SDCEP Drug Prescribing

Question 1

First line antibiotics for dental abcess + dose

Answer 1

Phenoxymethyl penicillin - 40 tabs 250mg 8 daily/5 days x2 at a time
Amoxicillin - 15 tabs 500mg 3daily/5 days 1 at a time
Metronidazole - 15 tabs 400mg 3daily/5days 1 at a time

Question 2

Second line antibiotic and dose

Answer 2

Clindamycin - 20 tablets 4daily/5 days 150mg

Question 3

Avoid prescribing in warfarin patients

Answer 3

Fluconazole
Miconazole
Metronidazole
Aspirin
Ibuprofen

Question 4

Avoid prescribing in those taking a statin

Answer 4

Fluconizole
Miconizole

Question 5

Prescriptions for treating a fungal infection and dose

Answer 5

Fluconazole - 50mg - 7 capsules take 1 daily for 7 days
Miconazole - 80g tube oromucosal gel - pea sized amount after meal 4x/day
Nystatin oral suspension 100:000units/ml - 30ml use 4x a day after meal for 7 days

CHX mouthrinse

Question 6

Asthma patients to prevent against fungal infections

Answer 6

Use spacer
Wash mouth out with water after use
Or brush teeth

Question 7

What’s the drug regime for denture stomatitis

Answer 7

The exact same for treating candidiasis

Question 8

Local measures for treating denture stomatitis

Answer 8

Brush palate daily
Clean dentures twice daily in chx for 15 minutes (or sodium hypochlorite for acrylic dentures)
Leave dentures out for as long as possible during treatment period

Question 9

Angular chilitis management

Answer 9

Mild cases go away on its own
Usually associated with denture stomatitis (fungal): miconazole cream 2% 30g tube applied twice daily until 10 days after lesions have healed

Question 10

Herpes simplex prescription in severe cases or immunocompromised patients

Answer 10

Aciclovir tablets
200mg
25 tablets
1 tablet/ 5x daily (for 5 days)

Question 11

First line management for herpes simplex

Answer 11

5 things

Nutritious diet
Plenty of fluids
Bed rest
Analgesics
Antimicrobial mouthwash
*controls plaque accumulation when toothbrushing is painful and helps to control secondary infection

Appropriate mouthwash:
Chx 0.2% 300ml rinse for 1min (10ml twice daily)

Instructions for mouthwash:
-spit after rinsing
-use until lesions have resolved
-use until patient can carry out good oral hygiene
-leave 30 minutes between mouthwash and toothpaste
-can be diluted 1:1 with water with no loss in efficacy

Question 12

Treating cold sores in non-immunocompromised patients

Answer 12

Aciclovir cream 5%
Send 2g
Apply to lesion every 4 hours
(5x daily for 5 days)
*can be used up to 10 days if required

Question 13

Management of shingles

Answer 13

Aciclovir tablets
800mg
35 tablets
1 tablet/ 5x daily (7 days)

Refer all patients to a specialist or to their GMP

*this drug reduces pain and incidence of post-infection complications

Question 14

Patient in odontogenic pain with peptic ulcers

Answer 14

Can prescribe lansoprazole or omeprazole to take an NSAID alongside paracetamol

Question 15

Trigeminal neuralgia management

Answer 15

Confirm diagnosis with pain history: sharp, shooting, unilateral facial pain, responsive to innocuous stimuli ie. Touching face - lasts a few seconds to a couple of minutes

Carbamazepine tablets 100mg
20 tablets
10 days
1 tablet/twice a day

Refer to specialist or GMP for FBC and liver function tests

Question 16

Fluoride toothpaste concentration, age group, use

Answer 16

2800ppm 10 or older (1,1,3)
5000ppm 16 or older (3,2,3)

(*Minutes, amount in cm, x/day)

Question 17

Mucosal ulceration/inflammation local measure

Answer 17

Half teaspoon of salt in glass of warm water to relief pain and swelling