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Oral Path > Smoking Cessations & medications Kerr! > Flashcards

Smoking Cessations & medications Kerr! Flashcards

(47 cards)

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1
Q

For Smoking Cessations

List the Nicotinic Drugs

(memorize Generic Names)

A

Nicotine Patch Generic Name

-Nicodern CQ/Habitrol

Nicotine Gum Generic Name

-Nicorette

Nicotine lozenge

  • Commit

Nicotine Inhaler

-Nicotrol lnholer

Nicotine Nasal Spray

  • Nicotrol NS

Combination NRT therapy is : NICTOINE Patch + Nictoine (gum,, or spray, or lozenge)

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2
Q

For Smoking Cessations

List Non-Nicotinic Drugs

(memorize the generic names)

A
  • Buprorpion Sustained release (Buprorpion SR)

Can be used
w/NRT

Start 1-2 weeks
before quit date.

  • Varenicline

Tartrate

Start 1 week
before quit date

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3
Q

give simple prescription for FDA approved

nicotone drug

(easier to memorize 1 for the exam)

A

Nicotine Nasal Spray

Max dosage: 40 spray for a day

Duration: 6 months, tapers 6 week

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4
Q

give simple prescription for FDA approved

Non-nicotone drug

(easier to memorize 1 for the exam)

A

Varencline (tablet)

First 3 days: 0.5 mg a day (QD)

Next 4 days: 0.5 mg twice a day (TID)

after 7 days: 1 mg a day twice a day (TID)

Duration: No tapering needed, can take up to 6 months

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5
Q

What are the adverse effects of Nicotine Inhaler?

A
  • Mouth and throat irritation
  • Cough

• Side effem generally caused by
inappropriate use

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6
Q

What are the adverse effects of Nicotine Nasal
Spray?

A
  • Nasal irrttation
  • Sneezing
  • Cough
  • Teary eyes
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7
Q

What are the adverse effects of Nicotine Patch?

A
  • local skin irritation
  • insomonia
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8
Q

What are the adverse effects of Nicotine Gum?

A
  • hiccups
  • Dyspepsia
  • mouth sorness
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9
Q

What are the adverse effects of Nicotine lozenge?

A
  • Dyspepsia
  • local irrttation mouth & throat
  • Rarely causes coughing & hiccups
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10
Q

What are the adverse effects of Sustained release
bupropion (Zyban or Wellbutrin)?

A
  • Insomnia
  • Dry mouth
  • Anxiety
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11
Q

What are the adverse effects of Varencline
tartrate Chontix ?

A
  • Nausea
  • Insomnia
  • Abnormal dreams
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12
Q

Nicotine inhaler

Precautions/Contraindications

A

Reactive Airway Disease

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13
Q

Nictotine Nasal Spray

Precautions

A

Reactive Ariway diseases

Not recomended for pts with Chronic Nasal diseases ( nasal polyps & sinusitis)

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14
Q

Sustained Release Bupropion

Contraindications

A
  • Seizure disorders
  • Current use of bullrin or MAO inhibitor
  • Eating disorder (bulimia, anorexia)
  • Alcohol
  • Head trauma

Moniter Blood presssure

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15
Q

Varenicline Tartlrate

Precaustions

A
  • women breasfeeding should avoid
  • pt with kidney problems -adjust dose
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16
Q

Nictoine Patch

Precutions

A
  • Caution with 6 months of MI
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17
Q

Nictotine Gum

Precuations

A
  • poor dentition
  • maybe inappropriate for use for pts with compelete or partial denture (hard for them to chew)
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18
Q

Nictotine Lozenge

Precautions

A
  • Xerostomia
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19
Q

TREATING TOBACCO DEPENDENCE:
A 2-PART PROBLEM

20
Q

Why is it so hard to quit: Nicotine addiction?

21
Q

What are the symptoms of Nicotine Withdrawal?

Study These Flashcards
A

■Irritability/frustration/anger

■Anxiety

■Difficulty concentrating

■Restlessness/impatience

■Depressed mood/depression

■Insomnia

■Impaired performance

■Increased appetite/weight gain

■Cravings

22
Q

WHAT WORKS (5A’s)

Study These Flashcards
A
  • Ask about tobacco use and secondhand smoke exposure
  • Advise to quit
  • Assess interest in quitting
  • Assist in quit attempt (referral and or pharmacotherapy)
  • Arrange for a follow-up
23
Q

Is Treating Tobacco is within the
Scope of Practice of dentists?

Study These Flashcards
A

Yes

•New York State Education Department has deemed that treating tobacco use is part of the scope of practice for dentistry, this includes prescribing smoking cessation products.

24
Q

Nicotine replacement therapy (NRT)

&

FDA labeling

Is it Safe?

