Drugs Flashcards
Antifungals
1. contraindications
2. relevant types
3. when needed
- interact with statins and warfarin
- fluconazole, muconazole and nystatin
- when
- acute psudomembranous candidiasis
- erythematous candidiasis
examples of antifungal drugs
- azoles:
- Fluconazole
- muconazole - Polyenes
- Nystatin - echinocandins
- caspofungin - allylamines
- naftifine
Aciclovir
1. Prescription
2. what for
- prescription
TABLETS:
- dossage = 200-500mg
- 2-5 tabs a day
- for 5 to 10 days
- longer for prophylactic tx
SYSTEMIC:
- what for
- Recurrent herpetic lesions
- PHG
- shingles (recurrent herpetic ZOSTER lesions)
prednisolone
- corticosteroid
- can be given systemically (erythema multiforme - up to 60mg/d)
chlorhexidine gluconate
1. how use
2. …
- dilute to 50% if needed
Antibiotics
1. types
- types
- Metronidazole
Corticosteroids
1. types of administration
2. types
3. use
4. licenced for these uses?
- administraiton
- topical
- MW
- inhailer
- systemic - types
- prednisolone (systemic)
- betamethazone MW
- Beclomethazone inhailer - use
- apthous ulceration
- lichen planus - licenced?
- no, so need to give own instructions
immunosupressive drugs
1. examples
- mycophenolate
- azathiopine
biologics
1. what
2. examples
- sourced from biological sources
- retuximab (monocolonal antibody)
Benzydamine
1. types
2. indications
3. how works
- types = difflam spray and MW
- indicaitons = pain from ulceration etc
- non-steroidal anti inflamatory with anaesthetics and analgesic effects
Pain medicaitons for trigmeninal neuralgia
- carbamazepine
- trycliclic antidepressants
- works in CNS preventing pain transmission - gabapentin / pregabalin
- more for neuropathic pain where nerves are damaged - medicines which modify immune system
- azathioprine (immune suppresive)
- mycophenolate (immune suppresive)
- hydroxychloroquine (immune modulating)
- colchicine (immune modulating)
definitions for medications
1. general sales
2. pharmacy medicines
3. prescription
4. controlled drugs
5. medical devices
- anywhere can sell
- pharamcy can sell
- prescription only
- restricted prescription, possession and use
- not a drug but treat or relieve symptoms without being immunosupressive, pharmacological or via metabolic means
- i.e. saliva treatment (artificial saliva, saliva stimulators via taste etc - glandozane - or saliva pastilles
licenced vs non-licenced medications
licenced
- drug tested for this specific conditon and passed by MHRA
non-licenced
- drug licenced for another purpose but known to have positive effect on prescribing conditon
- need to give tailored use directions
- need to tell patint this
- evidence not been presented to MHRA as expensive process
- used at prescribers disgretion
delivery of these drugs and what are they
- betamethazone
- Beclomethazone
dont get confused with benzydamine - difflam
- betamethazone MW
- Beclomethazone inhailer
- Corticosteroids
non - steroidal topical therapy (3)
- chlorhexidine MW
- benzdamine MW and spray
- OTC (bonjela, listerine, igloo)
steroid topical therapy (3)
- hydrocortisone mucoadhesive pellet
- dissove over lesion - betamethasone MW
- Beclomethasone Metered dose inhaler (MDI)
Corticosteroids
- prednisolone (MW)
- betamethasone (MW)
- Beclomethasone (inhailer)
- hydrocortisone (tablet onto lesion)
SDCEP drug guidance on patients with ulceration (primary care)
- local measures
* advise warm salt water MW
-
- antimicrobial
* chlorhexidine - 10ml, 1 min, 2/d
* hydrogen peroxide MW 6% - 15ml in half glass warm water, 2 mins, 3/d
* same for children
-
- if recurrent apthous stomatitis
* tetracycline mouthwashes (doxyxycline disolvable tablets - MW)
* give 48 tablets - to cover several episodes
* 1 tab in water, 2 mins, 4/d, for 3 days at onset of ulceration
* DONT SWALLOW
* NOT <12 yo as intrinsic staining of developing teeth
-
- local analgesics
* benzydamine MW (difflam)
* 0.15%, 15ml, every 1.5hrs as required
* <12 yo = Not recommended
- benzydamine spray
- 0.15%, 4 sprays, every 1.5hrs
- can be used <12 but different rules up to 6yo
- lidocaine ointment 5% and lidocaine spray 10% - both fine for any age
-
- topical steroids
* beclomethasone - 0.5mg/puff, 2 puffs direct into ulcer, 2-3/d (>2yo)
* betamethasone - 1 tab (1mg), 10ml water, 2 mins, 2/d (>12yo)
* hydrocortisone - 1 tab next to lesion, 4/d
SDCEP drug guidance on candidosis and erythematous candidosis
- local measures - if use corticosteroid inhailer then rinse mouth after use
- fluconazole - 50mg/5ml, 7 tabs, 1/d (now actually 100mg one a day for 14 days but not what SDCEP says)
- miconazole gel - 20mg/g, pea sized amount after food, 4/d (>2)
- nystatin oral suspension 100,000units/ml - 1ml after food, 4/d, 7 days
systemic treatment by oral medicine specialists
- disease modulators - colchicine
- steroids - prednisolone (pulsed 30mg for 5 days, once a month as prolonged course = adrenal supression)
- immune suppresants (mostly for lichen planus) - hydroxychloroquine, azathioprine, mycophenolate
- immunotherapy (biologic drugs) - adalimumab and enterecept / rituximab or infliximab
last two = risk of infeciton, cancer, drug reactions
treatment for neuralgia
First line
* carbamazepine (modified slower release - tegretol)
* oxcarbazepine
.
second line
* pregabalin
* gabapentin
.
others
* amitriptyline
* nortriptyline
ANXIOLYTIC DRUGS above?
* tryciclic antidepressants
ACE INHIBITORS
* what
* action
* exmples
tx for dry mouth
Replacement saliva
1. saliva orthana
2. glandosane (acidic)
.
Drugs
1. pilocarpine
.
other methods
1. chewing gum
2. sips of water
3. lauzenges
4. etc.
what have to do for a patient on carbamazepine
- blood tests for first 4 weeks then monthly - FBC, urea and electrolytes test, liver function test
- carful when patient on other diuretic drugs
