Mouth Care

Question 1

What is the cause of mucositis?

Answer 1

cancer therapy

Question 2

What are 3 causes of stomatitis?

Answer 2

1) Infection
2) Medication
3) Trauma

Question 3

In order to dx mucositis, does ulceration need to be present?

Answer 3

No

Question 4

How does mucositis manifest?

Answer 4

erythematous lesions- with or without ulceration

Question 5

Provide 5 examples of topical txt for mucositis.

Answer 5

1) Morphine 2% mouthwash
2) Lidocaine oral jelly 2%
3) Ketamine 20mg
4) Magic mouthwash often contain diphenhydramine, antacid, lidocaine, nystatin, steroid)
5) Doxepin 0.5% mouthwash

Question 6

How does oral candidiasis present?

Answer 6

white lesion

on exam: confluent white plaques that CAN be wiped off with gauze, leaving an erythematous surface below

Question 7

What is the first line txt for oral candidiasis?

Answer 7

Topical Nystatin (500 000 Units QID 7-14 days)

Question 8

Other than suspensions, what other txt options are available to treat oral candidiasis?

Answer 8

Fluconazole tablets
Itraconazole capsules

Question 9

How does herpes simplex virus present on exam?

Answer 9

erythematous vesicular ulcer

Question 10

What does HSV often coexist with?

Answer 10

mucositis

Question 11

What topical txt would you prescribe for confirmed oral HSV?

Answer 11

1) topical acyclovir 5%
2) docosanol 10%

Question 12

What oral txt would you prescribe for confirmed oral HSV?

Answer 12

1) acyclovir
2) valacyclovir
3) famciclovir

Question 13

Some cancer patients may be thrombocytopenic, local intraoral bleeding can coexist with mucositis. If blding cannot be controlled with pressure, what option can you offer?

Answer 13

Tranexamic acid 4.8% rinse 10ml QID

Class: antifibrinolytics

Question 14

What is xerostomia?

Answer 14

Sensation of dry mouth

Head and neck patients are particularly susceptible to this due to rads.

Question 15

Name 6 classes of medications that cause xerostomia

Answer 15

1) diuretics
2) opioids
3) anticholinergics
4) antidepressants
5) antipsychotics
6) antihistamines

Question 16

Name complications that can arise from xerostomia?

Answer 16

Halitosis
taste disturbance
Difficulty chewing or swallowing
Oral candidiasis
Dental caries and erosion
Psychosocial problems such as anxiety and isolation.

Question 17

Name 4 dietary changes that patients with xerostomia should make.

Answer 17

avoid salty food
avoid sugary food
avoid alcohol
avoid caffeine

Question 18

What drug can be used to treat dry mouth?

Answer 18

Pilocarpine

Question 19

What class of medication does pilocarpine belong to?

Answer 19

Cholinergic agonist

Question 20

What do you call oral inflammation caused by infection, trauma or medication

Answer 20

Stomatitis

Question 21

What do you call mucosal damage to the mouth, pharynx, larynx, esophagus and other areas of the GI tract caused by cancer therapy?

Answer 21

Mucositis

Question 22

What usually makes up magic mouthwash?

Answer 22

Diphenhydramine
nystatin
Antacid
Steroid
Morphine
Lidocaine

Question 23

Name classes of drugs that can cause xerostomia

Answer 23

anticholinergics
diuretics
opioids
antidepressants
antipsychotics
antihistamines