Oral Medicine Flashcards
(34 cards)
what is a licenced medication
A medicine that has been proven in evidence to the MHRA to have efficiency and safety at defined doses in a child and/or adult population when treating specified medical conditions
what is an unlicenced medicine
medicines that have not had evidence of efficacy submitted for the condition under treatment
- used at the discretion of the treating physician
- patients should be informed medicine being used is ‘off liscence’
- must be supplied with a PIL
What is aciclovir used to treat
- primary herpetic gingivostomatitis
- recurrent herpetic lesions
- recurrent herpes zoster
- herpes simplex in immunocompromised or severe infections in non immunocompromised
Give an appropriate regimen of drug to prescribe for a patient who is immunocompromised and has herpes simplex infection
- Aciclovir tablets 200mg
- 25 tablets, 1 to be taken 5 times a day for 5 days
Give an appropriate regimen of drug to prescribe for a patient who is not immunocompromised and does not have a severe herpes simplex infection
- Aciclovir cream 5%
- give 2g, and apply to lesion every 4 hours for 5 days
Give an appropriate regimen of drug to prescribe for a patient who has varicella zoster infection (shingles)
- aciclovir 800mg
- give 35 tablets, 1 tablet to be taken 5 times per day for 7 days
name the three antifungal medications used to treat pseudomembranous candidiasis and erythmatous candidiasis
- fluconazole
- miconazole
- nystatin
what patient groups are predisposed to pseudomembranous candidiasis and erythematous candidiasis
- Patients taking inhaled corticosteroids, cytotoxics or broad-spectrum antibacterials
- diabetic patients
- patients with nutritional deficiencies
- immunocompromsied > HIV, leukemia/other cancers
give a 7 day regimen for fluconazole (antifugnal)
- fluconazole 50mg capsules
- send 7 capsules, 1 taken daily
When should you not prescribe fluconazole
- if a patient takes warfarin or statins
give a 7 day regimen for miconazole to treat candidiasis
- miconazole gel 20mg/g
- send 80g tube and apply pea-sized amount after food four times per day
when should you not prescribe miconazole
- when a patient is on warfarin or statins
what is an appropriate regimen of beclomethasone diproprionate inhaler for mucosal ulceration condition
- 50micrograms/metered dose
- send 200 dose unit and label 1-2 puffs directed onto ulcers twice daily
what is an appropriate regimen of betamethasone for mucosal ulceration lesions
0.5mg (1mg with 10mls water) rinse for two minutes twice daily
what is an appropriate regimen of hydrocortisone oromusocsal tablets for oral ulcer lesions
- 2.5mg tablets
- send 20 tablets
- label 1 tablet dissolved next to lesion four times daily
Wha must be included in a prescription
- Patients name, address and age if under 18
- Patients identifier (DoB and CHI number)
- Number of days of treatment
- Drug to be prescribed
- Drug formulation and dosage
- Instructions on quantity to be dispensed
- Instructions to be given to the patient
- Signed, identifier of prescriber
how long is a prescription valid for
six months from the date of issue
what are the risks of systemic steroid use over a prolonged time
- adrenal suppression
- cushingoid features
- osteoporosis
- peptic ulcer risk
- mania/depression
what is hydroxychloroquine mainly used for in oral medicine
lichen planus
what special instructions would you give when prescribing betamethasone mouthwash
- oral candida risk
- must spit out to avoid systemic steroid effects
- do not rinse after use
When prescribing beclomethasoe what should you inform patient
- small candida risk
- dont rinse mouth after use or effect will be lost
why are white lesions white
- a thickening of the mucosa or keratin causes the blood vessels in the connective tissue to be less visible
- similarly, a decrease in blood flow through the connective tissues will cause a decrease in the pink colour seen in the mucosa (an example is blanching when LA is injected into mucosa)
what is leukoplakia
a white patch which cannot be scrapped off or attributed to any other cause
(it is a clinical description)
what are Fordyce’s Spots
Ectopic sebaceous glands that should be in the skin
benign and normal structures
not a disease with malignant potential
