drugs and oral medicine

8/14/2019 Drugs and Oral Medicine

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Drugs and oral medicine

Prepared by: Jamal Q Ahmed

Supervised by: Prof. Ali AlZubaidi


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Aspects of drug treatment

in oral medicine Some drug therapy may cause oral

complications

Drugs used for treatment oforofacial disease

Drug therapy may affect orofacial

managment of patient


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Drugs and specific oral

complications Drugs which may cause oral ulceration

NSAIDs Nicorandil

Drugs which may cause alteration in taste ACE inhibitors, lithium salts, carbimazole,

metronidazole,penicilinamine,allopurinol.

Drugs which causes halitosis Alcohol Disulfiram Cytotoxic and xerogenic drugs (indirectly) Isosorbide dinitrate


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contd Drugs which may cause sialosis

Alcohol Iodine components Thiouracil Sulfonamides Chlorhexidine

Drugs associated with xerostomia

Antidepressants Antihistamis Antipsychotic Antiparkinsoian agents Appetite suppressants diuretics Decongestants hypnotics


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contd Drugs that may cause oral pigmentation

Oral contraceptives Antimalarial drugs Minocycline Tranquilizers

Drugs which may cause lichenoid reaction NSAIDs ACE inhibitors Oral hypoglycemics

Diuretics Antimalarial Penicillamine gold


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Contd

Drugs which may be related toErythema multiform incidence Sulfonamides Anticonvulsants

Lupus erythromatosis

Hydralazine Fixed drug eruption

salicylates


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Drugs with therapeutic

purpose Analgesics NSAIDs

Aspirin: 3 main function: antipyretic,analgesic, reduce inflammation

Side effects: epigastric distress, inhibition ofplatelet aggregation, respiratory depression,hypersensitivity, Reys syndrome

Ibuprofen,naproxen Functions are like aspirin with less

gastrointestinal irritation. mainly use inchronic treatment of osteoarthritis, goutdisease,RA


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Contd Indomethacin

Piroxicam uses are like ibuprofen,has long half-life so can beprescribed one a day

Mefnamic acids may cause

diarrhea, hemolytic anemia diclofenac


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contd Acetaminophen: substitute on

NSAIDs inhibit PG synthesis in CNS.

Less anti-inflammatory property. Hepatic necrosis is major side effect

of toxic dose of paracetamol


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Opoids, Centrally acting analgesics(major analgesics)

Codeine: 30mg up to 4hourly Pethidine: 50-100mg,25-100mg IM,25-50mg

IV, more potent than codeine, has atropinlike effect that may cause dry mouth,doesn't cause pupilary constriction

Pentazocine:25-100mg, 30-6-mg i.m or i.v Morphine:10-20 mg i.m or i.v depress cough

reflex, produce miosis,respiratorydepression, urinary retention


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Anti microbials Indications:

Rapidly progressive swelling

Diffuse swelling Compromised host defences

Involvement of facial spaces

Sever pericoronitis Osteomyleitis


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prophylaxis Infective endocarditis

Cerebrospinal rhinrrhoea

In most facial or compound skullfractures

Surgery following radiotherapy


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Antibiotics

Amoxicillin, ampicillin, coamoxiclave,ampiclox They are usefull in most odontogenic infections, syphilis, gonorrhea

Oxacilin is useful in submandibular sialolithiasis Metronidazol

Active against anaerobic bacteria so useful in treatment ofANUG,periodontitis

Erythromycin: substitute of penicillin in penicillin sensitive patients Clindamycin use in treatment of Osteomyleitis Tetracyclins anerobic infections,as mouthwash to prevent

secondary infection of oral ulceration,chlamydia

Cephalosporins


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Antifungal Nystatin 1000000U topically used in all cases

of oral candidosis

amphotricinB like nystatin topically use in allcases of oral candidiasis

Azoles Itraconazole,ketoconazole,fluconazole they are

systemic antifungal drugs.


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Antiviral agents Acyclovir

Famciclovir

PenciclovirThey are used in treatment of viral

infections in immune suppressed

patients to prevent complications likeherpes simplex infection or treatment ofherpes zoster to prevent post herpeticneuralgia


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Immunosuppressive

agents Corticosteroids

Topical steroids Mouth washes

Sprays

Pastes

Intralesional lozenges


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contd

Systemic Prednisolone Before therapy monitor blood pressure, blood glucose

level, weight Side effects

Adrenal suppression Hypertension Sodium and water retention Diabetes

Cushings syndrome Osteoporosis Peptic ulceration/ muscle wasting/ fat redistribution/growth

suppression in children


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contd

Azathioprin: steroid sparing drug Bone marrow suppression

Ciclosporin

Colchicin

thalidomide


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Drugs which affectorofacial management

Steroids

Anticoagulants

Anti hypertensives

Hypoglycemics agent

drugs and oral medicine

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