Study These Flashcards
A
  • NO safety concerns association with using more than one NRT
  • NO significant safety concerns association with using NRT at the same time as a cigarettes
  • Use for longer than 12 weeks is safe
25
Assist-Prescribe FDA-Approved Medications
26
First Line Pharmacotherapy in combatting smoking?
* Combination long- and-short acting **Nicotine Replacement Therapy (NRT) (e.g., patch and gum, patch and inhaler)** * **Varenicline alone** * **Bupropion SR** with **NRT** (long- or short-acting)
27
**•What is NRT at the POC?** **•Rationale for NRT at the POC** **•Who will hand the patient NRT?** **•What kind of NRT will be on stock?** **•How to distribute NRT at POC?**
**•What is NRT at the POC?** –Distribution of a free starter pack of NRT to all smokers by clinic staff during the clinic visit **•Rationale for NRT at the POC** –NRT doubles the success rate of patients’ quit attempts –Inconvenience of purchasing RNT or filling a prescription creates barriers –The clinic is an opportune time to intervene **•Who will hand the patient NRT?** –Dental Students **•What kind of NRT will be on stock?** •Nicotine Patch, Gum, and Lozenge **•How to distribute NRT at POC?** –Take faculty-approved NRT request form to dispensary, where NRT is stored.
28
What is the The most effective treatment for smoking cessation
**a combination of pharmacotherapy and counseling**
29
PRIMARY HERPETIC GINGIOSTOMATITIS medication
* OTC Magic Mouthwash * OTC Analgesic Acetaminophen or Ibuprofen * Rx Topical Anesthetic: Viscous 2% Lidocaine Solution * Rx Antivirals: Acyclovir suspension
30
RECURRENT HERPES LABIALIS [PRODROME PHASE] – TOPICAL
* OTC Docosanol Cream * Rx Acyclovir cream 5% * Rx Penciclovir cream 1% * Rx Acyclovir 5%/Hydrocortisone 1% cream * Rx Acyclovir Buccal Tablets
31
RECURRENT HERPES LABIALIS [PRODROME PHASE] – SYSTEMIC
Rx Valacyclovir 1g tablets, Rx Famiciclovir 500mg tablets
32
RECURRENT HERPES LABIALIS [VESICLE/CRUSTED PHASE]
Nothing you can do! Antivirals do not help at this stage Helpful agents: Ice, Dessicants, L-lysine
33
RECURRENT INTRAORAL HERPES
Rx Topical Anesthetic: Viscous 2% Lidocaine Solution
34
MILD CANDIDIASIS
* Clotrimazole Troches * Miconazole mucoadhesive buccal 50mg tablet to mucosal surface over Canine Fossa * Nystatin suspension [100,000 u/mL] 4-6mL swish for \>1 minute then swallowed, 4x/day - High sucrose content  Caries risk
35
MODERATE-SEVERE CANDIDIASIS
* Fluconazole 100-200mg 1x/day for 7-14 days * Itraconazole suspension 200mg 1x/day * Posaconazole suspension
36
DENTURE STOMATITIS
* Nystatin on intaglio surface of denture when pt wears it * Remove & clean denture at night * Bleach 1:10 * Polident * Microwave * Reline denture/refit it
37
ANGULAR CHEILITIS
* Rx Clotrimazole cream 1% * Rx Nystatin-Triamcinolone Acetonide Ointment/Cream, 15g tube, Apply to angles of mouth after meals & before bedtime * Denture adjustment, reline, remake
38
CANDIDIASIS –IMMUNOCOMPROMISED, RECURRENT INFECTION CHRONIC SUPPRESSIVE THERAPY
Fluconazole 100mg 3x/week Clotrimazole 10mg troches 1 week/1 month
39
RECURRENT APHTHOUS STOMATITIS –ABORTIVE THERAPY: TOPICAL CORTICOSTEROIDS DO NOT USE MORE THAN 2+ WEEKS
Clobetasol Ointment 0.05% (ultra potent) Fluocinonide Gel/Ointment 0.05% (potent) Triamcinolone Acetonide in Orabase 0.1% (intermediate)
40
RECURRENT APHTHOUS STOMATITIS – ABORTIVE/SUPPRESSIVE THERAPY: CORTICOSTEROID RINSE
* **Dexamethasone Elixir [EtOH base]** * 0.5mg/5mL, 600 mL, Swish and spit with 5-10mL for 5 minutes (up to)4x/day * **Dexamethasone Solution [H2O base]** * 0.5mg/5mL, Swish and spit with 5-10mL for 5 minutes (up to) 4x/day
41
RECURRENT APHTHOUS STOMATITIS – SYSTEMIC CORTICOSTEROIDS [NOTE: SHORT-TERM USE ONLY TO GAIN CONTROL OF SEVERE DISEASE]
* Prednisone [Glucocorticoid & Immunosuppressant] 0.5mg/kg 1x/day for 1 week
42
ORAL LICHEN PLANUS – 1st LINE TOPICAL CORTICOSTEROIDS [NOTE: DO NOT USE 2+ WEEKS | A/E: Candidiasis]
Dexamethasone Elixir [EtOH base] Dexamethasone Solution [H2O base] Clobetasol 0.05%, 15g tube Halobetasol Ointment 0.05%
43
ORAL LICHEN PLANUS – CALCINEURIN INHIBITORS [NOTE: DO NOT USE 2+ WEEKS | \*BLACK BOX WARNING: CANCER]
* Tacrolimus Ointment 0.03% or 0.1%, 30g tube, Blot area dry, rub in thin film over areas 3x/day after meals & at bedtime * Tacrolimus Solution 0.5mg/5mL
44
PEMPHIGUS VULGARIS
STAGE 1 TREATMENT: CONTROL Systemic Corticosteroids STAGE 2 TREATMENT: CONSOLIDATION Immunosuppressants – i.e. CellCept [Mycophenolate mofetil] is steroid sparing - Must have no new lesions for 2+ weeks & 80% of lesions healed to get into “remission” stage - Can begin tapering steroids STAGE 3 TREATMENT: REMISSION/MAINTENANCE Rituximab
45
MUCOUS MEMBRANE PEMPHIGOID
Local Therapy [Local corticosteroids] Dapsone, Tetracycline + Nicotinamide [NOT IMMUNOSUPPRESSIVE] Low Risk: Oral mucosa only – Topical corticosteroid Clobetsol High Risk: Ocular, Esophageal involvement – Systemic Corticosteroids Prednisone 1mg/kg
46
XEROSTOMIA/SJOGREN’S SYNDROME
Artificial Saliva Biotene toothpaste & rinse Orabalance gel Pilocarpine 5-7.5mg 3x/day (tabletss) Cevimeline 30mg 3x/day (tablets)
47

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