Medicines + Theraputics in Oral Medicine

Question 1

What 3 drug types can antimicrobials be broken down into?

Answer 1

1. Anti-viral
2. Anti-fungal
3. Antibiotics

Question 2

What 5 classifications can medicines be categorised?

Answer 2

1. General Sales medications
2. Pharmacy sales medicines
3. Prescription only medicines
4. Controlled drugs
5. Medical Devices

Question 3

what is the difference between general sales medicines and pharmacy sales medicines?

Answer 3

General sales medicines can be purchased over the counter anywhere.
Pharmacy sales medicines can only be purchased from a pharmacy with a pharmacist present

Question 4

How does a pharmacy sales medicine differ from a prescription only medicine?

Answer 4

Pharmacy sales medicine can only be purchased from a pharmacy with a pharmacist present
Prescription only medicine is only available when a Pt presents a specific prescription from a qualified prescriber to a pharmacy

Question 5

What is the definition of a licenced medicine?

Answer 5

a medicine with a proven efficacy for the condition under treatment, the evidence has been presented to the MHRA by the manufacturer

Question 6

what is the definition of an unlicensed medication

Answer 6

medicines that do not have any efficacy proven to the MHRA for the condition under treatment

Question 7

Does an unlicenced medicine have any efficacy?

Answer 7

yes, it has efficacy but not to the condition under treatment

Question 8

Is benzdamine mouthwash ‘licenced’ for use in oral disease?

Answer 8

YES

Question 9

is carbamazepine lisenced for use in oral disease?

Answer 9

yes - licenced for tx of trigeminal neuralgia

Question 10

For antimicrobials, which of the following are licenced for use in oral diseases?
- antivirals
- antifungals
- antibiotics

Answer 10

• antivirals = yes
• antifungals = yes
• antibiotics = yes

Question 11

Name three uses of treatment of Aciclovir

Answer 11

• primary herpetic gingivostomatitis
• herpetic lesions
• shingles (recurrent herpes zoster)

Question 12

Name 3 antifungals

Answer 12

1. miconzole
2. fluconazole
3. nystatin

Question 13

name 2 topical steroids used in oral diseases

Answer 13

• betamethasone mouthwash
• beclomethasone metered dose inhaler

Question 14

what can betamethasone mouthwash and beclomethasone metered dose inhaler be used to treat

Answer 14

• apthous ulcers
• lichen planus

Question 15

what must you ensure in regards to unlicenced medicines and instructions to patients

Answer 15

the patient information leaflet included with the medicine applies to the medicine it is licenced for, not for the unlicenced use to treat the condition they have been prescribed for.
It is the prescribers responsibility to provide an accurate patient information leaflet for their unlicenced medicine

Question 16

What is a medical device?

Answer 16

Medical Devices are different from medicines, in that they are used in the same way to treat or alleviate disease but the key thing is that they do not achieve their primary intended action by pharmacological / immunological / metabolic means

Question 17

give an example of a medical device used in dentistry

Answer 17

mouthwashes used to treat dry mouth
- salivix pastilles
- saliva orthana
- biotene oral balance
- artificial saliva DPF
- glandosane

Question 18

what is gabapentin and pregablin prescribed to treat

Answer 18

chronic pain

Question 19

what is azathioprine + mycophenolate prescribed to treat

Answer 19

immunosuppression required to treat lichen planus, apthous ulcers, vesicular bullous conditions

Question 20

what is hydroxychloroquine + colchicine used to treat

Answer 20

ulceration + lichen planus

Question 21

6 things you must consider before prescribing medicine

Answer 21

1. clinical indication
2. licenced or unlicenced for use
3. dose + route of administration
4. important warnings for patient
5. drug interactions and cautions
6. treatment duration

Question 22

what must you include when writing a prescription

Answer 22

1. Patient name, address, age
2. Patient identifier - DOB / CHI
3. Number of days treatment
4. Drug to be prescribed
5. Drug formulation + dosage
6. Quantity to be dispensed
7. Instructions to be given to Pt
8. Signed - identifier of prescriber

Question 23

how long is a prescription valid for

Answer 23

up to 6 months from date issued

Question 24

can you have more than one item on a prescription?

Answer 24

yes
however suggested that each item has a separate prescription for clear illegibility

Question 25

what are the advantages of WRITTEN instruction

Answer 25

• stressed Pt may not remember instructions
• language barriers may prevent proper understanding
• contact number for any issues
• legal protection is post-tx cource questioned

Question 26

what should you include in written instructions for a Pt

Answer 26

• how to use medicine
  (take drugs at correct time + finish course)
• frequency + dose
• what to expect (e.g. normal side effects)
• contact number
• keep medicines safe (esp. from children)