Therapeutic Drug Use in Oral Med

Question 1

what are some non-steroidal treatments for oral mucosal lesions

Answer 1

• Chx mouthwash
• Benzydamine (NSAID) [spray/MW]
• Regular MW, bonjela, etc

Question 2

what are some steroid based TOPICAL treatments for oral mucosal lesions?

Answer 2

BETAMETHASONE MW
Beclomethasone Inhaler
hydrocortisone mucoadhesive tablet

Question 3

what is betamethasone MW?

Answer 3

steroidal MW, unlicensed for oral mucosal lesions but highly effective

Provide rinsing instructions, DONT SWALLOW or RINSE after use

Question 4

what type of drug is prednisolone and who can prescribe it?

Answer 4

Systemic steroid, specialist only

Question 5

what are the RISKS of prolonged use of systemic steroids?

Answer 5

adrenal suppression - steroid dependency, taper dose

osteoporosis risk - bone prophylaxis = calcium supps & bisphosphonates

peptic ulcer risk - proton pump inhibitor = omeprazole

mood/sleep alteration & mania/depression risk

Question 6

when a patient is getting prepared for immunosuppression through systemic steroid tx, what needs to be done first?

Answer 6

• BBV Screen
• FBC
• Liver function test
• Electrolytes
• Zoster antibody screen
• Epstein Bar Virus
• Chest X-Ray [evidence of Tuberculosis]

Question 7

what is short term & long term risk for immunomodulatory tx?

Answer 7

Short term: acute drug reactions

Long term: cancer risk increased