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Clinical Practice > Drugs and Periodontium > Flashcards

Drugs and Periodontium Flashcards

1
Q

what type of drug is Phenytoin?

A

An antiepileptic

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2
Q

what does phenytoin affect and cause?

A

directly affects the gingival tissues causes hyperplasia in 50% of cases : related to fibroblast activity/OH standards

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3
Q

hyperplasia will improve with what?

A

improved OH

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4
Q

when is they hyperplasia side effect of phenytoin most likely to occur?

A

within first 3 months
worse anteriorly
begins ID and grows and coalesces

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5
Q

what is the side effect of phenytoin related to?

A

serum conc of blood and not dose of drug

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6
Q

some examples of immunosuppresant drugs, what can they cause?

A

reduce inflamm response and reduce gingivitis

corticosteroids/cyclosporin

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7
Q

what can cyclosporin cause?

A

gingival hyperplasia in 30% of cases

increased incidence of women and children

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8
Q

what does cyclosporin hyperplasia resemble?

A

phenytoin hyperplasia

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9
Q

what medication can cyclosporin be switched to?

A

tacrolimus with gingival resolution

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10
Q

what do corticosteroids inhibit?

A

inhibit early and late stages of the inflammation process

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11
Q

periodontally what to corticosteroids cause?

A

reduced inflammation response/reaction to plaque
reduced swelling
reduced bleeding
occasionally allow a better response to tx

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12
Q

NSAIDS inhibit the synthesis and release of?

what does this result in?

A

prostaglandins
increased vasodilation
increased vacular permeability
stimulate bone loss - levels of PG’s in perio disease

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13
Q

periodontally what do NSAIDS cause?

A

reduced bleeding/reduced swelling/reduced bone than age/sex matched controls

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14
Q

why not use NSAIDs in perio disease?

A

GI effects

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15
Q

what does osetrogen cause in the mouth?

A

increased keratinisation and alters composition of CT

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16
Q

what does progesterone cause in the mouth?

A

increased permeability of gingival blood vessels

17
Q

at puberty what can be seen in the mouth?

A

increased prevalence and sensitivity to gingivitis

increased host response to presence of plaque

18
Q

during pregnancy what can be seen in the mouth?

A

pregnancy only exacerbates any underlying conditions
gingivae may become red/swollen/sensitive/bleed spont/increased gcf’mobility
tx - elimiate plaque retentive factors/good oh

19
Q

what is a pregnancy epulis?

A 
pyogenic granuloma
soft. pedunculated granuloma arising from an inflammed papilla
deep red/bleeds easy
usually around ants
usually 3rd month
20
Q

what are pregnancy epulis’s associated with?

A

plaque deposits and another factor:
carious cavity
poor tooth contact
overhang

21
Q

only remove epulis if?

A

being traumatised easily

remove after birth b/c recurrence unlikely

22
Q

what can the OCP cause?

A

increased flow of g.fluid and higher prevalence if gingival inflammation
inflammation associated with length of time and length medication taken
does not affect a healthy mouth

23
Q

what are chemotheraputic agents?

A

used to tx malignant disease

24
Q

what can chemotheraputic agents cause?

A

gingival haemorrhage
thrombocytopenia
lack of clotting factors

25
Q

low white blood count, pt more susceptible to ?

A

periodontal destruction

26
Q

what calcium channel blockers can cause problems orally?

A

nifedipine/amlodipine induced hyperplasia

amlodipine - 30% - soon after 1st dosage

27
Q

contact hypersensitivity caused by?

signs?

A

LA/penicillin/gum/MW

gingivae sore/red/epitheloum may peel of and leave ulcerated areas

28
Q

drugs causing hyperplasia?

A

phenytoin
cyclosporin
nifedipine

29
Q

destruction inhibition caused by?

A

immunosuppressants

NSAIDs

30
Q

increased susceptibility caused by?

A

sex hormones

31
Q

exacerbate and cause destruction?

A

chemotheraputic agents

smoking

Clinical Practice (22 decks)

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