Week Nine: Corticosteriods Flashcards
Corticosteroids can be either be…
glucocorticosteroids or mineralocorticosteriods
Do glucocorticosteroids inhibit immune and inflammatory responses
Yes
Do mineralocorticosteriods inhibit immune and inflammatory responses?
No
Corticosteroid medications do what?
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)
How are corticosteroids classified?
- Potency
- Chemical structure
- How they are used
What are intradental corticosteroids?
- Used to target inflammatory pulp and periapical disease
Available as pastes and cements: dependant on the condition being treated
Where are paste versions of intradental corticosteroids used?
Endodontic treatment - intracanal medicament
What is the dental use for a paste version of intradental corticosteroids?
Reduce Inflammation:
- Pain relief in irreversible pulpitis
- Reduction periapical infection
Prevention inflammatory types of root resorption in permanent teeth.
What are cement intradental corticosteroids?
- 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
What is a dental use for cement intradental corticosteroids?
When symptoms of reversible inflammation of the pulp.
Name some examples of pastes and cements
- Ledermix Paste
- Ledermix Cement
- Odontopaste
What are the dental uses of topical corticosteroids?
Management of:
- Minor mucosal inflammation
- Lichen planus
- Apthous ulcers
- Mucous membrane pemphigoid and pemphigus vulgaris
What are considerations for topical corticosteroids?
- 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
How do you educate patients in the use of topical corticosteroids?
- 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.
What are adverse effects of topical corticosteroid agents?
- 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
