Pharmacology and Medical Emergencies. Chapters 29, 30. Test 1 Flashcards
(74 cards)
1
Q
a.a. means
A
of each
2
Q
a.c. means
A
before meals
3
Q
a.m.
A
morning
4
Q
b.i.d.
A
twice a day
5
Q
disp.
A
dispense
6
Q
h, hr
A
hour
7
Q
h.s.
A
at bedtime
8
Q
NPO
A
nothing by mouth
9
Q
p.c.
A
after meals
10
Q
prn
A
as needed
11
Q
q.
A
every
12
Q
q.d.
A
once a day
13
Q
q.i.d.
A
four times a day
14
Q
SL
A
Sublingual, under the tongue
15
Q
tsp
A
teaspoon
16
Q
tbsp
A
tablespoon
17
Q
t.i.d.
A
three times a day
18
Q
More than ___ of older people may be affected by periodontal disease, and most___
A
50%/unaware of it
19
Q
Category I
A
Healthy patients. No special modifications
20
Q
Category II
A
A patient who require scheduling changes or shorter appointment.
21
Q
Category III
A
Patients who have lifelong implications, requires modifications in dental treatment planning, including alteration in anesthetic, types of dental materials, and patient positioning
22
Q
Category IV
A
Patients who require more significant modifications, including treatment to meet dental needs within the operating room.
23
Q
Category V
A
Patients with serious medical conditions who require only limited care to eliminate serious acute oral disease; includes patients who must be kept free of pain and discomfort.
24
Q
Autism commonly appears by age____
A
2 or 3
25
The Alzheimer disease is the_____cause of death in adults older than age___ in the United States.
fourth-leading/65
26
tonic (during a seizure) describes
the muscles in the body becoming stiff
27
Atonic (during a seizure) describes
the muscles in the body relaxing
28
Myoclonic (during a seizure) describes
short jerking in parts of the body
29
Clonic (during a seizure) describes
periods of the body shaking and jerking
30
Medicine - phenytoin (Dilantin).
Antiepileptic medicine. May cause increased bleeding tendencies, drowsiness, lack of coordination, drug-induced gingival overgrowth, and xerostomia. Epilepsy can affect up to 1% of the general pop
31
Types of seizures:
1. Generalized:
- Absence seizure (petit mal seizures). Rapid blinking or a few seconds of starting into space.
- Tonic-clonic seizures (grand mal seizures). A person can cry out, lose consciousness, fall, and have muscle jerks or spasms.
2. Focal seizures (partial seizures) affect one area of the brain:
- Simple focal seizures affect the small part of the brain and can cause twitching or a change in sensation such as a strange taste or smell.
- Complex focal seizures can make a person confused or dazed and unable to respond.
- Secondary generalized seizures begin in one part of the brain and spread to both sides.
32
Multiple sclerosis (MS) is ______common neurologic disorders affecting adults _____
one of the most/between the ages of 30 and 50.
33
The Parkinson disease usually affects people older than age____
50
34
Cerebral Palsy affects ______individuals in _____ live birth.
1 to 4/1000. Usually resulting from anoxia. Group of NONprogressive neuromuscular disorders caused by brain damage
35
Amyotrophic Lateral Sclerosis referred to as_____ is progressive, with patient survival of_____years or less.
Lou Gehrig disease/3 to 5. A degenerative nervous system disease that causes loss of motor neurons in the cerebral cortex, brain stem, and spinal cord, resulting in muscular atrophy, weakness, and spasticity.
36
The leading cause of death among men over 40 and among women over age 65 is....
cardiovascular disease
37
Examples of Neurologic disorders
- Alzheimer disease
- Seizures (including Epilepsy)
- Multiple Sclerosis (MS)
- Cerebrovascular Accident (stroke)
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Examples of Neuromuscular disorders
- Muscular Dystrophy (MD)
- Parkinson Disease
- Cerebral Palsy (CP)
- Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig disease
- Rheumatoid Arthritis
- Osteoathritis
39
In the Unites States, more than______ people are known to have asthma. Nearly______ of these people are children,
22 million/6 million
40
Hyperthyroidism (overactive thyroid gland) affects woman_____times more often than men. The average age of onset is before____.
four to seven/40
41
Incidence of Downs is __ in ___live births
1/700. Incidence increases with age of the mother. Signs: Slanted eyes, broad flat nose, short stature
42
Adrenal suppressants and muscle relaxants for Multiple Sclerosis (MS)
prednisone (Adrenal suppressant) and diazepam (muscle relaxant)
43
Clinical Considerations for MS
- Development of respiratory problems due to the disease’s effect on the muscles that control breathing; a rubber dam may be useful only if the patient can breathe through the nose.
