2 Medicines and therapeutics in oral medicine Flashcards
What medicines are used in oral medicine
- Antimicrobials e.g. ant-viral/fungal/antibiotics
- Topical steroids e.g. inhaled/steroid mouthwash
- mouthwash topical treatments e.g. Benzdamine
- Systemic ‘medical’ treatments e.g. Carbamazepine
How are medicines classified
- general sales
- pharmacy medicines
- prescription only medicines
- controlled drugs (defined individuals - not dentistry)
- medical devices
what is a licenced medicine
a medicine that has been proven in evidence to the MHRA (medicines and healthcare products regulatory agency) to have efficacy and safety at defined doses in a child and/or adult population when treating specified medical conditions
What is an unlicenced medicine
medicines that have not had evidence of efficacy submitted for the condition under treatment
will be licenced medicines but for another condition
if using an unlicenced medicine what must you say and provide to the patient
- inform them that it is being used ‘off-licence’
- patient must be given specific Patient information leaflet to the condition under treatment
What medicines are used ‘licenced’ for use in oral diseases
- antimicrobials
- Benzdamine mouthwash
- Carbamazepine
nb topical steroids (inhaled and as a mouthwash) are unlicenced
Example of an antiviral and what does it treat
Aciclovir
- primary herpetic gingivostomatitis
- recurrent herpetic lesions
- shingles
Example of antifungal and what does it treat
Miconazole/Fluconazole/Nystatin
- acute pseudomembranous candidiasis
- acute erythematous candidiasis
Example of topical steroids and what does it treat
Betamethasone mouthwash
Beclomethasone Metered Dose Inhaler
(both used for):
- aphthous ulcers
- lichen planus
when using e.g. betamethasone mouthwash, what do you need to remember to tell and give your patient
- Condition specific PIL
- tell them not to use the standare PIL
patient information leaflet
what are medical devices
In dentistry, what are included as medical devices
Xerostomia treatments
- salivix pastilles
- saliva orthana
- biotene oral balance
- artificial saliva DPF
- Glandosane
Common medicines used in oral medicine specialist practice
- tricyclic antidepressants
- gabapentin/pregabalin (chronic pain)
- azathrioprine (immunosuppressant)
- mycophenolate (immunosuppressant)
- hydroxycholoroquine
- colchicine
what needs to be considered when providing medication
- clinical indication
- licenced or unlicensed for this used
- dose and route of administration
- imporatant warnings for the patient e.g. managing with other medicines
- drug interactions and cautions
- treatment duration and monitoring
what do you include on a prescription
- patients name, address, age (under 18)
- patient identifier (DoB, CHI number)
- number of days treatment
- drug to be prescribed
- drug formulation and dosage
- instructions on quantity to be dispensed
- instructions to be given to the patient
- signed - identifier of the prescriber
How to use, frequency, dose, normal effects, contact number
Example of a prescription
see chapter 1 BNF for guide
