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Pharm 154* > Dental Health > Flashcards

Dental Health Flashcards

1
Q

What is the reason for not prescribing tetracyclines in children?

A

Tetracyclines can cause permanent tooth staining

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2
Q

What are some possible causes for toothaches?

A

Tooth decay
Abscess/infected gums
Damaged fillings
Repetitive motions (grinding teeth)

Our main concern us that they do not have an infection

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3
Q

What can pharmacists do for toothaches?

A

Analgesics can help patient get to an appointment with a dentist

ex. Acetaminophen (including T1 and T3), NSAIDs (ibuprofen, naproxen)

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4
Q

What are some red flags associated with toothaches?

A

Fever, pus, swelling, headaches

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5
Q

Is acetaminophen + ibuprofen combo therapy useful?

A

It is a standard practice by dentists, acet. works more centrally while ibu. works peripherally to decrease prostaglandins

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6
Q

Are OTC acet/ibu combo products indicated for toothaches?

A

Currently available OTC combos do not have high enough doses. Better to use separate OTC products

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7
Q

What are some topical treatments for toothaches?

A

Heat or cold packs on the outside of the cheek

Benzocaine (relief if pain is from the gums, but will not help pain from inside the tooth)

Clove oil

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8
Q

Why do children start to become more fussy at 6 months?

A

Teething pain (especially molar eruptions)

But it could also be due to the following:
extra drooling
irritable
facial rash
mild fever

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9
Q

What is usually used to help with teething pain?

A

Teething rings or objects that act like a teething ring(toys, cold face cloth)

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10
Q

Is topical benzocaine useful to manage teething pain?

A

Not reccomended

It washes off and there is worry about numbing of throat(inhibited gag reflex)

Also associated with blue baby syndrome

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11
Q

What is methemoglobinemia (blue baby syndrome)?

A

It is the reduction of the blood’s oxygen-carrying capacity.

Topical benzocaine use in infants is associated with methemoglobinemia.

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12
Q

What is the efficacy of natural teething pain gel?

A

Next to nothing, they are effectively unmedicated gels

Go with teething ring instead

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13
Q

Are cold sores a condition commonly seen by pharmacists?

A

Yes, it is the most common condition that pharmacists prescribe for

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14
Q

What pathogen causes cold sores and what factors induce it’s reactivation?

A

Primarily caused by HSV-1 (oral herpes). This virus is usually dormant in everyone, but it can activate in some people and cause cold sores

Reactivated by stress, sunlight, trauma, etc.

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15
Q

What are cold sores?

A

It is a condition characterized by painful fluid-filled sores. These sores are located on the lips and around the nostrils

Symptoms usually last 7-10 days

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16
Q

What are the stages of a cold sore?

A

Stage 1 (prodromal): Tingling, itching, or burning (pharmacists can prescribe effective therapy at this stage) (0.5 days)

Stage 2: blister formation (1-2 days after tingling)

Stage 3: blister bursts (pharmacists cannot prescribe something effective at this stage, need MD prescription) (day 4)

Stage 4: scab formation (days 5-8)

Stage 5: healing stage

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17
Q

What condition can cold sores be confused with?

A

Impetigo

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18
Q

How to differentiate between cold sores and impetigo?

A

Impetigo is…

less painful
no prodromal phase
seen in younger children (cold sores can still happen in kids)

Can be difficult to diagnose, so we might have to resort to diagnosis by treatment

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19
Q

Can cold sores last for longer than 7 days?

A

No, it could be something worse (basal/squamous) especially if the lesion remain for 2-3 weeks

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20
Q

What are some non-drug options for cold sore treatment?

A

Reduce stress (easier said than done)

Protect from the sun

Don’t squeeze or pop

Lip balm (keep soft)

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21
Q

What are some OTC products used in cold sore treatment?

A

Docosanol (might actually treat cold sore directly)

Other options either dry or moisturize skin:
benzocaine
lysine
benzoyl alcohol

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22
Q

Does covering a cold sore with an unmedicated patch help reduce recovery time?

A

It seems like they slightly reduce duration. Not really a mainstay of cold sore therapy?

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23
Q

What is the efficacy of lipivir?

A

Not medicated, simply an emollient

prevents outbreaks, not to actually treat cases.

The emollient in lipivir is made of a mixture of polyethylene glycols (PEGs), a substance that interferes with the herpes simplex virus

24
Q

What is the efficacy of Abreva (docosanol 10%)?

A

It helps reduce viral entry into host cell

Apply at first sign of cold sore (prodromal tingling)

Apply to lesion 5x/day until healed

25
Q

How to reduce auto-innoculation of cold sores?

A

Use a q-tip to apply agents like abreva (docosanol)

26
Q

Does docosanol reduce duration significantly?

A

Not really, it marginally reduces duration

ex. 4.8 days (without docosanol) vs. 4.1 days (with docosanol)

27
Q

What are some prescribed agents used in cold sore treatment?

A

Oral antivirals must be started before lesions appear (during prodromal stage) or will be ineffective

oral:
Valacyclovir 2g BID

topical:
Acyclovir/HC cream applied 5 times per day x 5 days (25 applications)

28
Q

What is the efficacy of acyclovir/HC cream?

