising cell membrane and inhibit ENZYME activity
benefit of EO 5x
1.slow bacterial multiplication [cannot penetrate cz oily]
2 prevent bact. agg [oily]
3reduce bact. load [quantity reduced]
4 prevent biof. maturation [2 btter than 1 , less matured]
5 reduce pathogenicity of biofilm
Adalimumab (Humira®) Facts
General class:
(MOA):
Excretion:
side effect
General class: Monoclonal antibody
Mechanism of Action (MOA): Blocks action of TNF ; Tumor Necrosis Factor causes inflammation
Excretion: Half-life changes between 10 to 20 days and may be longer depending on dose.
s/effect: Can lower the ability of the immune system to fight infections.
biologic medication that reduces inflammation and treats moderate to severe diseases: eg
Rheumatoid arthritis (RA) or
Psoriatic arthritis / Crohn’s disease
Zolpidem tartrate Facts
General class + fx:
(MOA):
Brand names:
excretion
General class: Hypnotic to tx insomnia
Brand names: Ambien®, Edluar®, Intermezzo®, Zolpimist®
Mechanism of Action (MOA): Inhibits GABA action through benzodiazepine 1 receptor, but medication is not benzodiazepine; this leads to sedation and hypnosis
Excretion: 1:1 Urine/feces; fast onset (1/2 hour)
Etanercept Facts
General class:
(MOA)
tx autoimmune conditions,eg plaque psoriasis, rheumatoid arthritis
General class: Tumor Necrosis Factor (TNF) Blocking Agent; Antirheumatic
Brand name: Enbrel®
Mechanism of Action (MOA): Anti-inflammatory effect in affected joints through blockage of TNF action
Gabapentin Facts
General class:
(MOA)
Excretion:
side effects:
Gabapentin Clinical Significance
Treats:
Interacts with:
General class: GABA analog- used as anticonvulsant
Brand names for Gabapentin: Neurontin®, Gralise®
Mechanism of Action (MOA): Even though related to GABA, does not bind GABA receptors. Generally reduces excitatory neurotransmitters associated with voltage-gated calcium channels in presynaptic neurons.
Excretion: urine
Trivia: May cause dry throat sensation; Caries risk+ Xerostomia
Treats: Postherpetic neuralgia, seizures
Interacts with:
Opioids: increased sedative effect
Buprenorphine : increased sedative effect-> may lead to coma
(bupropion for tobacco cessation)
Lisinopril Facts
General class:
MOA):
General class: Angiotensin-converting enzyme (ACE) inhibitors (~pril ending)
Common examples: Benazepril (Lotensin®), Captopril, Enalapril (Vasotec®), Lisinopril (Zestril®, Prinivil®)
Mechanism of Action (MOA): Inhibits conversion of Angiotensin I to Angiotensin II
Angiotensin II is vasoconstrictor
ACE inhibitors can cause dry, hacking, non-productive cough that is highly irritating to individuals taking ACE inhibitors
ACE inhibitors are associated with angioedema, Stevens-Johnson syndrome
Lisinopril Clinical Significance
Treats:
Indicates risk for:
Interacts
class of angiotensin-converting enzyme ACE inhibitors and is used to treat hypertension, heart failure, and heart attacks. For high blood pressure it is usually a first-line treatment.
- used to prevent kidney problems in people with diabetes mellitusTreats: Hypertension
Indicates risk for: MI, stroke (as related to hypertension risk)
Orthostatic hypotension risk during dental appointments
Interacts with: causes increase in NSAID renal toxicity
Losartan Facts
General class:
(MOA):
Excretion:
tx
risk
interacts
Angiotensin II Receptor Blocker (~sartan)
examples: Losartan (Cozaar®), Valsartan (Diovan®), Olmesartan (Benicar®), Telmisartan (Micardis®)
Mechanism of Action (MOA): Blocks vasoconstrictor and aldosterone-secreting effects of Angiotensin II, resulting in lower blood pressure
Excretion: 1/3 urine, 2/3 feces
Clinical Significance
Treats: Hypertension
Indicates risk for:
Orthostatic hypotension
Interacts with: NSAIDs diminish effect of Angiotensin II receptor blockers
Glipizide Facts
General class:
(MOA):
excretion
Sulfonylureas
Common examples: Glipizide (Glucotrol®), Glimepiride (Amaryl®), Glyburide
Mechanism of Action (MOA): Stimulates insulin release from beta cells; reduces hepatic glucose release; increases insulin sensitivity in tissues
Excretion: Mostly Urine
Allopurinol Facts
General class:
moa:
Xanthine Oxidase Inhibitor
Mechanism of Action (MOA): Inhibits conversion of hypoxanthine to xanthine to uric acid in joints in GOUT pt
Diclofenac Facts
General class:
(MOA):
Excretion:
used for-dose?
Post Op risk:
Non-steroidal anti-inflammatory drug (NSAID), non-selective COX-1 & COX-2 inhibitor
examples: Ibuprofen ;Naproxen, Diclofenac (Voltaren®.)
Mechanism of Action (MOA): Inhibition of COX enzymes reduces prostaglandins formation; antipyretic, analgesic, anti-inflammatory effects
Excretion: 2/3 urine, 1/3 feces
used for mild-moderate oral pain
50 mg Diclofenac Sodium 3 times/day; Maximum dose 150 mg/day
Post Op risk: Possible bleeding risk through inhibition of platelet aggregation
no in-office dental treatment that has the potential for severe bleeding (i.e., extractions, scaling/root planing) should be rendered, IF:
Bleeding time >
Platelet count <
PTT >
PT >
INR >
Bleeding time > 10 minutes
Platelet count < 50,000
PTT > 45 seconds
PT > 22 seconds
INR > 3
partial thromboplastin time (PTT) vs prothrombin time (PT)