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🔵SCR - Oral Medicine > Drugs > Flashcards

Drugs Flashcards

1
Q

Antifungals
1. contraindications
2. relevant types
3. when needed

A
  1. interact with statins and warfarin
  2. fluconazole, muconazole and nystatin
  3. when
    - acute psudomembranous candidiasis
    - erythematous candidiasis
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2
Q

examples of antifungal drugs

A
  1. azoles:
    - Fluconazole
    - muconazole
  2. Polyenes
    - Nystatin
  3. echinocandins
    - caspofungin
  4. allylamines
    - naftifine
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3
Q

Aciclovir
1. Prescription
2. what for

A
  1. prescription
    TABLETS:
    - dossage = 200-500mg
    - 2-5 tabs a day
    - for 5 to 10 days
    - longer for prophylactic tx

SYSTEMIC:

  1. what for
    - Recurrent herpetic lesions
    - PHG
    - shingles (recurrent herpetic ZOSTER lesions)
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4
Q

prednisolone

A
  • corticosteroid
  • can be given systemically (erythema multiforme - up to 60mg/d)
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5
Q

chlorhexidine gluconate
1. how use
2. …

A
  1. dilute to 50% if needed
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6
Q

Antibiotics
1. types

A
  1. types
    - Metronidazole
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7
Q

Corticosteroids
1. types of administration
2. types
3. use
4. licenced for these uses?

A
  1. administraiton
    - topical
    - MW
    - inhailer
    - systemic
  2. types
    - prednisolone (systemic)
    - betamethazone MW
    - Beclomethazone inhailer
  3. use
    - apthous ulceration
    - lichen planus
  4. licenced?
    - no, so need to give own instructions
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8
Q

immunosupressive drugs
1. examples

A
  • mycophenolate
  • azathiopine
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9
Q

biologics
1. what
2. examples

A
  1. sourced from biological sources
  2. retuximab (monocolonal antibody)
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10
Q

Benzydamine
1. types
2. indications
3. how works

A
  1. types = difflam spray and MW
  2. indicaitons = pain from ulceration etc
  3. non-steroidal anti inflamatory with anaesthetics and analgesic effects
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11
Q

Pain medicaitons for trigmeninal neuralgia

A
  1. carbamazepine
  2. trycliclic antidepressants
    - works in CNS preventing pain transmission
  3. gabapentin / pregabalin
    - more for neuropathic pain where nerves are damaged
  4. medicines which modify immune system
    - azathioprine (immune suppresive)
    - mycophenolate (immune suppresive)
    - hydroxychloroquine (immune modulating)
    - colchicine (immune modulating)
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12
Q

definitions for medications
1. general sales
2. pharmacy medicines
3. prescription
4. controlled drugs
5. medical devices

A
  1. anywhere can sell
  2. pharamcy can sell
  3. prescription only
  4. restricted prescription, possession and use
  5. 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
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13
Q

licenced vs non-licenced medications

A

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

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14
Q

delivery of these drugs and what are they
- betamethazone
- Beclomethazone

dont get confused with benzydamine - difflam

A
  • betamethazone MW
  • Beclomethazone inhailer
  • Corticosteroids
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15
Q

non - steroidal topical therapy (3)

A
  1. chlorhexidine MW
  2. benzdamine MW and spray
  3. OTC (bonjela, listerine, igloo)
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16
Q

steroid topical therapy (3)

A
  1. hydrocortisone mucoadhesive pellet
    - dissove over lesion
  2. betamethasone MW
  3. Beclomethasone Metered dose inhaler (MDI)
17
Q

Corticosteroids

A
  1. prednisolone (MW)
  2. betamethasone (MW)
  3. Beclomethasone (inhailer)
  4. hydrocortisone (tablet onto lesion)
18
Q

SDCEP drug guidance on patients with ulceration (primary care)

A
  1. local measures
    * advise warm salt water MW

-

  1. antimicrobial
    * chlorhexidine - 10ml, 1 min, 2/d
    * hydrogen peroxide MW 6% - 15ml in half glass warm water, 2 mins, 3/d
    * same for children

-

  1. 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

-

  1. 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

-

  1. 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
19
Q

SDCEP drug guidance on candidosis and erythematous candidosis

A
  1. local measures - if use corticosteroid inhailer then rinse mouth after use
  2. fluconazole - 50mg/5ml, 7 tabs, 1/d (now actually 100mg one a day for 14 days but not what SDCEP says)
  3. miconazole gel - 20mg/g, pea sized amount after food, 4/d (>2)
  4. nystatin oral suspension 100,000units/ml - 1ml after food, 4/d, 7 days
20
Q

systemic treatment by oral medicine specialists

A
  1. disease modulators - colchicine
  2. steroids - prednisolone (pulsed 30mg for 5 days, once a month as prolonged course = adrenal supression)
  3. immune suppresants (mostly for lichen planus) - hydroxychloroquine, azathioprine, mycophenolate
  4. immunotherapy (biologic drugs) - adalimumab and enterecept / rituximab or infliximab

last two = risk of infeciton, cancer, drug reactions

21
Q

treatment for neuralgia

A

First line
* carbamazepine (modified slower release - tegretol)
* oxcarbazepine
.
second line
* pregabalin
* gabapentin
.
others
* amitriptyline
* nortriptyline
ANXIOLYTIC DRUGS above?
* tryciclic antidepressants

22
Q

ACE INHIBITORS
* what
* action
* exmples

A
23
Q

tx for dry mouth

A

Replacement saliva
1. saliva orthana
2. glandosane (acidic)
.
Drugs
1. pilocarpine
.
other methods
1. chewing gum
2. sips of water
3. lauzenges
4. etc.

24
Q

what have to do for a patient on carbamazepine

A
  1. blood tests for first 4 weeks then monthly - FBC, urea and electrolytes test, liver function test
  2. carful when patient on other diuretic drugs

🔵SCR - Oral Medicine (8 decks)

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