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PHAR 154 > Dental > Flashcards

Dental Flashcards

1
Q

Avoid Tetras with who?

A

-2nd & 3rd TM (Pregnancy)
-Kids < 8yrs

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2
Q

What causes tooth aches?

A

-Tooth Decay
-Abscess or Infected Gums
-Damaged Fillings
-Repetitive Motions (tooth grinding, chewing gum)

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3
Q

Common agents given for tooth aches?

A

-Ace (incl. T1-T3s)
-NSAIDs (Ibu, Nap, ASA)

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3
Q

Common agents given for tooth aches?

A

-Ace (incl. T1-T3s)
-NSAIDs (Ibu, Nap, ASA)

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4
Q

What is the Rx daily limit for Ibu intake? OTC?

A

Rx: 2400mg (400-600mg Q4-6hrs)

OTC: 1200mg

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5
Q

Daily Rx limit for Ace intake?

A

4000mg (650-1000mg Q6hrs)

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6
Q

Topical Benzocaine… Good for pain originating from a tooth?

A

Nope… Only provides relief of pain if it originates from the Gums.

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7
Q

Teething pains are common for infants between 1-2yrs of age… What other conditions might it be?

A

-Ear Infection
-RSV
-Food Allergies
-Colic

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8
Q

What signs indicate an infant is going through teething pains?

A

-Extra Drooling
-Irritable
-Facial Rash
-Mild Fever

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9
Q

What can we give infants for teething pain?

A

-Teething Rings or other things to gnaw on (toys, cold facecloth, etc.)

-Topical Benzocaine (QID application & avoid feeding for 1hr after use due to throat numbing)

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10
Q

Name of rare, acute blood disorder associated with Topical Benzocaine (<2yrs)?

A

Methemoglobinemia (or “Blue Baby Syndrome”)

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11
Q

How does Methemoglobinemia present?

A

-Within mins to hrs

-1st app or repeat use

-Less O2 carrying capacity in the blood (Pale, Gray or Blue Skin & Lips)

-Can also present in adults during Surgical / Tracheal Applications

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12
Q

Best Topical Benzocaine product for teething?

A

Orajel Medicated Teething Relief

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13
Q

Why is Baby Orajel shit?

A

Lacks Benzocaine (is unmedicated… jump straight to teething rings).

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14
Q

1 Pharmacist prescribing scenario?

A

Cold Sores

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15
Q

What virus primarily causes cold sores?

A

HSV-1

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16
Q

What is recurrence rate for cold sores?

A

20-40% people (2-6 episodes / yr)

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17
Q

What re-activates dormant HSV-1 virus in cold sore patients?

A

Stress, Sunlight, Trauma

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18
Q

How do cold sores present?

A

Painful, fluid-filled sores that linger around for 7-10d

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19
Q

Can cold sores start in the mouth?

A

Yes (but canker sores can as well)

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20
Q

In what phase of cold sore infection are meds beneficial?

A

During the “Prodrome Syndrome” phase (ie. Day 1-2)… Must catch infection early.

21
Q

Progression of cold sores?

A

Day 0.5: Tingling, Itching, Burning

Days 1-2: Blister Formation

Day 4: Blister Bursting

Days 5-8: Scab Formation

21
Q

Progression of cold sores?

A

Day 0.5: Tingling, Itching, Burning

Days 1-2: Blister Formation

Day 4: Blister Bursting

Days 5-8: Scab Formation

22
Q

Differential conditions that may present similarly to cold sores?

A

-Angular Cheilitis (cracking around corners of lip creases)

-Impetigo (brown, crusty lesions & painless)

23
Q

What differentials can be used to distinguish cold sores from impetigo?

A

-Less painful

-Vesicles present within lesions themselves (occasionally w cold sores but more Impetigo)

-Age (Impetigo more common in kids)

24
Q

Non-Pharmacological measures for cold sore management?

A

-Reduce stress
-Protect from sun
-No popping / squeezing
-Lip Balm

25
Q

Is Heparin / ZnSO4 good for cold sores?

A

Nope… Sulfate present dries lesions out & could lead to cracking.

26
Q

Propolis or Lysine good to use for cold sores?

