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VT > TOK prescribing and pharmacology > Flashcards

TOK prescribing and pharmacology Flashcards

1
Q

Routine management of patients at increased risk but who

do not require antibiotic prophylaxis to prevent infective

endocarditis should include:

A

Ensuring the patient and/ or carer is aware of the risk of developing infective endocarditis. Oral hygiene instruction.

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2
Q

Antibiotic prophylaxis should be given to appropriate

patients when

A

Placing stainless steel crowns Performing subgingival scaling Preparing subgingival margin for a non-precious shell crown

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3
Q

Which of the following are appropriate short term

interventions for painful oral ulceration?

A

Use of a benzydamine mouthwash using 15mL every hour and a half in an adult. Use of benzydamine oromucosal spray, 4 sprays onto affected area every hour and half in an adult.

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4
Q

Which two of these antibiotics are most suitable for a 50

year old male taking methotrexate 25mg orally once per week

A

Erythromycin Metronidazole

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5
Q

According to the SDCEP guidelines:

A

The correct dose of varnish containing 22,600ppm Fluoride is 0.25mL for a child between 2 and 5 years. If a child is at increased risk of dental caries they should have 5% Sodium Fluoride varnish application 4x/year.

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6
Q

The following measures are recommended to minimise the

risk of osteonecrosis in patients who take bisphosphonate

drugs undergoing invasive dental procedures:

A

None of the above

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7
Q

In patients having daily injections of Tinzaparin Sodium for

prophylaxis of deep vein thrombosis who require surgical
extraction

A

The patient can be treated without any adjustment to the frequency of injections Stage extensive or complex procedures Pack and suture

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8
Q

Which of the following is true when prescribing Antibiotic

prophylaxis against Infective Endocarditis for dental

treatment:

A

Antibiotic prophylaxis against infective endocarditis is not recommended routinely for people undergoing dental procedures

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9
Q

The subgroup of patients requiring ‘’special consideration’’ who are at increased risk of infective endocarditis include

A

Patients who have a prosthetic valve replacement Patients who have had previous infective endocarditis Patients with cyanotic congenital heart disease

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10
Q

Which of the following cardiac conditions are included in

the subgroup requiring special consideration when

prescribing antibiotic prophylaxis against Infective

Endocarditis

A

Previous Endocarditis Cyanotic congenital heart disease Prosthetic valve replacemen

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11
Q

An adult patient presents with denture stomatitis and drug

treatment is required. Which of the following may be

appropriate drug regimes?Prescription of..

A

Miconazole oromucosal gel (20mg/ml), pea sized amount after food four times daily Fluconazole capsules (50mg), 1 capsule daily for 7 days

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12
Q

The incidence of MRONJ

A

In patients with osteoporosis given a once yearly IV infusion of bisphosphonates appears to be no greater than that in patients taking the drug orally. Is 0-10 cases per 10 000 in osteoporosis patients treated with anti-resorptive drug. Is thought to be increased in patients taking anti-resorptive or anti-angiogenic drugs with prostate cancer and multiple myeloma

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13
Q

Which of the following statements are true regarding

patients that take direct oral anticoagulants (DOACs) such

as apixiban

A

High risk procedures to be carried out early in the day with missed morning dose Low risk procedures can be carried out without alteration to dose

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14
Q

You decide to prescribe a steroid mouthwash for a patient

with recurrent apthous ulceration. What would be an

appropriate regime?

A

Hydrocortisone oro-mucosal tablets 250mg. 1 tablet dissolved in 10ml of water as a mouthwash four times daily spitting out after rinsing.

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15
Q

A prescription for chlorhexidine can…

A

Be written by a dental nurse and signed by a dental surgeon.

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16
Q

When writing an NHS Dental Prescription for an adult a

dentist must include which of the following?

A

The patients full name The dose of the medicine prescribed The dentists signature in ink The patients full address

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17
Q

In relation to giving advice to a patient taking oral

bisphosphonates, before the commencement of your

treatment which of the four statements is false?

A

Explain to the patient that they should have drug holidays during dental treatment

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18
Q

If drug treatment is required for acute necrotizing

ulcerative gingivitis, which of the following is the drug

regimen of choice for non-severe infection in adult

patients?

