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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
Q

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

A
  1. Autoimmune conditions
  2. Gingival swelling
26
Q

Give four examples of systemic disorders that could cause oral ulceration?

A
  1. Anaemia
  2. Coeliac disease
  3. Lichen planus
  4. Herpes virus
27
Q

What systemic disorder might cause glossitis of the tongue?

A

Anaemia

28
Q

what two localised disorders may cause glossitis of the tongue?

A
  1. Lichen planus
  2. Candidosis
29
Q

What are the two different categories of DMARDs?

A

Conventional DMARDs
Biological DMARDs

30
Q

What does DMARDs stand for?

A

Disease modifying anti-rheumatic drugs

31
Q

What is the main function of DMARDs?

A

Suppress the immune system and this allows them to slow or stop the disease progression.

32
Q

Why do DMARDs require regular blood monitoring?

A

Because these drugs can cause bone marrow suppression, amongst other side effects

33
Q

What is the function of the DMARD:

Aziothioprine

A

Inhibits purine synthesis, which is needed to produce RNA and DNA. It inhibits DNA synthesis in dividing immune cells.

34
Q

What is the function of the DMARD:

Mycophenolate mofetil

A

Potent inhibition of purine synthesis

35
Q

What is the function of the DMARD:

Cyclosporine

A

A calcineurin inhibitor- inhibits calcium dependant signals in T cells and therefore inhibiting their function.

36
Q

What is the function of the DMARD:

Hydroxychloroquine

A

Interferes with lysosomes in immune cells, raising the pH so that cells are not able to function properly

37
Q

What is the function of the DMARD:

Gold (sodium aurothiomalate)

A

Suppresses the synovitis of active RA

38
Q

What is the function of the DMARD:

Leflunomide

A

Inhibits mitochondrial enzymes which inhibits DNA and RNA synthesis.

39
Q

What is the function of the DMARD:

Methotrexate

A

Inhibits the enzyme, dihydrofolate reductase, essential for the synthesis of purines and pyramidines

40
Q

What is the function of the DMARD:

Penicillamine

A

Aids the elimination of copper ions in Wilson’s disease

41
Q

What is the function of the DMARD:

Sulfasalazine

A

Inhibits the formation of prostoglandins

42
Q

What are the three checks that need to be made prior to commencing DMARD treatment?

A
  1. Baseline blood investigations
  2. Screening for viral infections
  3. Chest x-ray to look for signs of TB
43
Q

What baseline investigation is essential before starting the DMARD, azothioprene?

A

This-urine methyltransferase (TPMT) activity

44
Q

Why are folic acid supplements required when a patient is taking methotrexate?

A

Helps to protect healthy cells in the body and reduces the side effects of methotrexate

45
Q

What is the main side effect of all DMARDs?

A

Bone marrow supression

46
Q

What is the main dental consideration of an individual who takes DMARDs?

A

Increased susceptibility to infection

47
Q

What are the three broad groups that biologics can be divided into?

A
  1. Monoclonal antibodies
  2. Cytokines
  3. Fusion proteins
48
Q

What are fusion proteins?

A

Transmembrane proteins connected to another molecule

49
Q

What are monoclonal antibodies?

A

Antibodies that target a specific antigen. Some will suppress the immune system and others will up-regulate parts of the immense system.

50
Q

What is the main difference between biologics and conventional DMARDS?

A

Biologics target one aspect of the immune system, whereas conventional DMARDS suppress the entire immune system

51
Q

What is the only form of administration of biologics?

A

IV infusion

52
Q

When is monoclonal antibody therapy indicated for autoimmune disease?

A

When patients have failed therapy with at least two DMARDS

53
Q

Give 4 examples of monoclonal antibody drugs that act as TNF alpha inhibitors?

A
  1. Adalimumab
  2. Certolizumab
  3. Infliximab
  4. Golimumab
54
Q

Name a monoclonal antibody that targets CD20 antigen on B cells?

A

Rituximab

55
Q

What programmed death receptor-1 blocking antibody is involved in the treatment of head and neck squamous cell carcinoma?

A

Pembrolizumab

56
Q

What anti-epidermal growth factor receptor is involved in treatment of squamous cell carcinoma of the head and neck?

A

Cetuximab

57
Q

What are the key dental considerations of a patient taking biologics?

A
  • increased risk of infection (neutropenia)
  • thrombocytopenia ( increased bleeding risk)
  • risk of MRONJ
  • mucosal disease
58
Q

Why should NSAIDs be avoided with corticosteroid use?

A

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
Q

Bendroflumethiazide is a thiazide diuretic which can be associated with lichenoid reactions. True or flase?

A

True

Dentistry Human Disease (29 decks)

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