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Dentistry Human Disease > Medical History And Medication > Flashcards

Medical History And Medication Flashcards

1
Q

What does it mean if a patient has atrial fibrillation?

A

They have an irregular and often fast heartbeat

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2
Q

What condition weakens bones, making them fragile and more likely to break?

A

Osteoporosis

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3
Q

What medication is often used to treat an individual with atrial fibrillation?

A

Warfarin

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4
Q

What medication is often used to treat deep vein thrombosis?

A

Rivoraxaban

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5
Q

What medication is often taken to treat osteoporosis?

A

Alendronic acid ( a type of bisphosphonate)

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6
Q

what is the risk during dental procedure if the patient is on warfarin?

A

Bleeding risk post- operatively

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7
Q

what are four examples of direct oral anticoagulants?

A
  1. Apixaban
  2. Dabigatran
  3. Rivaroxaban
  4. Edoxaban
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8
Q

What medication is often used to treat deep vein thrombosis?

A

Rivoraxaban ( a direct oral anticoagulant)

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9
Q

What is the risk during dental procedure if a patient is on direct oral anticoagulants?

A

Bleeding risk

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10
Q

If patient is at high risk of bleeding during dental procedure, what should you advise them to do prior to treatment?

A

To miss or delay morning dose of medication

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11
Q

At what point in the day should you treat a patient with bleeding risk?

A

Early in the day

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12
Q

What dental procedures are unlikely to cause bleeding?

A
  • LA
  • BPE
  • supragingival PMPR
  • restorations with supragingival margins
  • impressions
  • endodontics
  • fitting and adjustment of orthodontic appliances
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13
Q

what dental procedures are likely to cause bleeding, but at low risk?

A
  • simple extractions
  • incision and drainage of intra-oral swelling
  • 6 point full periodontal examination
  • RSD or subgingival PMPR
  • restorations with subgingival margins
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14
Q

what dental procedures are likely to cause bleeding at high risk?

A
  • complex extractions
  • 3 or more extractions at one time
  • flap raising procedures (e.g. dental implant surgery)
  • biopsies
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15
Q

what are three examples of vitamin K antagonists?

A
  1. Warfarin
  2. Acenocoumarol
  3. Phenindione
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16
Q

What are three examples of injectable anticoagulants?

A
  1. Dalteparin
  2. Enoxaparin
  3. Tinzaparin
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17
Q

Which anti-platelet drug should we be especially aware of a patient taking, when preparing for a preclude such as an extraction?

A

Aspirin

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18
Q

What type of drug us Alendronic acid?

A

Bisphosphonate

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19
Q

What condition does Alendronic acid treat?

A

Osteoporosis

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20
Q

What dental related risk is there when taking Alendronic acid?

A

Risk of medication-related osteonecrosis of the jaw (MRONJ)

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21
Q

What is Nicornadil used to treat? And what intra-oral finding can result from its use?

A
  1. Angina
  2. Oral ulceration
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22
Q

What are NSAIDs used to treat? And what intra-oral finding can result from their use?

A
  1. Pain and reduces inflammation
  2. Oral ulceration
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23
Q

What is Phenytoin used to treat? And what intra-oral finding can result from its use?

A
  1. Epilepsy
  2. Gingival swelling
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24
Q

What are calcium channel blockers used to treat? And what intra-oral finding can result from their use?

