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AU '19 - Oral Path Final > Pharmacologic Management of Oral Diseases > Flashcards

Pharmacologic Management of Oral Diseases Flashcards

(70 cards)

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1
Q

underlying caveats of oral diseases

A
  1. have an established dx
  2. be familiar with med you are prescribing
  3. be able to explain MOA and possible side effects
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2
Q

why should you have an established dx before prescribing?

A

corticosteroids make even SCC feel better

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3
Q

why should you be familiar with the med you’re prescribing?

A

don’t prescribe Vytone to pt allergic to shellfish (iodine)

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4
Q

why should you be able to explain MOA and possible side effects before prescribing?

A

potent corticosteroids increase potential for candidiasis

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5
Q

disease categories

A
  1. herpesviruses-HHV-1, HHV-3
  2. aphthous ulcers
  3. pemphigoid, pemphigus, lichen planus
  4. erythema multiforme
  5. candidiasis
  6. xerostomia
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6
Q

HHV-1 causes what?

A

acute herpetic gingivostomatitis

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7
Q

when should acute herpetic gingivostomatitis be tx’d?

A

tx early, within 2-3 days

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8
Q

why is a rinse prescribed for tx’ing acute herpetic gingivostomatitis?

A

rinse has better topical contact so better uptake

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9
Q

Rx for acute herpetic gingivostomatitis

A

acyclovir suspension (200 mg/5 ml) (must be compounded fresh)

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10
Q

Disp for acute herpetic gingivostomatitis

A

100 (one hundred) ml

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11
Q

Sig for acute herpetic gingivostomatitis

A

rinse then swallow 5 ml five times a day for 3 days

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12
Q

pediatric formulation for HHV-1

A

dose acyclovir rinse at 15 mg/kg

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13
Q

T/F: systemic drug txs are more effective for primary herpes infections

A

false, are NOT as effective

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14
Q

tx for primary herpes infections

A
  1. palliative care

2. limit hand and hand to eye contact with oral lesions

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15
Q

systemic Rx for recurrent herpes

A

valacyclovir 1 g caps

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16
Q

systemic Disp for recurrent herpes

A

5 (five) caps

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17
Q

systemic Sig for recurrent herpes

A

take 2 stat, then 2 at 12 h, then 1 at 24 hour

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18
Q

topical Rx for recurrent herpes

A

penciclovir cream, 1%

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19
Q

topical Disp for recurrent herpes

A

1.5 gram tube

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20
Q

topical Sig for recurrent herpes

A

apply small amount to affect area q 4h while awake

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21
Q

systemic Rx for recurrent herpes should be taken when?

A

during prodromal symptoms

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22
Q

palliative care is most essential with what condition?

A

primary herpetic stomatitis

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23
Q

Rx for primary herpetic stomatitis

A

1% dyclonine hydrochloride

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24
Q

Disp for primary herpetic stomatitis

A

topical spray

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25
Sig for primary herpetic stomatitis
apply before meals and when needing to talk
26
what can be taken prn for pain relief in pts with primary herpetic stomatitis?
NSAIDS
27
T/F: pts with herpes zoster need to be treated ASAP
true
28
Rx for herpes zoster
valacyclovir 1 g
29
Disp for herpes zoster
21 (twenty one) caps
30
Sig for herpes zoster
take 1 cap t.i.d. for 7 days
31
Sig for pts with herpes zoster but are also immunocompromised
take 2 caps t.i.d. for 7 days
32
what should be given to pts with herpes zoster if they were nonresponsive to oral meds?
IV acyclovir or foscarnet
33
aphthous ulcers arise on what?
freely movable mucosa
34
Rx for aphthous ulcers
clobetasol gel 0.05%
35
Dis for aphthous ulcers
30 (thirty) gm
36
Sig for aphthous ulcers
apply a small amount to affected area q.i.d.
37
what is possible in pts with aphthous ulcers?
superimposed Candida infection possible post steroids
38
what should be considered for pts with aphthous ulcers with superimposed Candida infection?
consider Zilactin overlay
39
pemphigus causes what?
intraepithelial clefting
40
intraepithelial clefting
loss of protective integument
41
intraepithelial clefting may increase what?
infections
42
how is pemphigus managed?
with systemic corticosteroids and steroid sparing meds
43
pts with pemphigus should be referred to who?
1. rheumatologist 2. dermatologist 3. immunologist
44
pemphigus has a very high fatality prior to what?
steroids
45
dx of pemphigus will require what?
1. 2 biopsy specimens | 2. positive Niklosky's sign
46
what does a positive Nikolsky's sign indicate?
intraepithelial clefting
47
the 1st biopsy if suspecting pemphigus should be what?
lesional tissue in formalin
48
the 2nd biopsy if suspecting pemphigus should be what?
perilesional in Michael's
49
what other "desquamative" oral disease have a similar protocol for biopsies like pemphigus?
1. pemphigoid | 2. erosive lichen planus
50
mucous membrane pemphigoid has what characteristic?
sub-basilar clefting
51
what persist longer in mouth of pts with mucous membrane pemphigoid?
vesicles and bullae
52
what is an additional area of concern for pts with mucous membrane pemphigoid?
ocular lesions
53
eye lesions of pts with mucous membrane pemphigoid include what?
1. subconjunctival fibrosis 2. symblepharons-fusion bulbar 3. palpebral conjunctiva 4. entropion-eyelids turn inward
54
what percent of untreated pts with mucous membrane pemphigoid have ocular disease?
25%
55
what should be done after dx'ing pts with mucous membrane pemphigoid?
prompt referral to opthamalogist
56
dx of mucous membrane pemphigoid
D.I.F.
57
oral manifestations of pts with mucous membrane pemphigoid should be tx'd with what?
topical corticosteroids
58
Rx for mucous membrane pemphigoid with oral manifestations
clobetasol gel (0.05%)
59
Disp for mucous membrane pemphigoid with oral manifestations
30 (thirty) gm
60
Sig for mucous membrane pemphigoid with oral manifestations
apply small amount to affected area 4 to 5 times a day
61
what should be considered if pts with mucous membrane pemphigoid have more generalized oral lesions?
consider mouth rinse
62
if the gingiva of pts with mucous membrane pemphigoid is the primary site, what should be considered in addition to the mouth rinse?
custom trays
63
Rx for mucous membrane pemphigoid with more generalized lesions
dexamethasone elixir (0.5 mg/5 ml)
64
Sig for mucous membrane pemphigoid with more generalized lesions
rinse with 1 tsp, then expectorate, b.i.d.
65
caveat of prescribing dexamethasone elixir to pts with mucous membrane pemphigoid with more generalized lesions
keep rinse in contact with lesions as long as possible so need to check for superimposed Candidiasis
66
erosive lichen planus has similar management as what?
pemphigoid
67
management of erosive lichen planus
topical corticosteroids but may also want ot ocnsider a less potent corticosteroid
68
Rx for erosive lichen planus
fluocinonide gel 0.05%
69
Disp for erosive lichen planus
15 (fifteen) gm
70
Sig for erosive lichen planus
apply small amount to the affected area 4 to 5 times daily

AU '19 - Oral Path Final (6 decks)

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