Oral Medicie YR4 Flashcards
(460 cards)
Name the 4 categories of medcinies used in Oral Medicine (OM)?
Anti-microbial - virals, fungals and bioticsTopical Steroids - inhaled and mouthwashDry mouth medication - benzdamine washOthers - carbamazepine
Name the 5 classification of medicines?
General SalesPharmacy MedicinesPrescription only MedicinesControlled DrugsMedical Devices
What is the definition of a licensed medication?
A medicine that has been proven in evidence to the MHRA to have efficacy and safety at defined doses in a child and/or adult population when treating specified medical conditionsClinical trial data providedPost licence surveilence via MHRA
What is the defintiion of an unlicensed medication?
Medicines that have not had evidence of efficacy submitted for the condition under treatmentWill be ‘licenced medicines’ – but for another conditionUse is at the discretion of the treating physicianPatient must be informed that medicine is being used ‘off-licence’Patient must be given PIL specific to the condition under treatment
Name antimicrobials used for OM? and what they treat?
virals - primary herpetic gingivostomatosis, recurrent herpetic lesions and shingles- aciclovirfungals - Acute pseudomembranous candidiasis and acute erythematous candidiasis- miconazle- fluconazole- nystain
Name topical steroids used for OM? and what they treat?
Betamethasone mouthwashBeclomethasone Metered Dose InhalerBoth used for - Treating aphthous ulcers- Treating Lichen planus
What is the definition of a medical devices?
‘Medical device’ means any instrument, apparatus, implement, machine, appliance, implant, reagent for in vitro use, software, material or other similar or related article, intended by the manufacturer to be used, alone or in combination, forhuman beings, for one or more of the specific medical purpose- diagnosis, prevention, monitoring, treatment or alleviation of disease,• diagnosis, monitoring, treatment, alleviation of or compensation for an injury,• investigation, replacement, modification, or support of the anatomy or of a physiological process,• supporting or sustaining life,• control of conception,• disinfection of medical devices• providing information by means of in vitro examination of specimens derived from the human body
Medical devices include dry mouth treatments - name 5 types of treatments?
Salivix pastillesSaliva orthanaBiotene Oral BalanceArtificial Saliva DPFGlandosane
Name 6 other medicines used in OM?
Tricyclic AntidepressantsGabapentin/PregabalinAzathioprineMycophenolateHydroxycholoroquineColchicine
What needs to be considered before any drug is prescribed or drug is reccomended?
Clinical indicationLicenced or unlicensed for this useDose and route of administrationImportant warnings for the patientDrug interactions and cautionsTreatment duration and monitoring
What to include on a presciption?
Patient’s name, Address, Age (under 18)Patient identifier – DoB, CHI NumberNumber of Days treatmentDrug to be prescribedDrug formulation and DosageInstructions on quantity to be dispensedInstructions to be given to the patientSigned – identifier of Prescriber
What are the rules and regulation on prescrption validity?
Six months from date issuedMore than one item on a scriptMore than one repeated dispensing occasion
Tips for writing a prescription?
Key Patient information MUST be legibleAVOID abbreviations – write full instructions in INKOnly legal requirement is for dentist to SIGN prescription – this confirms all the other information is correct and has been checked.Essentially the SAME information for Private – GDC number usually added
What are the advantages of written instruction for the patient?
Stressed patient may not remember instructionsLanguage issues may prevent proper understandingMultilingual options, large print optionsContact number for Patient Issues with the medicineLegal protection if post-treatment course questioned
What advice should you give to your patient after prescribing the drug?
Take drugs at correct time and finish the courseUnexpected reactions: STOP! and contact prescriberKnown side-effects should be discussed e.g. Metronidazole and alcohol Keep medicines safe: especially from children
Types of drugs for mucosal disease?
Non-steroid topical therapy - inconvientient lesions with discomfortSteroid topical therapy- disabling immunologically driven lesions
Non-steroid topical therapy for mucosal diease? - Name 4?
Chlorhexidene mouthwash- dilute 50% with water if neededBenzdamine mouthwash or spray - green things help! Useful topical anaesthetic/pain reliefOTC remedies such as Igloo, Listerine, BonjelaAnything else the patient finds helpful!- check that it is not harmful though – bleach, aspirin!
Steroid topical therapy for mucosal diease? - Name 3?
Hydrocortisone mucoadhesive pelletBetamethasone mouthwashBeclomethasone Metered Dose Inhaler (MDI/Puffer) - - CFC-free preparations, e.g. ‘Clenil Modulite’
How does it work - hydrocortisone mucoadhesive tablet?
allow tablet to dissolve over the ulcer
How to use betamethasone mouthwash?
Unlicenced product• Supply patient with a tailored information leafletUse Betnesol tabs 0.5mg - 1mg 2 tablets - 10mls water 2 teaspoons water - 2 mins rinsing - Twice dailyRefrain from eating/drinking for 30 min after useDO NOT SWALLOWDo not rinse after use
What must be included on betamethasone mouthwash PIL?
Licenced for other medical conditionsExplain dose range and frequency of useExplain hazards of exceeding the standard doseAdd any known side effects – small oral candida riskAdd special instructions
How to use beclomethasone medical device?
Unlicenced product - Supply patient with a tailored information leafletDental Prescribing 50mcg/puff device - Position device correctly – exit vent directly over ulcer area - 2 puffs - 2-4 times daily - Don’t rinse after useMust be a pressurised device
What must be included on beclomethasone medical device PIL?
This is an accepted and proven effective treatment for the oral conditionLicensed for other medical conditions – asthma and COPDInstruct to discard the manufacturer’s PiLExplain dose range and frequency of useExplain technique used for oral lesions – different from use for lung conditionsAdd any known side effects – small oral candida riskAdd special instructions
Systemic drugs used in OM, only for specialists?
Disease modulator- colchineSteroid- prednisilone (ulcers) 30mg for 5 daysImmune suppressants:- hydroxychloroquine - lichen planus- azathioprine- mycophenolateImmunotherapy:- adalimumab- enterecept