Week Nine: Corticosteriods Flashcards

1
Q

Corticosteroids can be either be…

A

glucocorticosteroids or mineralocorticosteriods

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2
Q

Do glucocorticosteroids inhibit immune and inflammatory responses

A

Yes

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3
Q

Do mineralocorticosteriods inhibit immune and inflammatory responses?

A

No

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4
Q

Corticosteroid medications do what?

A

They act on the immune system by blocking the production of inflammatory mediators.

  • Anti-inflammatory and immunosuppressant effects
  • Mediator of inflammation by acting on arachidonic acid pathway - which inhibits production of prostaglandins (mediators and modulators of inflammation)
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5
Q

How are corticosteroids classified?

A
  • Potency
  • Chemical structure
  • How they are used
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6
Q

What are intradental corticosteroids?

A
  • Used to target inflammatory pulp and periapical disease

Available as pastes and cements: dependant on the condition being treated

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7
Q

Where are paste versions of intradental corticosteroids used?

A

Endodontic treatment - intracanal medicament

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8
Q

What is the dental use for a paste version of intradental corticosteroids?

A

Reduce Inflammation:
- Pain relief in irreversible pulpitis
- Reduction periapical infection
Prevention inflammatory types of root resorption in permanent teeth.

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9
Q

What are cement intradental corticosteroids?

A
  • Powder and liquid
  • Coronal medicament - used as cavity liner base indirect or direct pulp cap or as a pulpotomy agent

Other constituents include:
Calcium hydroxide, Zinc oxide, Eugenol

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10
Q

What is a dental use for cement intradental corticosteroids?

A

When symptoms of reversible inflammation of the pulp.

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11
Q

Name some examples of pastes and cements

A
  • Ledermix Paste
  • Ledermix Cement
  • Odontopaste
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12
Q

What are the dental uses of topical corticosteroids?

A

Management of:

  • Minor mucosal inflammation
  • Lichen planus
  • Apthous ulcers
  • Mucous membrane pemphigoid and pemphigus vulgaris
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13
Q

What are considerations for topical corticosteroids?

A
  • Only prescribed after diagnosis is made
  • Clear treatment goals need to be articulated to the patient
  • Not to be used in presence of infection without antimicrobial cover
  • Ointment preferred for mucosal use
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14
Q

How do you educate patients in the use of topical corticosteroids?

A
  • Packaging states external use only, safe for intraoral application when prescribed and used as instructed
  • Best applied with clean pad of finger to wet mucosa, frugal application and brief gentle rubbing, best applied after OHB - follow any other application instruction specified by prescriber.
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15
Q

What are adverse effects of topical corticosteroid agents?

A
  • Loss of dermal collagen, leading to skin atrophy, formation of stria, fragility and easy bruising
  • Development of prominent blood vessels
  • Increased susceptibility to infection
    idiosyncratic reactions
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16
Q

What do systemic corticosteroids do?

A
  • Supress the immune response: prednisolone.
  • Rarely indicated in dentistry: mucous membrane pemphigoid and pemphigus vulgaris

Dentist must consult with patients G.P and possibly refer to a dental specialist.