- Do not position the pt in a supine position.
- Sedation may be required.
- Difficulty in localizing intraoral pain and discomfort.
- Some patients develop trigeminal neuralgia.
- Shorter appointments
- May have to be transferred from wheelchair to dental chair
44
Clinical Considerations for Neuromuscular Disorders
- Patients require shorter appointments.
- Dental dam may be useful if pt can breathe through the nose.
- Do not place pt in supine position.
- Nitrous oxide (N20), sedation, and general anesthesia should be avoided with these patients because of their impaired pulmonary (breathing) function.
45
What is Parkinson’s Disease (PD)?
Motor system disorder that is the result of the loss of dopamine-producing brain cells.
4 primary symptoms of PD are tremor, or trembling in the hands, arms, legs, jaw, and face; rigidity or stiffness of the limbs and trunk; slowness of movement; and impaired balance and coordination.
46
Clinical Considerations for Arthritis
Physicians prescribe aspirin and corticosteroids to reduce the symptoms of arthritis.
- Schedule patients with arthritis in the morning, keep appts short.
- Arthritis of the jaw joints limits the patient’s ability to chew comfortably .
Rheumatoid arthritis- autoimmune disorder in which the body recognizes its own tissue as foreign and makes antibodies to attack what it thinks is an invader.
Osteoarthritis- happens when the protective cartilage over the ends of bones wears away and bone rubs on bone.
47
_____Americans today have some form of cardiovascular disease. The cardiac dose of dental local anesthetic with epinephrine is ______, or the amount of epinephrine found in two cartridges of dental local anesthetic with _________ epinephrine.
20 million/0.04 mg/1/100,000. Epinephrine (also known as adrenaline) is vasoconstrictor and sympathomimetic agent that is often used in combination with local anesthetics to prolong their effects and reduce bleeding at the site of injection.
48
Endocarditis
Cardiac disease and/or prosthetic replacements convey an increased risk for bacteria to be carried in the blood system.
A severe infection of the cardiac valves and supporting structures caused by bloodborne pathogens that gain entry to the bloodstream from such places as the mouth and gastrointestinal tract.
49
Clinical Considerations for Bronchial Asthma
- Every effort should be made to minimize stress.
- It is best to shorten appointments and to use sedation techniques.
- The use of epinephrine and aspirin should be minimized.
50
Clinical Considerations for COPD
- Minimize stress by keeping appointments short and scheduling them in the morning.
- Consider using sedation techniques in low-risk to moderate-risk patients.
- Consider using humidified oxygen given by nasal cannula.
- Avoid the use of nitrous oxide.
- Do not treat patients in a fully reclined chair.
- Avoid anticholinergic drugs, which dry bronchial secretions.
- Do not schedule elective treatment during hot and humid weather.
51
Clinical Considerations for Blood Disorders
- The important factor for patients with a blood disorder is their susceptibility to bacterial infection.
- Treatment modifications have to be made for any surgical procedure.
- Antibiotic prophylaxis may need to be prescribed for high-risk procedures.
- Patients on blood thinners have their international normalized ratio (INR) measured each month. The dose of their medication is modified according to the results of the test.
52
Clinical Considerations for Hyperthyroidism
The thyroid gland regulates metabolism in body cells and stimulates passage of calcium into bones from the blood.
Hyperthyroidism - A patient with an overactive thyroid gland has Graves’ disease.
Hypothyroidism - When the thyroid gland is underactive and produces fewer hormones than usual.
Hyperthyroid patients who are not being treated are highly sensitive to epinephrine and other amine anesthetics.
You can think of the thyroid gland as the thermostat of the body. A hyperthyroid patient runs hot. A hypothyroid patient runs slow and cold.
53
Clinical Considerations for Diabetes Mellitus
Minimize stress by keeping appointments short and scheduling them in the midmorning.
Use sedation techniques such as administration of nitrous oxide (laughing gas) or oral diazepam (muscle relaxant).
