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Fall 2024 > Dental and Pharyngitis Pharm > Flashcards

Dental and Pharyngitis Pharm Flashcards

1
Q

What causes dental plaque

A

bacterial biofilm

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2
Q

Define gingivitis

A

inflammation of the gums with redness, swelling, and provoked bleeding

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3
Q

Define periodontitis

A

Gingival inflammation accompanied by loss of supportive connective tissue including the periodontal ligament and alveolar bone

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4
Q

What prescription is helpful for gingivitis treatment?

A

Chlorhexidine Gluconate

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5
Q

What and how does chlorhexidine gluconate work

A

basically all bacteria + yeast; bacteriostatic at low doses and bacteriocidal at higher doses

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6
Q

What are the indications for chlorhexidine gluconate?

A

Gingivitis and periodontitis

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7
Q

What is chlorhexidine gluconate used to treat gingivitis?

A

oral rinse swish for 30 seconds with 15 mL; repeat twice daily

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8
Q

How is chlorhexidine gluconate used for periodontitis treatment?

A

periodontal chip - 1 chip inserted into a periodontal pocket with a probing pocket >=5mm (up to 8 chips);
Treat every 3 months
dislodges < 48 hrs, replace
dislodges > 7 days, fully treated

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9
Q

What are the adverse effects of chlorhexidine gluconate

A

Toothache, URI, sinusitis

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10
Q

What are the active ingredients in OTC mouthwash

A

Cetylpyridinium chloride
Chlorhexidine
Essential oils
Fluoride
Peroxide

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11
Q

Which OTC mouthwash ingredient reduces bad breath

A

Cetylpyridinium chloride

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12
Q

Which OTC mouthwash ingredient helps control plaque and gingivitis?

A

Chlorhexidine and essential oils

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13
Q

Which OTC mouthwash ingredient helps prevent tooth decay

A

Fluoride

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14
Q

Which OTC mouthwash ingredient helps whiten teeth

A

Peroxide

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15
Q

What population should not use mouthwash and why

A

Children <6 due to risk of ingestion

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16
Q

How is dental calculus (calcified dental plaque) prevented?

A

Tartar control toothpastes

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17
Q

What ingredients are in tartar control toothpastes?

A

Zinc salts
Pyrophosphate
Sodium Hexametaphosphate

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18
Q

What are the mechanisms of topical fluoride

A
  1. Enhance remineralization of carious lesions before they become cavities
  2. Inhibition of demineralization
  3. Destroy enzymes in bacteria that produce acids that erode the teeth
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19
Q

Outline the fluoride supplement guidelines ages <6 months

A

None

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20
Q

Fluoride supplement guidelines 6 months - 3 years

A

<0.3ppm = 0.25 mg/day

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21
Q

Fluoride supplement guidelines 3 years to 6 years

A

<0.3ppm = 0.5mg/day
0.3-0.6ppm = 0.25mg/day

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22
Q

Fluoride supplement guidelines 6-16 year

A

<0.3ppm = 1mg/day
0.3-0.6ppm = 0.5mg/day

23
Q

What to note about gingivitis vs periodontitis AB treatment

A

Gingivitis: need to cover anaerobes if ulcerative vs simple (clindamycin, metronidazole, Augmentin)

Periodontitis:
Stage I-2 = topical
Stage 3-4 = oral
Immunocompromised = IV

24
Q

What are common dental pain medications

A

NSAIDs
Acetaminophen
Opioids

25
What must be avoided when treating dental pain
XR or long acting opioids
26
What should be done if dental pain is due to infection
Surgery to remove infected tissue
27
What does postoperative pain lasting >3 days indicate
alveolar osteitis
28
What is the preoperative pain management for acute dental pain
NSAIDs single dose 30-60 minutes prior to dental procedure +/- chlorhexidine gluconate
29
What is the postoperative pain management for acute dental pain
1. Chlorhexidine gluconate 2. Ice/heat/rest 3. NSAID +/- acetaminophen on scheduled basis Mild - NSAID (400) or Acetaminophen (325) Moderate - NSAID (800) + Acetaminophen (500) Severe - NSAID (800) + Acetaminophen (325) + low dose opioid (no more than 3 days)
30
What are the classifications of chronic oral face pain
1. temporomandibular disorders 2. Persistent idiopathic facial pain 3. Atypical odontalgia *often associated with psychosocial problems
31
What are the pharmacotherapy treatments for chronic oral facial pain
Carbamazepine Lamotrigine Baclofen Tricyclic Antidepressants
32
What medications cause Xerostomia
SSRI Sulfonylureas Respiratory agents (anticholinergics) Thiazides CCB Urinary Antispasmodics NSAIDs Opioids Ophthalmologic agents
33
Non-pharm treatments of Xerostomia
Increase hydration Humidification Avoidance of irritating triggers
34
OTC medications to treat Xerostomia
1. Saliva substitutes: - Mouth Kote - Oasis mouth spray - Biotene gel - Salivart 2. Mucosal lubricants 3. Saliva Stimulants
35
Rx med for Xerostomia
Pilocarpine 1. related to head-neck cancer treatment - 5-10 mg PO tid, may take 12 weeks to help 2. related to Sjogren's - 5mg PO qid, may take 6 weeks to help
36
Pilocarpine MOA
Cholinergic agonist Increases parasympathetic activity Increases secretion from salivary glands
37
What are adverse issues of bruxism
1. Jaw muscle hypertrophy 2. Tooth wear and crack development 3. Pain
38
What are potential drug related causes
1. Antipsychotics 2. SSRI 3. SNRI Fluoxetine, Venlafaxine, Sertraline Symptoms onset 3-4 weeks and take 3-4 weeks to subside after cessation
39
What does "meth mouth" look like
Blackened Stained Rotting Crumbling Falling apart
40
Potential etiology of meth mouth
Acidic nature of meth Dry mouth - less protective saliva Increased carbonated beverages increased grinding Not properly cleaning teeth
41
Treatment of choice for pharyngitis
Penicillin
42
Penicillin VK dosing
Adults: 500mg BID Children: 50mg/kg/day in 3 doses - both 10 days
43
Penicillin benzathine dosing
Adults: 1.2 million units IM once Children (<27kg): 0.6 million units IM once
44
Amoxicillin dosing
Adults: 500mg TID Children: 40-50mg/kg/day - both 10 days
45
How to treat epiglottitis if not maintaining airway
immediate endotracheal intubation
46
Maintain airway and less than 6
endotracheal intubation
47
Maintaining airway and >6
individual decision of intubation vs observation
47
Adults without severe respiratory stress and <50% airway obstruction
Closely monitor in ICU w/o artificial airway
48
Most common organisms - epiglottitis
H. influenza type B Strep pneumoniae GA strep Staph aureus
49
What should be done prior to AB administration for epiglottitis
Blood culture and (if intubated) epiglottic culture
50
What empiric therapy for epiglottitis
Ceftriaxone or cefuroxime + vancomycin for 7-10 days If allergy, Vancomycin + quinolone OR carbapenem
51
Who gets DTaP and who gets Tdap
DTaP - peds (Infanrix, Daptacel) Tdap - 7 or older (Boostrix, Adacel)
52
At what ages do babies get DTaP
2, 4, and 6 months 15-18 months 4-6 years
53
Variations of combo DTaP vaccines
Pediarix - DTaP-IPV-HepB Pentacel - DTaP-IPV-Hib

Fall 2024 (34 decks)

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