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Oral Med > Therapeutics > Flashcards

Therapeutics Flashcards

0
Q

Which drugs raise serotonin levels and noradrenaline synaptic levels?

A

MAD
Mirtazapine
Amitryptulin
Dukoxetine

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1
Q

How do TCA work?

A

Indirect neuromodulatji on CNS opioid system

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2
Q

Which immunosuppressants are used in OM?

A

Steroid and non steroid

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3
Q

Which non steroid drugs are commonly used as immunosuppressants?

A

Tacrolimus
Azothiarpine
Mycophenalate mofetil
Infliximab

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4
Q

How does tacrolimus work?1

A

It is a calcineurin inhibitor
Targets T cell response via inhibition of IL-2

No affect on B cells

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5
Q

Which immunosuppressantsminterfer with purine and pyramidine synthesis?

A

Mycophenalte mofetil: inhibits synthetis of guanine and inhibited proliferation of B and T cell response to antigen stimulation
Azothiarpine : need to test levels of TPMT

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6
Q

What is infliximab?

A

Type of monoclonal antibodies

It is a chimeric mouse and human antibody with human IGg1 and mouse binding site for TNF alpha

HIGH AFFINITY FOR TNF ALPHA

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7
Q

What is an example of polyclonal antibodies and when are they used? Give an example of a disease

A
  • IVIG
  • used in patients that have AI disease and administered at high dose to reduce the severity

Eg pemphigus vulgaris

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8
Q

What is an example of a non TNF alpha monoclonal AB?

A

Rituximab

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9
Q

T/F, Rituximab is a chimeric monoclonal AB?

A

T

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10
Q

T/F Rituximab targets the CD20 protein on T cells?

A

F

Cd20 on B cells

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11
Q

T/F Rituximab can be used in lymphoma?

A

T

Since it targets B cells can be used in any diseases where there is over active B cells

Eg lymphoma, leukaemia, transplant rejection, AI, RA

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12
Q

Give examples of commonly used immune modulator drugs?

A

Dapson

Minocycline

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13
Q

Give an example of a topical immunosuppressant?

A

Calcineurin

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14
Q

What is an example of a immunosuppressant sialogogue drug use in dry mouth?

A

Cevimeline

Pilocarpine

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15
Q

Give an example of drugs used in oral candidiasis?

A

Daktarin

Fluconazzole

16
Q

Give an example of drugs used in bacteria infections.

A

Metronidazole

17
Q

Give an example of drugs used in viral infections?

A

Acilovir
Penciclovir
Valciclovir

18
Q

Give an example of a barrier preparation used in OM?

A

Orabase

Gelckair

19
Q

What are the implications of immunosuppressant for dentist?

A
  1. Poor wound healing
  2. Risk of opportunistic infections
  3. AB cover when WBC less than 3* 10^9
  4. Increases risk of malignancy eg skin and lip and lymphoma
20
Q

At what level is AB cover needed?

A

WBC less than 3 x 10^9

21
Q

Which drugs can use gingival overgrowth?

A

Calcium channel blockers

Ciclosporin

22
Q

How frequent is cyclosporin induced over growth?

A

30% prevelence

23
Q

T/F Ciclopsrin induced over growth is worse in adolescents than adults?

A

T

24
Q

T/F Ciclopsrin induced overgrowth occurs in all of the gingiva?

A

F

Mainly effect anterior

25
Q

At what month after taking Ciclopsrin will you see increase in gingiva?

A

3 months

26
Q

T/F Ciclopsrin induced gingival hyperplasia has a low recurrence rate?

A

F

High

27
Q

What is the CYP3A?

A

A gene locus that codes for 3A family of p450

28
Q

Which drugs inhibit the CYP3A?

A

Azoles

29
Q

Which drugs promote the CYP3A?

A

Anticonvulsants

30
Q

What is the effect of broad spectrum AB on OC?

A

Pharmacokinetic interactions.

Which may increase breakdown of pill

31
Q

What can you do with people on OC when you want to prescribe AB?

A
  1. Advise additional contraception
  2. Can consider additional non hormonal contraception which may be justified at initiation and until after 1 week after AM therapy
32
Q

How is alcohol metabolised ?

A

Ethyl alcohol is broken down via alcohol hydrogenase to produce acetaldehyde. Acetaldehyde is then broken down by aldehyde dehydrogenase to produce water and CO

33
Q

T/F metronidazole influences alcohol metabolism?

A

T

34
Q

Which enzyme does metronidazole inhibit?

A

Aldehyde dehydrogenase

35
Q

What is the effect of inhibition of aldehyde dehydrogenase?

A

The level of acetaldehyde rises in the body and this can lead to unpleasant symptoms which are said to be that of ‘disulfram’

36
Q

What is the effect of St. John’s wort on serotonin inhibitors and antidep?

A

Leads too serotonin syndrome which can be life threatening leading to agitation fever, sweating,rapid heart rate, seizure

37
Q

What is an immunosuppressant ?

A

Drugs which differentials block or suppress various aspects of the bodies immune system

Oral Med (31 decks)

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