A

Metronidazole tablets (400mg), 1 tablet three times daily for 3 days.

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19
Q

A 45 year old patient presents to your practice with a

spreading infection from a PA abscess. The patient is an

alcoholic who is allergic to penicillin. He is taking Atenolol

and Simvastatin. An appropriate antibiotic regime would

be:

A

Clindamycin Capsules 150mg, 1 capsule four times daily for 5 days.

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20
Q

The antibiotic most frequently associated with the adverse

effect of antibiotic associated colitis is…?

A

Clindamycin

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21
Q

The use of which of the following should be avoided for a

seven-year-old patient?

A

Aspirin

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22
Q

You are prescribing Artificial Saliva Pastilles to a patient

with dry mouth. Which of the following abbreviations

should the prescription be endorsed with:

A

ACBS (stands for Advisory Committee on Borderline Substances)

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23
Q

Which of the following is true when assessing if a patient is

at risk of MRONJ:

A

Anti-angiogenic drugs are not thought to remain in the body for extended periods of time.

Patients taking Zoledronic acid for treatment of cancer are at higher risk. There is no evidence that MRONJ risk will be reduced if the patient permanently stops taking bisphosphonate drugs prior to invasive dental procedures.
If the patient is currently taking Denosumab they are at increased risk

24
Q

A patient taking aflibercept requires an essential

extraction

A

Perform regular reviews with essential review at week 8 Advise the patient they are at risk of developing MRONJ Focus on minimising periodontal/dental infection or disease

25
Q

Dental Prescribing within the National Health Service…?

A

Is restricted to drugs within ‘’The List of Dental Preparations’’ found in the ‘’British National Formulary’’. Caries no charge to the patient by the issuing pharmacy in Scotland.

26
Q

A 65 year old female patient presents with angular

cheilitis. She takes Bendroflumethiazide for high blood

pressure. You prescribed Miconazole cream 2 weeks ago,

but it remains unresponsive. An appropriate alternative

regime would be:

A

Miconazole (2%) and Hydrocortisone (1%) Ointment. Apply to angles of mouth twice daily for a maximum of 7 days.

27
Q

Which of the following is/ are true of patients taking

Rivaroxaban?

A

Inferior dental blocks are unlikely to cause bleeding.

28
Q

Which of the following treatments are not considered

essential in a patient taking bisphosphonates?

A

Undertake tooth whitening.

29
Q

Which of the following MUST be included in an NHS

prescription?:

A

Patients full name Patients address Dentists stamp Date prescription was written Duration of course of medication Patients age if under 12 years old

30
Q

With regard to the emergency supply of prescription only

medicine, the prescriber must undertake to furnish a

prescription within what period of time?

A

72 hours

31
Q

A patient arrives at the practice requiring a prescription.

The patient is registered with another dentist at the

practice who is on holiday for 2 weeks. How should you

proceed?

A

Write an appropriate NHS prescription for the patient.

32
Q

A 62 year old patient requires antibiotic prophylaxis for a

tooth extraction. They are allergic to penicillin and unable

to swallow capsules. An appropriate antibiotic would be:

A

Azithromycin Oral Suspension 200mg/5ml, 12.5mls 1 hour before treatment

33
Q

A nine year old child presents at your practice with pain

and localised swelling from a dental abscess. The child is

not amenable to local anaesthesia and you wish to refer.

The child is also allergic to penicillin. Which of the

following regimens is recommended?

A

Metronidazole 100mg. One to be taken 3 times a day for 5 days.

34
Q

Which of the following are appropriate medications for

treatment of trigeminal neuralgia?

A

Carbamazepine

35
Q

A patient presents to your practice with what you think is

undiagnosed trigeminal neuragia. Which of the following

is/are true:

A

carbamazepine tablets 100mg can be prescribed to otherwise healthy adult patients without consulting a Oral Medicine Consultant. The patients current medication should be inspected prior to prescribing Carbamazepine

Patients prescribed Carbamazepine should be referred for a full blood count and liver function tests

36
Q

Which of the following is an appropriate antifungal

medication for a patient taking Warfarin?

