Pharmacologic Management of Oral Diseases Part 2 Flashcards Preview

AU '19 - Oral Path Final > Pharmacologic Management of Oral Diseases Part 2 > Flashcards

Flashcards in Pharmacologic Management of Oral Diseases Part 2 Deck (57)
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1
Q

first consideration when managing ulcers

A

etiology

2
Q

management of ulcers if suspected of trauma

A
  1. remove local irritants

2. monitor for healing (digital photo + ruler)

3
Q

management of ulcers with rolled borders

A

biopsy

4
Q

differential dx of ulcers with rolled borders

A
  1. OSCC
  2. TUGSE
  3. Histoplasmosis
  4. TB
  5. other deep fungal
5
Q

immune-mediated ulcers can include…

A
  1. pemphigus
  2. pemphigoid
  3. lichen planus
  4. apthous ulcers
6
Q

distinct clinical presentation of aphthous ulcers

A
  1. red halo
  2. very sore
  3. abrupt onset
  4. no apparent local etiology
7
Q

T/F: in order to properly manage ulcers, dx should be established first

A

true - don’t prescribe emperically esp topical corticosteroids

8
Q

if unsure of cause of ulcer, what should be done?

A

refer for evaluation or biopsy

9
Q

side effects of topical steroids in tx’ing ulcers

A

could mask symptoms of SCC and superimposed Candida (impair ulcer healing) so ESTABLISH DX FIRST

10
Q

erythema multiforme has a variety of clinical presentations but are often with what?

A

crusted hemorrhagic lips

11
Q

erythema multiforme may follow what?

A

viral infections such as HHV-1

12
Q

it’s essential to distinguish erythema multiforme from what?

A

herpeviruses

13
Q

T/F: use of systemic steroids for erythema multiforme minor is now controversial

A

true

14
Q

erythema multiforme is what type of ulcerative disorder?

A

acute, self-limiting

15
Q

erythema multiforme is probably what?

A

immune-mediated

16
Q

erythema multiforme mostly affects what demographic?

A

young adult male predilection

17
Q

etiology of erythema multiforme

A

hypersensitivity

18
Q

erythema multiforme due to hypersensitivity is usually triggered by what?

A

infection in 90% of cases

19
Q

what type of infections trigger hypersensitivity in pts with erythema multiforme?

A
  1. HSV

2. mycoplasma

20
Q

erythema multiforme is distinct from what?

A
  1. Stevens Johnson

2. toxic epidermal necrolysis

21
Q

tx for mild cases of erythema multiforme

A

supportive care…

  1. analgesics
  2. soft diet
  3. hydration
22
Q

what is somewhat controversial in tx’ing erythema multiforme major?

A

corticosteroids are often given empirically

23
Q

if suspect HSV trigger causing erythema multiforme. what should be given?

A

prophylactic acyclovir

24
Q

prognosis of mild-moderate cases of erythema multiforme

A

good

25
Q

T/F: Stephens Johnson and TEN are very rare, acute, serious and potentially fatal

A

true

26
Q

Stephens Johnson and TEN is nearly ALWAYS associated with what?

A

meds

27
Q

most common meds that are associated with Stephens Johnson and TEN?

A
  1. abx
  2. antifungals
  3. antivirals
  4. NSAIDS
  5. anticonvulsants
28
Q

characteristics of Stephens Johnson and TEN

A
  1. prodromal illness-flulike
  2. rash starts at trunk
  3. progresses to face and limbs
29
Q

dx of Stephens Johnson and TEN is based on what?

A

clinical presentation and extent of detachment

30
Q

tx of Stephens Johnson and TEN

A
  1. stop suspected drug
  2. hospitalization
  3. fluid replacement
  4. pain management
  5. sterile handling
  6. caution superimposed infections
31
Q

Stephens Johnson infects what percent of the body vs TEN?

A

<10% body infected for Stephens Johnson and is more extensive for TEN

32
Q

Candidiasis can be confirmed with what?

A

culture and/or cytology

33
Q

Rx for Candidiasis

A

clotrimazole troches

34
Q

Disp for Candidiasis

A

70 (seventy)

35
Q

Sig for Candidiasis

A

dissolve in mouth 5 times a day until gone

36
Q

Sig for pts with Candidiasis and angular cheilitis

A

lick corners of mouth while dissolving troche

37
Q

why would you want local delivery when tx’ing Candidiasis?

A
  1. sustained contact necessary

2. reduced load on liver

38
Q

local delivery Rx for Candidiasis

A

fluconazole 100 mg

39
Q

local delivery disp for Candidiasis

A

8 (eight) tabs

40
Q

local delivery sig for Candidiasis

A

take 2 tabs on Day 1, then 1 qd until gone

41
Q

T/F: there are reported incidence of fluconazole resistant organisms especially in HIV patients

A

true

42
Q

OTC meds for pts with xerostomia

A
  1. oral balance liquid or spray (Biotene)
  2. oasis moisturing mouth spray (sensodyne)
  3. orajel dry mouth moisturizing gel (church and dwight)
43
Q

recommendations for xerostomia pts

A

stay hydrated - abundant water, not soft drinks, coffee or juice

44
Q

rx for xerostomia

A

pilocarpine HCl 5 mg

45
Q

disp for xerostomia

A

90 (ninety) tabs

46
Q

sig for xerostomia

A

take one tab tid (may be increased to 2 tid if necessary and side effects tolerable)

47
Q

pilocarpine is what type of drug?

A

parasympathetic mimetic drug

48
Q

side effects of pilocarpine

A
  1. sweating
  2. nausea
  3. decreased visual acuity
49
Q

decreased visual acuity from pilocarpine reflects what?

A

drug category and fxn

50
Q

what may you also want to consider when managing xerostomic pts?

A

chlorhexidine gluconate (non-alcohol containing formula)

51
Q

rx for chlorhexidine gluconate (non-alcohol containing formula)

A

G-U-M Chlorhexidine Gluconate 0.12% rinse (alcohol free)

52
Q

disp for chlorhexidine gluconate (non-alcohol containing formula)

A

1 bottle (473 ml)

53
Q

sig for chlorhexidine gluconate (non-alcohol containing formula)

A

rinse with 1/2 cap of liquid every day then expectorate

54
Q

tx for cheilitis

A
  1. velvachol - pharmacists’ formulation base

2. aquaphor lip

55
Q

why is velvachol excellent for?

A

tx’ing cheilitis on lips and skin since it’s hydrophilic

56
Q

what is used to tx lip fissure?

A

1% iodoquinone, 1% hydrocortisone cream (Vytone)

57
Q

prescription fluoride

A
  1. prevident rinse, gel and toothpase (colgate)

2. Preventech- Pediagel