A

Not therapeutically helpful

27
Q

One OTC product that may actually help treat cold sores?

A

Docosanol

28
Q

Preventative lip gel that can be used to prevent cold sores (doesn’t actually treat).

A

Lipivir

29
Q

How does Docosanol actually help treat cold sores?

A

-Reduces viral entry into host cells

30
Q

Application instructions for Docosanol?

A

-Apply at 1st sign (ie. During Prodromal Phase).

-Apply 5x / day until healed.

31
Q

Given Docosanol is 2nd best topical product for cold sores, what are some other options?

A

Valacyclovir 2g BID (8tabs)

or

Acyclovir 5% / HC 1% crm (5x daily for 5d)

32
Q

Referral cases that might present cold sore-ish would be what?

A

Basal / Squamous Cell infiltration with the Elderly (pre-cancerous?)

33
Q

What will you say to someone who has already blistered over cold sores?

A

-AV’s of no use (didn’t catch early enough).

-Lip Balms & Benzocaine for numbing!

34
Q

A younger patient (4yrs) comes in with his mom & presents painful sores in the mouth. She tells you he had a fever, malaise & sore throat 1.5d ago. He also presents with a light skin rash. What might be his condition?

A

HFM Disease

35
Q

Johnny comes in with complaints of painful, white ulcers within the inside of his mouth. He is otherwise asymptomatic & healthy. What might he have?

A

Canker Sores (Aphthous Ulcers)

36
Q

Kimmy recently went in for chemo treatments & comes to your Pharmacy complaining of internal mouth ulcers. What might she have developed from the chemo?

A

Stomatitis

37
Q

Are Sodium Perborate or Hydrogen Peroxide rinses more effective anti-septic treatments for Canker Sores than Regular Saline?

A

Nope

38
Q

Is Orabase Paste better than Zilactin Gel for intra-oral applications in Canker Sore treatments?

A

Yes, paste better (slightly better adherence to mucosal tissues but tamper pt. expectations).

39
Q

Rx Therapy option for Canker Sores?

A

Oracort (Triamcinolone Paste)… Apply to sore HS & prn after meals.

-No healing within 7d = Referral to Dentist or MD.

40
Q

What does Oral Thrush (C. albicans) sometimes present as in young babies?

A

Milk Residue (wipes off much easier though… C. albicans much grabbier).

41
Q

How does Thrush present?

A

-Creamy white lesions along tongue or cheek

-Painful or burning sensation

-Slight bleeding when scraped

-Potential accompanying diaper rash (infants)

42
Q

Predispositions for Oral Thrush infections?

A

-Disease States (DM / HIV / Anemia / Leukemia / Xerostomia)

-Meds (ICS / BS AB’s / Chemo)

-Poor Oral Hygiene, Dentures, Babies…

43
Q

If I wanted a Holistic fix for Oral Thrush for my baby, what product might I try?

A

Gentian Violet 1% Sol’n (very messy)

NO LONGER ON MARKET!!!

44
Q

Rx Therapy for Oral Thrush?

A

Nystatin Oral Suspension… Typically relief in 1-2d but carry out therapy for 4-7d to prevent relapse.

<1yr: 100-200 000 U applied QID

> 1yr: 500 000 U applied QID

45
Q

Secondary Rx Therapies for Oral Thrush?

A

Miconazole & Fluconazole (MD Prescription)

46
Q

Xerostomia is commonly seen with what pt. demographic?

A

Elderly

47
Q

Other causes of dry mouth?

A

-Radiation / Chemo

-Mouth Breathing

-Chronic Disease

-Meds (ie. TCA’s / 1st gen AH’s / Opioids)

-Anxiety / Dehydration / Viral Infections

48
Q

Pharmacological agents to treat Xerostomia?

A

Saliva Subs (Moi-Stir, Oralbalance, Biotene)

49
Q

What medications can potentially induce Gingivitis?

A

-Phenytoin
-Cyclosporine
-Ca2+ Channel Blockers

50
Q

Name of condition associated with clicking or popping sounds & pain or discomfort around the jaw joint?

A

TMJ

PHAR 154 (11 decks)

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