Instruct patients to maintain normal dietary intake before dental appointments
Minimize the risk for infection
54
DEA (Drug Enforcement Administration) scheduled drugs
Schedule I: No current accepted medical usefulness and a high potential for abuse –Heroin, LSD
Schedule II: High potential for abuse but accepted medical usefulness as well –Adderall, Percocet, cocaine. Cannot be refilled.
Schedule III: Less abuse potential and accepted medical uses –Didrex, Tylenol with codeine. No more than five prescriptions in 6 months
Schedule IV: Low abuse potential and accepted medical uses –Xanax or Valium
Schedule V: Not required to be prescribed, Robitussin AC
55
Prescription Terminology
Superscription: Pt name, address, date, symbol Rx (from Latin word "recipe" meaning "take")
Inscription: Name, quantity of the drug
Subscription: Directions for mixing
Signature: Instructions for pt on how to take medication, when to take it, and how much to take
56
Drugs that would be routinely prescribed by the dentist for their patients
Analgesics- most common in dental office.
Antibiotics- most common in dental office.
Antifungal agents.
Antiviral agents.
Antianxiety agents.
57
Classification of antibiotics
1. Bactericidal antibiotics such as penicillin directly kill an infecting organism. Penicillin remains the most effective antibiotic for the types of organisms causing the majority of oral infections. Penicillin e.g. amoxycillin, least toxic but many people have allergy to it.
Cephalosporin – similar structure to penicillin
2. Bacteriostatic antibiotics such as tetracycline and erythromycin (when penicillin is contraindicated) inhibit the production of bacteria by interfering with their metabolic process.
58
Medicine - nystatin (Mycostatin, Nilstat, Nystex).
Antifungal Agents
One of the most commonly prescribed drugs. Fungal infections can be diagnosed in patients who are immunocompromised, poorly fitting prosthesis, pts with xerostomia, and pts who are taking antibiotics
59
Medicine - acyclovir (Zovirax).
Most common antiviral agent.
60
Antianxiety Agents
Antianxiety agents have become a large part of “pain-free dentistry”.
One of the current trends is to use enteral (meaning tablets) antianxiety agents rather than parenteral (meaning an injection) agents.
61
Respiratory Drugs
Inhibitors or anti-inflammatory drugs are prescribed inhalers
Stabilize mast cells, which release histamines, and other inflammatory cells
Bronchodilators - work by relaxing the smooth muscles of the airway.
For treatment of acute bronchospasms
Examples include albuterol (Proventil, Ventolin) and epinephrine (Bronkaid Mist.)
62
Medicine for cardiovascular disorders. Statins
Cholesterol lowering - Lipitor, meds ending with ‘or’.
63
Medicine - thiazides
Reduce fluid retention. Medicine for cardiovascular disorders. Diuretics
64
Medicine - warfarin.
Prevent blood clotting. Medicine for cardiovascular disorders. Anticoagulants
65
Medicine for cardiovascular disorders. Antiplatelet drugs
Also work to keep blood clots from forming – aspirin
66
meds ending with ‘olol’.
Medicine for cardiovascular disorders. Beta-blockers. Control blood pressure, slow fast arrhythmias, reduce angina chest pain.
67
Medicine for cardiovascular disorders. Digitalis
Stimulates the heart to beat more forcefully.
68
meds ending with ‘ine’, such as nitroglycerine.
Medicine for cardiovascular disorders. Vasodilators. Reduce the work of the heart.
69
Medicine for cardiovascular disorders. Calcium channel blockers
Useful for some forms of angina, may be prescribed for certain arrhythmias or high blood pressure.
70
meds ending with ‘ril’.
Medicine for cardiovascular disorders. ACE (Angiotensin-converting enzyme) inhibitors. Slow the progression of heart failure.
71
Psychoactive Drugs. Antianxiety drugs
For patients who are in a state of uneasiness of mind that resembles fear - diazepam.
72
Medicine - Prozac.
Patients diagnosed with depression. Psychoactive Drugs. Antidepressant drugs
73
Medicine - lithium.
Psychoactive Drugs. Antimanic/bipolar disorder drugs. For patients who are in a state of hyperactivity or are exhibiting aggressive behavior.
74
Medicine - chlorpromazine (Thorazine).
Psychoactive Drugs. Antipsychotic drugs. Used to treat psychosis.