A
  1. They lower blood pressure
  2. gingival swelling
25
What is cyclosporine used to treat? And what intra-oral finding can result from its use?
1. Autoimmune conditions 2. Gingival swelling
26
Give four examples of systemic disorders that could cause oral ulceration?
1. Anaemia 2. Coeliac disease 3. Lichen planus 4. Herpes virus
27
What systemic disorder might cause glossitis of the tongue?
Anaemia
28
what two localised disorders may cause glossitis of the tongue?
1. Lichen planus 2. Candidosis
29
What are the two different categories of DMARDs?
Conventional DMARDs Biological DMARDs
30
What does DMARDs stand for?
Disease modifying anti-rheumatic drugs
31
What is the main function of DMARDs?
Suppress the immune system and this allows them to slow or stop the disease progression.
32
Why do DMARDs require regular blood monitoring?
Because these drugs can cause bone marrow suppression, amongst other side effects
33
What is the function of the DMARD: Aziothioprine
Inhibits purine synthesis, which is needed to produce RNA and DNA. It inhibits DNA synthesis in dividing immune cells.
34
What is the function of the DMARD: Mycophenolate mofetil
Potent inhibition of purine synthesis
35
What is the function of the DMARD: Cyclosporine
A calcineurin inhibitor- inhibits calcium dependant signals in T cells and therefore inhibiting their function.
36
What is the function of the DMARD: Hydroxychloroquine
Interferes with lysosomes in immune cells, raising the pH so that cells are not able to function properly
37
What is the function of the DMARD: Gold (sodium aurothiomalate)
Suppresses the synovitis of active RA
38
What is the function of the DMARD: Leflunomide
Inhibits mitochondrial enzymes which inhibits DNA and RNA synthesis.
39
What is the function of the DMARD: Methotrexate
Inhibits the enzyme, dihydrofolate reductase, essential for the synthesis of purines and pyramidines
40
What is the function of the DMARD: Penicillamine
Aids the elimination of copper ions in Wilson’s disease
41
What is the function of the DMARD: Sulfasalazine
Inhibits the formation of prostoglandins
42
What are the three checks that need to be made prior to commencing DMARD treatment?
1. Baseline blood investigations 2. Screening for viral infections 3. Chest x-ray to look for signs of TB
43
What baseline investigation is essential before starting the DMARD, azothioprene?
This-urine methyltransferase (TPMT) activity
44
Why are folic acid supplements required when a patient is taking methotrexate?
Helps to protect healthy cells in the body and reduces the side effects of methotrexate
45
What is the main side effect of all DMARDs?
Bone marrow supression
46
What is the main dental consideration of an individual who takes DMARDs?
Increased susceptibility to infection
47
What are the three broad groups that biologics can be divided into?
1. Monoclonal antibodies 2. Cytokines 3. Fusion proteins
48
What are fusion proteins?
Transmembrane proteins connected to another molecule
49
What are monoclonal antibodies?
Antibodies that target a specific antigen. Some will suppress the immune system and others will up-regulate parts of the immense system.
50
What is the main difference between biologics and conventional DMARDS?
Biologics target one aspect of the immune system, whereas conventional DMARDS suppress the entire immune system
51
What is the only form of administration of biologics?
IV infusion
52
When is monoclonal antibody therapy indicated for autoimmune disease?
When patients have failed therapy with at least two DMARDS
53
Give 4 examples of monoclonal antibody drugs that act as TNF alpha inhibitors?
1. Adalimumab 2. Certolizumab 3. Infliximab 4. Golimumab
54
Name a monoclonal antibody that targets CD20 antigen on B cells?
Rituximab
55
What programmed death receptor-1 blocking antibody is involved in the treatment of head and neck squamous cell carcinoma?
Pembrolizumab
56
What anti-epidermal growth factor receptor is involved in treatment of squamous cell carcinoma of the head and neck?
Cetuximab
57
What are the key dental considerations of a patient taking biologics?
- increased risk of infection (neutropenia) - thrombocytopenia ( increased bleeding risk) - risk of MRONJ - mucosal disease
58
Why should NSAIDs be avoided with corticosteroid use?
Because corticosteroids increase gastric acid production in the stomach, NSAIDs will increase this also and therefore there is higher risk of developing duodenal ulcers/ peptic ulceration.
59
Bendroflumethiazide is a thiazide diuretic which can be associated with lichenoid reactions. True or flase?
True

Dentistry Human Disease (29 decks)

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