31 drugs Used To Treat Oral Disorders

Question 1

Caused by the herpes simplex type 1 virus (herpes simplex labialis). Commonly found at the junction of the mucous membrane and the skin of the lips or nostrils, although they can occur inside the mouth, especially affecting the gums and soft palate

Answer 1

Cold sores (fever blisters)

Question 2

where is the live virus (that is contagious if transferred to other people) contained in cold sores (fever blisters)

Answer 2

the liquid from inside the vesicles contain the live virus

Question 3

what can happen if pus develops in the vesicles or under the crust of a cold sore

Answer 3

a secondary bacterial infection, should be evaluated for antibiotic therapy

Question 4

aka recurrent aphthous stomatitis

Answer 4

canker sores

Question 5

there appears to be a familial, nutritional, emotional, and physiologic factor with these sores. Lesion is usually gray to whitish yellowwith an erythematous halo of inflamed tissue surrounding the ulcer crater

Answer 5

canker sores

Question 6

three forms of this sore: minor aphthous stomatitis (most common), major aphthous stomatitism herpetiform aphthous stomatitis (uncommon)

Answer 6

canker sores

Question 7

a fungal infection caused by Candida albicans

Answer 7

Candidiasis

Question 8

often called “the disease of the diseased” (appears in debilitated patients and patients taking varitey of medications)

Answer 8

candidiasis

Question 9

Which medicians predispose a pt to candidiasis

Answer 9

those that depress the defense mechanisms: immunosuppressants, corticosteroids, cytotoxis, broadspectrum antibiotics
and those that cause xerostomia: anticholinergics, antidepressants, antipsychotics, antihypertensives, antihistamines

Question 10

medications that depress the defense mechanisms

Answer 10

immunosuppressants, corticosteroids, cytotoxics, broadspectrum antibiotics

Question 11

medications that cause xerostomia

Answer 11

anticholinergics, antidepressants, antipsychotics, antihypertensives, antihistamines

Question 12

a form of candidiasis characterized by white, milk curd-appearing plaques attached to the oral mucosa

Answer 12

thrush

Question 13

plaques of this can be easily detached, and erythematous, bleeding, sore areas appear beneath them

Answer 13

thrush

Question 14

treatment of this requires local or systemic therapy with antifungal agents, such as nystatin (Mycostatin) suspension or clotrimazole lozenges

Answer 14

thrush

Question 15

General term to describe a painful inflammation of the mucous membranes of the mouth. Commonly associated with chemotherapy and radiation therapy in the head and neck area

Answer 15

Mucositis

Question 16

These sores are erythematous ulcerations intermixed with white, patchy mucous membranes. Candidal infections are also often present

Answer 16

Mucositis

Question 17

How can mucositis affect the pt’s quality of life

Answer 17

typically very painful and can be highly debilitating, can cause difficulty in speaking and swallowing as well as pain that prevents eating or drinking

Question 18

what can results be due to the painfulness and debilitating effects of mucositis

Answer 18

weight loss, anorexia, malnutrition, anemia, and fatigue

Question 19

What is the primary cause of most tooth, gum (gingiva), and periodontal disease

Answer 19

plaque

Question 20

When plaque is on teeth, if not removed regularly it will thicken and grow bacteria. The bacteria will secrete acids that eat into the enamel of teeth, causing what? After 24 hours, if the plaque has not been removed it will calcify and become what

Answer 20

dental caries (cavities), tarter

Question 21

The calculus forms a foundation for additional plaque to form, eventually it will erode under the gum line causing periodontal disease and what

Answer 21

inflammation (gingivitis)

Question 22

what foul smelling breath can signify an underlying pathologic condition

Answer 22

halitosis

Question 23

nonoral sources of halitosis include:

Answer 23

sinusitis, tonsillitis, rhinitis; pulmonary diseases- tb or bronchiectasis

Question 24

term used when flow of saliva has partially or completely stopped

Answer 24

xerostomia

Question 25

goals of cold sore treatment:

Answer 25

control discomfort, allow healing, prevent spread to others, prevent complications

Question 26

what complications could arise from cold sores, how to prevent them

Answer 26

cold sores can become dry and crack, making them more susceptible to a secondary bacterial infection. Keeping the area moist can prevent this from happening

Question 27

docosanol, acyclovir, famciclovir, penciclovir, valacyclovir (think ovir- over this already)

Answer 27

drug therapy for cold sores

Question 28

goals of treatment for canker sores

Answer 28

control discomfort and promote healing

Question 29

for canker sores: what can be used as debriding and cleansing agents

Answer 29

Oxygen-relasing agents: Gly Oxide, hydrogen peroxide (alcohol-free Peroxyl Mouth Sore Rinse) can be used up to four times a day for 7 days. Do not swallow Salien rinses (1 to 3 teaspoons of table salt in 4 to 8oz warm tap water) may be soothing and can be used before a topical application of medication

Question 30

Side effects of canker sore medications

Answer 30

tissue irritation, black hairy tonuge

Question 31

Mucositis pt education. Shoud a baseline assessment should be completed? What would it rule out?

