medications with interactions Flashcards
What type of drug is nifedipine?
Calcium channel blocker which can be used as an antihypertensive agent.
What are calcium channel blockers used for?
To treat conditions of the heart and blood vessels (e.g: hypertension, angina, arrhythmias and Raynaud’s).
What are the oral manifestations of calcium channel blockers?
Gingival hyperplasia.
What type of drug is amitriptyline?
A tricyclic antidepressant.
What is amitriptyline used for?
- antidepressants
- muscle relaxant when used in low doses for cases of TMJ or back pain.
What type of oral manifestation do tricyclic antidepressants cause?
Xerostomia
What oral complications can be caused by amoxicillin?
- Candidiasis due to being a broad-spectrum antibiotic (disrupts the microbiome, favouring the fungal pathogens in the mouth).
- Antibiotic sore mouth.
- GI upset.
What type of drug is penicillamine?
An anti-rheumatic drug.
What kind of reaction does penicillamine cause?
Lichenoid Reaction
What type of drug is carbamezapine?
Anticonvulsant
(anti-epileptic drug)
What potential complications arise due to long term carbamazepine use?
Liver dysfunction (long term use pts should have regular liver function tests as it can cause drug-induced liver failure).
What type of drug is phenytoin?
Anticonvulsant
What oral complication can arise due to phenytoin use?
Gingival Hyperplasia and drowsiness.
What rare complication can be caused by phenytoin and is especially seen in children?
Steven-Johnson Syndrome (flu-like symptoms).
What type of medications cause gingival hyperplasia?
- Calcium Channel Blockers (e.g: nifedipine, amlodipine)
- Immunosuppressants (e.g: cyclosporine for transplant pts)
- Anticonvulsants (e.g: phenytoin and sodium valproate)
What types of medications can cause xerostomia?
Selective Serotonin Reuptake Inhibitors
&
Tricyclic Antidepressants
What is the main type of medication that can cause candidiasis?
Corticosteroids
What type of chemical should be avoided in patients with asthma?
Colophony (found in fluoride varnish).
What type of medication should be avoided in patients who are taking statins?
Azole antifungals (e.g: miconazole, fluconazole)
Explain the interactions between statins and azole fungals.
Azoles are CYP3A4 inhibitors which interacts with the mechanism of action (pharmacokinetics) for statins which are CYP3A dependent.
The interaction produces toxicity (e.g: rhabdomyolysis - destruction of striated muscle cells).
How might bisphosphinate use interfere with treatment (e.g: extractions)?
Potential to cause medication-related osteonecrosis of the jaw.
Prevents successful healing after XLA - sequestra comes off (fragments of bone) which delays the socket from healing.
When would a patient be prescribed bisphosphinates?
- Multiple Fractures (on older pts).
- Cancer treatment - to strengthen bone.
- Paget’s Disease (bone enlargement causing weakness, skull most commonly affected so can show on OPGs)
- Osteoporosis
When are bisphosphinates given?
For osteoporosis - reduce bone resorption by stopping the formation, recruitment and function of osteoclasts.
Where do bisphosphinates accumulate?
At sites of high bone turnover (e.g: the jaw).
What effect do bisphosphinates have on bone?
Reduced blood supply which can lead to death of the bone (osteonecrosis).
What kind of treatment should be avoided if a patient is on bisphosphinates?
Extractions or any treatment that has an impact on bone.
What class of medication is Warfarin?
anticoagulant
What type of medication is omeprazole?
proton pump inhibitor -
used to reduce stomach acid.
Which drug interacts with warfarin?
metronidazole
Which drug classification is Alendronic Acid part?
bisphosponates
