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AU '19 - Oral Path Final > Pharmacologic Management of Oral Diseases Part 2 > Flashcards

Pharmacologic Management of Oral Diseases Part 2 Flashcards

(57 cards)

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1
Q

first consideration when managing ulcers

A

etiology

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2
Q

management of ulcers if suspected of trauma

A
  1. remove local irritants

2. monitor for healing (digital photo + ruler)

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3
Q

management of ulcers with rolled borders

A

biopsy

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4
Q

differential dx of ulcers with rolled borders

A
  1. OSCC
  2. TUGSE
  3. Histoplasmosis
  4. TB
  5. other deep fungal
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5
Q

immune-mediated ulcers can include…

A
  1. pemphigus
  2. pemphigoid
  3. lichen planus
  4. apthous ulcers
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6
Q

distinct clinical presentation of aphthous ulcers

A
  1. red halo
  2. very sore
  3. abrupt onset
  4. no apparent local etiology
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7
Q

T/F: in order to properly manage ulcers, dx should be established first

A

true - don’t prescribe emperically esp topical corticosteroids

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8
Q

if unsure of cause of ulcer, what should be done?

A

refer for evaluation or biopsy

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9
Q

side effects of topical steroids in tx’ing ulcers

A

could mask symptoms of SCC and superimposed Candida (impair ulcer healing) so ESTABLISH DX FIRST

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10
Q

erythema multiforme has a variety of clinical presentations but are often with what?

A

crusted hemorrhagic lips

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11
Q

erythema multiforme may follow what?

A

viral infections such as HHV-1

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12
Q

it’s essential to distinguish erythema multiforme from what?

A

herpeviruses

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13
Q

T/F: use of systemic steroids for erythema multiforme minor is now controversial

A

true

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14
Q

erythema multiforme is what type of ulcerative disorder?

A

acute, self-limiting

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15
Q

erythema multiforme is probably what?

A

immune-mediated

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16
Q

erythema multiforme mostly affects what demographic?

A

young adult male predilection

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17
Q

etiology of erythema multiforme

A

hypersensitivity

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18
Q

erythema multiforme due to hypersensitivity is usually triggered by what?

A

infection in 90% of cases

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19
Q

what type of infections trigger hypersensitivity in pts with erythema multiforme?

A
  1. HSV

2. mycoplasma

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20
Q

erythema multiforme is distinct from what?

A
  1. Stevens Johnson

2. toxic epidermal necrolysis

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21
Q

tx for mild cases of erythema multiforme

A

supportive care…

  1. analgesics
  2. soft diet
  3. hydration
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22
Q

what is somewhat controversial in tx’ing erythema multiforme major?

A

corticosteroids are often given empirically

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23
Q

if suspect HSV trigger causing erythema multiforme. what should be given?

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A

prophylactic acyclovir

24
Q

prognosis of mild-moderate cases of erythema multiforme

25
T/F: Stephens Johnson and TEN are very rare, acute, serious and potentially fatal
true
26
Stephens Johnson and TEN is nearly ALWAYS associated with what?
meds
27
most common meds that are associated with Stephens Johnson and TEN?
1. abx 2. antifungals 3. antivirals 4. NSAIDS 5. anticonvulsants
28
characteristics of Stephens Johnson and TEN
1. prodromal illness-flulike 2. rash starts at trunk 3. progresses to face and limbs
29
dx of Stephens Johnson and TEN is based on what?
clinical presentation and extent of detachment
30
tx of Stephens Johnson and TEN
1. stop suspected drug 2. hospitalization 3. fluid replacement 4. pain management 5. sterile handling 6. caution superimposed infections
31
Stephens Johnson infects what percent of the body vs TEN?
<10% body infected for Stephens Johnson and is more extensive for TEN
32
Candidiasis can be confirmed with what?
culture and/or cytology
33
Rx for Candidiasis
clotrimazole troches
34
Disp for Candidiasis
70 (seventy)
35
Sig for Candidiasis
dissolve in mouth 5 times a day until gone
36
Sig for pts with Candidiasis and angular cheilitis
lick corners of mouth while dissolving troche
37
why would you want local delivery when tx'ing Candidiasis?
1. sustained contact necessary | 2. reduced load on liver
38
local delivery Rx for Candidiasis
fluconazole 100 mg
39
local delivery disp for Candidiasis
8 (eight) tabs
40
local delivery sig for Candidiasis
take 2 tabs on Day 1, then 1 qd until gone
41
T/F: there are reported incidence of fluconazole resistant organisms especially in HIV patients
true
42
OTC meds for pts with xerostomia
1. oral balance liquid or spray (Biotene) 2. oasis moisturing mouth spray (sensodyne) 3. orajel dry mouth moisturizing gel (church and dwight)
43
recommendations for xerostomia pts
stay hydrated - abundant water, not soft drinks, coffee or juice
44
rx for xerostomia
pilocarpine HCl 5 mg
45
disp for xerostomia
90 (ninety) tabs
46
sig for xerostomia
take one tab tid (may be increased to 2 tid if necessary and side effects tolerable)
47
pilocarpine is what type of drug?
parasympathetic mimetic drug
48
side effects of pilocarpine
1. sweating 2. nausea 3. decreased visual acuity
49
decreased visual acuity from pilocarpine reflects what?
drug category and fxn
50
what may you also want to consider when managing xerostomic pts?
chlorhexidine gluconate (non-alcohol containing formula)
51
rx for chlorhexidine gluconate (non-alcohol containing formula)
G-U-M Chlorhexidine Gluconate 0.12% rinse (alcohol free)
52
disp for chlorhexidine gluconate (non-alcohol containing formula)
1 bottle (473 ml)
53
sig for chlorhexidine gluconate (non-alcohol containing formula)
rinse with 1/2 cap of liquid every day then expectorate
54
tx for cheilitis
1. velvachol - pharmacists' formulation base | 2. aquaphor lip
55
why is velvachol excellent for?
tx'ing cheilitis on lips and skin since it's hydrophilic
56
what is used to tx lip fissure?
1% iodoquinone, 1% hydrocortisone cream (Vytone)
57
prescription fluoride
1. prevident rinse, gel and toothpase (colgate) | 2. Preventech- Pediagel

AU '19 - Oral Path Final (6 decks)

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