Answer 31

reinforce importance of good oral care throughout cancer treatment. Baseline assessment should be completed, assessment would rule outpreexixting conditions or infections that might aggravate impending mucositis

Question 32

What can be used before meals to relieve the pain of mucositis?

Answer 32

Viscous lidocaine 2%. Frequent applications are required, the sense of taste is diminished. Entire mouth and throat or anesthetized, gag reflex may be anesthetized- be sure to educate patients on this side effect, so they do not burn their mouths or throats or choke on their food. Ensure proper positioning, while eating to prevent choking.

Question 33

What can be used to rinse the mouth and coat the mucous membranes have a patient suffering from mucositis

Answer 33

Milk of magnesia

Question 34

What is a suspension dubbed “swish and swallow”- how is it used and for which patients

Answer 34

Nystatin liquid suspension. Swish in the mouth for one minute, then swallow. Used by patients with mucositis.

Question 35

What lozenge can someone suffering from mucositis can take that will dissolve slowly in the mouth, then swallowed to reduce candidal oral infections

Answer 35

Clotrimazole lozenges

Question 36

What has been approved specifically for stimulating, epithelial cell proliferation to prevent or treat the mucositis that develops in hematologic malignancies and patients undergoing chemotherapy before bone transplantation

Answer 36

Palifermin (Kepivance)- recombinant human keratinocyte growth factor

Question 37

How is xerostomia treated?

Answer 37

By changing the medication’s that cause dry mouth, or with artificial saliva

Question 38

Do artificial saliva products, stimulate natural saliva production, or mimic the viscosity mineral content and taste

Answer 38

Artificial saliva products mimic the viscosity mineral content and taste of natural saliva

Question 39

Nursing implications for all health therapy assessment: drug history- which drug causes alterations in the gums and oral mucositis after chemotherapy and radiation therapy

Answer 39

phenytoin (Dilantin)

Question 40

Nursing implications for oral health, dental history: what questions should be asked?

Answer 40

Frequency of visits to the dentist, brief summary of dental procedures that have been performed within the past 1 to 3 years

Question 41

Nursing implications for oral health: oral cavity- what should be noted and observed about the saliva present

Answer 41

The amount and consistency

Question 42

Nursing implications for oral health: oral cavity- what should be noted about the breath

Answer 42

Presence or absence of halitosis

Question 43

Nursing implications for oral health implementation: cold sores- cold sores should be kept clean by gentle washing, with what kind of soap solution

Answer 43

Mild

Question 44

Nursing implications for oral health-implementation- cold sores: why should cold sores be kept moist?

Answer 44

To prevent drying and cracking, which could lead to secondary bacterial infection, delay, healing, and increased discomfort

Question 45

Nursing implications for our health implementation- cold sores: should highly astringent products, such as tannic acid, and zinc sulfate, be used or avoided

Answer 45

Avoided

Question 46

Nursing implications for oral health implementation- mucositis: when fungal infections are present, should the cleaning regimen be performed immediately before administering the topical agents or sometime before administering the topical agents?

Answer 46

Immediately before

Question 47

Nursing implications for oral health implementation- mucositis: caution, the patient not to take food or drink approximately 15 minutes before or after medication has been given

Answer 47

After

Question 48

What to teach patience with pain in regard to oral health

Answer 48

Proper use of prescribed analgesics and comfort measures

Question 49

When should the patient be advised to avoid hot and spicy foods, alcohol, and tobacco?

Answer 49

When mucous membranes are irritated

Question 50

What viscous oral solution is a longer lasting local anesthetic that can be used as a gargle for patients with a sore throat or mouth ulcers

Answer 50

Lidocaine viscous 2%

Question 51

What should the patient be cautioned about when using viscous lidocaine and eating or drinking?

Answer 51

Not to eat or drink for at least 30 minutes after using product because of the absence of the gag reflex and potential risk for aspiration