Oral medicine lecture 1 Flashcards
When examining an ulcer what should you be looking for?
Firmness, Pain, Edge, regional lymphadenopathy
What are the oral manifestations of anaemia?
Atrophic glossitis (very smooth tongue)
Angular Chelitus
Apthous ulcers
dysesthesia (abnormal sensation)
What microbiological investigations can be carried out?
Direct lesion sampling - Swab for culture and sensitivity -Swab for PCR -Tissue biopsy Serum based assays -serology
Prednisolone is a systemic glucocorticiod used for immunosuppression. What are its side effects?
Heart Burn Increased thirst and unrination Mood changes weight gain slow wound healing think skin
Give examples of 3 topical steroids
Dermovate,
Clenil (inhaler)
Betnosol tablet
Give an example of a non glucocorticoid immunosupressor?
Calcineurin inhibitors ( Tacrolimus) Calcineuring is a protein phosphate drug involved in activating t-cells of immune system
How do Anti TNF drugs work in immunosupression
They are either polyclonal or monoclonal antibodies which bind to TNF alpha. TNF alpha is involved in inflammation. By monoclonal anti tnf (infliximab) binding to TNF-alpha it inhibits it.
What are the treatments for dry mouth?
Biotene orogel
Artificial saliva- Orthana (Spray)
Sialogogic drugs- (Stimulate flow) Cevimeline and pilocarpine (M3 Muscurinic receptor)
What are the treatments for oral infections? Such as Oral candida? Bacterial and viral infections?
Candida- Daktarin oral gel (15g gel)
Fluconazole (oral caps, 150mg)
Bacterial infections-
Metronidazole (250mg) and Chlorohexidine
Viral - Penciclovir
Valciclovir (Valtrex 500mg)
Barrier preparations include Gelclair and orobase
What are the adverse side effects of immunosupression?
increased risk of candida and Herpes
Poor wound healing
Increased risk of malignancy (Skin and Lip, Lymphoma)
If neutropenic (WBC 3X 109) then need antibiotic cover
Side effects of cyclosporin?
Drug induced gingival hypertrophy
Likely to occur after 3 months of drug
Occurs in the anterior gingival
Contraindication of Aspirin and warfarin?
Aspirin binds and displaced warfarin
Contraindication for Antifungals and warfarin?
Decreases the clearance of warfarin
What is a pharmacodynamic drug interation?
Drugs that have a similar or antagonistic pharmacological effect. (E.G St Johns wart and antidepressants can lead to excess serotonin and lead to serotonin syndrome.
