Throat & Oral Cavity Flashcards
What are common causes of xerostomia?
Xerostomia = dry mouth
1) Drug side effect
2) Obligate Mouth Breathers
3) Sjogrens Syndrome
What can you recommend to treat xerostomia?
- Sugar alcohols (xylitol)
- Limit caffeine intake
- Avoid alcohol and product with alcohol
- Avoid oral nicotine
- Regularly sip H2O
- Use saliva substitutes/oral moisturizers
- Breathe through nose when possible
- Humidify the sleeping space
A patient is suffering from dry mouth. Treat or Refer?
May treat but MUST REFER TO THE DENTIST yo!
May also refer to PCP
When do you refer a patient to a PCP for dry mouth?
- Nutrition status declines
- Unintentional weight loss
- Snores
- Needs a medication changed due to side effects.
What is stomatitis?
general term describing an inflamed or sore mouth that interferes with a patients ability to eat, talk and/or sleep
When do you refer a patient with stomatitis to a PCP?
1) Failure of OTC products to provide relief
2) Symptoms last longer than 7 days
3) Interference with sleep or nutrition
4) Body temp of > 103
What products can be used to treat symptoms of stomatitis?
1) Topical or oral analgesics: benzocaine, lidocaine, NSAIDs, APAP
2) Ice
What is mucositis?
Who is likely to develop this condition?
What are the signs/symptoms?
Inflammation and/or ulceration of the mucous membranes lining the digestive tract
Patients undergoing cancer chemotherapy or radiation therapy
S/S: Oral soreness, ulcers present, patient has difficulty swallowing food
What counseling point should you make sure to information patients about who use magic mouthwash?
Be aware that you may not feel hot/cold foods as easily due to the numbing and you may be at risk for burns and chocking
- Try to avoid eating or drinking around the time of administration
When should you refer patients who have mucositis?
Right away and only to the PCP. Call the PCP for a heads up especially if there is an ulcer
What do you use Abreva, an OTC product, to treat? When is it most effective?
Used to treat Herpes Simplex infection aka cold sores
- Best to use when “Prodrome” symptoms begin
What is docosanol?
OTC product ingredient in Abreva
- Inhibits the fusion of the HSV envelope to the host cell’s plasma membrane to prevent entry and replication
What Rx therapies are prescribed for cold sores?
- Antivirals: Acyclovir, famiciclovir or valacyclovir
Dr. Ally recommends 3 g @ onset of prodrome then 3 g Q12H later
She does not recommend topical acyclovir = ineffective
When do you refer a patient who comes into the pharmacy with a cold sore?
- If it is their 1st cold sore
- If it is larger than a dime and extensively red
- If it interferes with sleep or nutrition
- Patient has a temp of > 103
Which triggers should you counsel patients to avoid to reduce cold sore development?
Sun, wind, extreme stress, sleep deprivation
Treat a fever quickly (always have a thermometer)
Another name for canker sores is ___________________.
Aphthous ulcer
What can you recommend for patients who complain of canker sore pain and presence?
- Avoid citrus/acidic foods
- Use analgesics like benzocaine or NSAIDs or APAP
- May use a debriding agent like H2O2
When should you refer a patient with a aphthous ulcer?
- Unintentional weight loss
- Last longer than 7 days
- If it interferes with sleep or nutrition
- Patient has a temp of > 103
- Associated with an oral appliance
What can you recommend for teething pain?
Systemic anagesics dosed appropriately
Cold, Chewing Massage
Under 2 = NO benzocaine (baby orajel)
What can you recommend for a tooth ache?
NOTHING besides going to the Dentist ASAP and some topical/systemic analgesics
Poor oral health progresses from ___________ to _____________.
Gingivitis to Periodontitis
Why do we want to prevent gingivitis?
Prevent pockets of bacteria in the gums
Why do we want to prevent periodontitis?
Prevent tooth loss
Which drugs increase a patients chance of developing gum disease?
Antidepressants: Tricyclics Phenytoin due to increased gum growth CCBs: Dihydropyridines High Progestin contraceptives Methamphentamine
Anticholinergic drugs that cause dry mouth
What is important about gum disease and smokers?
Their gums don’t bleed but they are at risk for gum disease as well
Why are the following ingredients included in tooth and oral health products:
- Fluoride
- Potassium Nitrate
- Zinc
- Soluble pyrophosphates
- Fluoride = Reduction of the solubility of enamel
- Potassium Nitrate = Decreases tooth sensitivity by decreasing intradental nerve sensation
- Zinc = tartar control
- Soluble pyrophosphates = tartar control
- May cause contact dermatitis
