Therapeutic Drugs in Oral Medicine Flashcards
What are the different types of drugs used in Oral Medicine ?
Anti-microbial- anti-viral/fungal/biotics
Topical Steroids (most common)- inhaled, mouthwashes
Dry mouth medication
Other- Carbamezepine, Benzdamine
What are the different classifications of medicines?
General Sales- OTC
Pharmacy Medicines
Prescription only Medicines
Controlled Drugs- specialists only
Medical Devices
What is a licensed drug?
A medicine that has been proven in evidence to the MHRA to have efficacy and safety (in trials) at defined doses in a child and/or adult population when treating specified medical conditions
-> undergoes surveillance
What is an unlicensed drug?
Medicines that have not had evidence of efficacy submitted for the condition under treatment
-> Will be ‘licenced medicines’ – but for another condition
-> ‘off-licence’ or ‘off-label’ use is at the discretion of the treating physician
When should an off-license drug never be used?
If there is a licensed drug for that specific condition
What is different about the patient information leaflet for off-license meds?
Patient information leaflets by manufacturer is only for licensed condition
-> prescriber must give directions on other use via leaflet (patient must be aware the drug is off-licence)
Which antiviral is licensed for use in dentistry? What is it used to treat?
Acyclovir
Used to treat: primary herpetic gingivostomatitis, recurrent herpetic lesions, shingles (recurrent herpes zoster)
Which antifungals are licensed for use in dentistry? What are they used to treat?
Miconazole, Fluconazole, Nystatin
Used to treat: Acute pseudomembranous candidiasis/acute erythematous candidiasis
What can carbamezipine be used for?
Epilepsy and trigeminal neuralgia
-> licensed for both
What are topical steroids used for in OM?
Treating aphthous ulcers and Lichen planus
What topical steroids are used in OM?
Betamethasone mouthwash- water soluble tablets
Beclamethasone MDI
-> Both have own specific PIL by British and Irish Oral medicine society
What are medical devices?
Devices used to treat or alleviate disease but do not achieve by function pharmacological, immunological or metabolic means
What are examples of reasons for use of medical devices?
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
What medical devices are used in dentistry?
Salivix pastilles
Saliva orthana
Biotene Oral Balance
Artificial Saliva DPF
Glandosane
-> lubricant function as opposed to medical
What are examples of other medicines which may be used by specialists in OM?
Tricyclic Antidepressants
Gabapentin/Pregabalin- chronic pain
Azathioprine/Mycophenolate- lichen planus, ulcers, vesiculobullous conditions
Hydroxycholoroquine- ulcers
Colchicine
What must be considered when prescribing a drug for a patient?
Clinical indication
Is it licenced or unlicensed for this use
Dose and route of administration
Important warnings for the patient
Drug interactions and cautions
Treatment duration and monitoring
What must be included in a prescription?
Patient’s name, Address, Age (under 18)
Patient identifier – DoB, CHI Number
Number of Days 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
Why should only one item be included per script?
Risk of reduced legibility
->Typed is better- can include more than one item more easily (but not in dentistry)
How long are prescriptions valid?
6 months from issue
-> repeat prescriptions can last up to 6 months
How should instructions to the patient about medicines be provided?
Verbal and Written
-> different language, larger print options if required
What advice should be given to patients about their medicines that you have prescribed?
How to use
Frequency and dosage- remind them to finish course
What to expect- normal and abnormal affects
Drug interactions
Known side effects
Safety instructions- keep away from children