A

This combination combines pros of both agents. These are secondary to oral agents, but they are still fairly effective

29
Q

What should a patient with fully developed cold sores do to help with cold sores?

A

Anesthetics could help with the pain, but nothing that will treat cold sores directly

30
Q

What should people with recurrent cold sore episodes do to help reduce frequency ?

A

An MD could prescribe an antiviral for regular use. This can decrease the probability of a cold sore coming back by 1/3

31
Q

What are canker sores?

A

Apathous ulcers

They are characterized by white or cream-coloured lesion within red/inflamed bodies.

Painful

Often have an unknown etiology
ex. local trauma, stress, allergies, nutritional deficiencies

32
Q

How to differentiate between mouth sores seen in hand-foot-mouth disease vs. canker sores?

A

Mouth sores from hand-foot-mouth disease only happen once

Canker sores can be recurrent

33
Q

What are mucoceles?

A

Mucoceles often result from trauma and are are characterized by a cyst-like growth

They are also less painful vs. canker sores

34
Q

Can drugs induce canker sores?

A

Canker sores can be aggravated by many things, and drugs like NSAIDs, beta blockers, and cytotoxic agents are commonly blamed for inducing canker sores

35
Q

What is stomatitis?

A

These are ulcers that form in the mouth following radiation or chemotherapy. Patients will be aware that this can develop

36
Q

What are some non-drug options to help prevent canker sores?

A

Prevent local trauma

Reduce stress

Nutritional deficiencies
ex. iron, folic acid, zinc, Vit B

37
Q

Are hydrogen peroxide rinses more effective vs. saline?

A

Saline is just as effective, hydrogen peroxide also has a metallic taste

38
Q

What are some drug therapy options for canker sores?

A

Benzocaine

Protectants like Zilactin and Orabase
Magic mouthwash

39
Q

How to use benzocaine for canker sores?

A

Apply directly to the lesion (can apply q2h)

Short term pain relief

Do not use in children under 2 die to concerns with methemoglobemia

40
Q

How to protectants work in canker sores?

A

They act by adhering to mucosal tissue and protecting canker sore from impact

41
Q

What is magic mouthwash?

A

Milk of magnesia + diphendyramine

Swish around in the mouth QID for pain relief

42
Q

Should pharmacists recommend AgNO3/styptic sticks for canker sores?

A

No, this is usually used on shaving cuts

Don’t apply on canker sore

43
Q

What is a prescribed agent for canker sores?

A

Oracort (triamcinolone) paste. This is an topical steroid paste

Apply small amount at bedtime

If no improvement in 7 days, see dentist or MD

44
Q

What is oral candidiasis (thrush)?

A

It is an oral infection of C. albicans

Creamy white lesions along tongue or cheek

Can be painful or have a burning sensation

45
Q

What is a common cause for oral thrush?

A

This is commonly seen in people that use inhalers (opportunistic infection)

(rinse mouth after administration to prevent oral candidiasis)

46
Q

How to differentiate between milk residue and oral candidiasis?

A

Milk residue is easily brushed off compared to the white residue associated with oral candidiasis

47
Q

If a child has oral candidiasis and a diaper rash, is it justifiable to assume their diaper rash is infected?

A

Yes, this child has a yeast infection

48
Q

What are some risk factors associated with thrush (oral candidiasis)?

A

Disease states:
Diabetes, HIV, Anaemia, Leukemia

Medications:
Inhaled corticosteroids, broad spectrum antibiotics, chemo/radio therapy

Other:
Poor oral hygiene, dentures, babies

49
Q

How can people prone to oral candidiasis do to prevent them from developing?

A

Asthmatics:
improve inhaled corticosteroid use (use spacer and rinse out mouth after use)

Seniors:
clean dentures at night

Babies:
clean pacifiers and bottles

50
Q

Is Gentian Violet 1% solution effective in oral candidiasis?

A

It is a herbal product and its efficacy is lower than the DOCs covered earlier

causes mucosal irritation

Safety is questionable

51
Q

What is angular cheilitis?

A

It is irritation of the edges around the corners of the patient’s mouth

52
Q

Can shingles on the face be easily mistaken for cold sore?

A

No, these shingles are rare on the face. They also can cause scarring once cleared up. The areas affected are not limited to the lips alone, but can affect surrounding skin

53
Q

When should mouth ulcers be referred to an MD?

A

Last longer than 3 weeks

Suspected adverse drug reaction (ex. NSAIDs)

Crops of 5-10 or more ulcers

Rash

54
Q

How many people have an oral Candidiasis colonization?

A

Approx 30-60% of healthy individuals

55
Q

What is leukoplakia?

A

An asymptomatic and often well-demarcated white-plaque that cannot be wiped away or characterized clinically or pathologically as any other disease

Usually found in older men (40-70)

Smokers are 6x more likely to develop leukoplakia

56
Q

What are some symptoms associated with thrush (oral candidiasis)?

A

Creamy white lesions along tongue or cheek

Can be painful or a burning sensation

May bleed slightly when scraped during removal

Infants will be more fussy and could also develop candidial diaper rash

Pharm 154* (18 decks)

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