A

Nystatin

37
Q

Which drugs listed below is/are not associated with an

increased bleeding risk?

A

Amoxicillin, Cetirizine

38
Q

Which of the following drugs are associated with increased

bleeding risk:

A

Carbamazepine, Methotrexate, Apixaban, Naproxen, Gold

39
Q

An adult patient presents with denture stomatitis in the

upper arch. The local measure to be used in the first

instance include:

A

Advise patient to clean dentures thoroughly by soaking in chlorhexidine mouthwash. Advise patient to brush the palate daily. Advise patient to leave denture out as often as possible during the treatment period.

40
Q

If patients are taking oral bisphosphonates

A

Straight forward extractions should be performed in primary care.

41
Q

Patients who are taking the novel oral anticoagulant

Dabigatran:

A

Should miss their morning dose if having a biopsy

42
Q

When a patient requires Antibiotic prophylaxis against

infective endocarditis

A

The prescription should include a note that the antibiotic is being prescribed for prophylaxis For patients who require sequential invasion treatments over a short time period, the same antibiotic can be prescribed for the purpose of prophylaxis for each treatment episode In a patient who isn’t allergic to penicillin, the correct dose is 3g (1 sachet) 60 mins before the procedur

43
Q

NICE guidelines state that for individuals at risk of infective

endocarditis:

A

Any episodes of infection in people at risk of infective endocarditis should be investigated and treated promptly to reduce the risk of endocarditis developing Chlorhexidine mouthwash should not be offered as prophylaxis

44
Q

According to the BNF, which of the following are not

known to be harmful during pregnancy?

A

Paracetamol Amoxicillin

45
Q

If drug treatment is required for ANUG, which of the

following is the drug regime of choice for non-severe

infection in adult patients?

A

Metronidazole tablets (400mg), 1 tablet 3x/day x3days

46
Q

Doxycycline dispersible tablets

A

Can enhance the anticoagulant effect of warfarin Can be prescribed to a 12 year old patient

47
Q

Which of the following is true regarding paracetamol?

A

Dosage should be no greater than 4g per day in a healthy adult Sugar-free paediatric suspensions are available

48
Q

It is appropriate to prescribe Gladosane Aerosol Spray to

patients with a dry mouth:

A

In patients with sicca syndrome

49
Q

A dental extraction should be postponed if:

A

The patient’s INR is 4.1 The patient has an unstable INR which was measured at 1.8 two days ago

50
Q

When carrying out root surface instrumentation on a

patient taking Warfarin, which of the following statements

are true?

A

If the patients’ INR is 4 or above, delay treatment until their INR has been reduced Ensure that the patients’ INR has been checked, ideally no more than 24 hours before the procedure

51
Q

A warfarinised, pain free, patient requires an extraction

and can attend any day and at any time. The patient has a

stable INR reading 3.8. Best management would be to

treat this patient:

A

In the early part of the day and early in the working week within 72 hours of having their INR checked.

52
Q

For a patient taking Aspirin and Clopidogril following a TIA

A

Bleeding can be prolonged up to 1 hour

53
Q

You are carrying out root surface instrumentation on a

patient with BPEs of 4 in all sextants and the patient is

taking Aspirin, which of the following should you consider

A

Carry out treatment in a staged manner Limiting the initial treatment area Use local haemostatic measures to achieve haemostasis

54
Q

Which of the following are not drugs associated with

Medication-related Osteonecrosis of the jaw?

A

Acetic Acid Ascortic Acid

55
Q

Which patients would be at higher risk of MRONJ?

A

Patients with a previous diagnosis on MRONJ Patients being treated with anti-resorptive or anti-angiogenic drugs (or both) as part of the management of cancer

56
Q

A patient is at high risk of MRONJ following tooth

extraction if:

A

If the patient is taking Apixaban and Alendronic Acid If the patient is taking Denosumab and hydrocortisone

57
Q

If a patient is at higher risk of developing MRONJ

A

TRY The patient should contact the practice if they have altered sensation in a socket following an extraction

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