Therapeutics

Question 0

Which drugs raise serotonin levels and noradrenaline synaptic levels?

Answer 0

MAD
Mirtazapine
Amitryptulin
Dukoxetine

Question 1

How do TCA work?

Answer 1

Indirect neuromodulatji on CNS opioid system

Question 2

Which immunosuppressants are used in OM?

Answer 2

Steroid and non steroid

Question 3

Which non steroid drugs are commonly used as immunosuppressants?

Answer 3

Tacrolimus
Azothiarpine
Mycophenalate mofetil
Infliximab

Question 4

How does tacrolimus work?1

Answer 4

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

No affect on B cells

Question 5

Which immunosuppressantsminterfer with purine and pyramidine synthesis?

Answer 5

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

Question 6

What is infliximab?

Answer 6

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

Question 7

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

Answer 7

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

Eg pemphigus vulgaris

Question 8

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

Answer 8

Rituximab

Question 9

T/F, Rituximab is a chimeric monoclonal AB?

Answer 9

T

Question 10

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

Answer 10

F

Cd20 on B cells

Question 11

T/F Rituximab can be used in lymphoma?

Answer 11

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

Question 12

Give examples of commonly used immune modulator drugs?

Answer 12

Dapson

Minocycline

Question 13

Give an example of a topical immunosuppressant?

Answer 13

Calcineurin

Question 14

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

Answer 14

Cevimeline

Pilocarpine

Question 15

Give an example of drugs used in oral candidiasis?

Answer 15

Daktarin

Fluconazzole

Question 16

Give an example of drugs used in bacteria infections.

Answer 16

Metronidazole

Question 17

Give an example of drugs used in viral infections?

Answer 17

Acilovir
Penciclovir
Valciclovir

Question 18

Give an example of a barrier preparation used in OM?

Answer 18

Orabase

Gelckair

Question 19

What are the implications of immunosuppressant for dentist?

Answer 19

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

Question 20

At what level is AB cover needed?

Answer 20

WBC less than 3 x 10^9

Question 21

Which drugs can use gingival overgrowth?

Answer 21

Calcium channel blockers

Ciclosporin

Question 22

How frequent is cyclosporin induced over growth?

Answer 22

30% prevelence

Question 23

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

Answer 23

T

Question 24

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

Answer 24

F | Mainly effect anterior

Question 25

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

Answer 25

3 months

Question 26

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

Answer 26

F | High

Question 27

What is the CYP3A?

Answer 27

A gene locus that codes for 3A family of p450

Question 28

Which drugs inhibit the CYP3A?

Answer 28

Azoles

Question 29

Which drugs promote the CYP3A?

Answer 29

Anticonvulsants

Question 30

What is the effect of broad spectrum AB on OC?

Answer 30

Pharmacokinetic interactions. Which may increase breakdown of pill

Question 31

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

Answer 31

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

Question 32

How is alcohol metabolised ?

Answer 32

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

Question 33

T/F metronidazole influences alcohol metabolism?

Answer 33

T

Question 34

Which enzyme does metronidazole inhibit?

Answer 34

Aldehyde dehydrogenase

Question 35

What is the effect of inhibition of aldehyde dehydrogenase?

Answer 35

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

Question 36

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

Answer 36

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

Question 37

What is an immunosuppressant ?

Answer 37

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