ch 21 pharmacology

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jackiedh
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80362
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ch 21 pharmacology
Updated:
2011-04-18 16:27:25
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Pregnancy menopause
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pharmacology IN RED
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  1. what does estrogen provide in the oral cavity?
    energy source to perio organisms leading to gingivitis!
  2. pregnancy and the cardiovascular system leads to ______ CV demand (_____), water ______, compensation by increased ______.
    • INCREASED
    • RETENTION
    • CO
  3. what can happen with pregnancy in the GI system?
    • nausea
    • vomiting
    • other dyspeptic symptoms (heartburn, reflux)
  4. t/f periodontal treatment affects the rate of preterm delivery
    FALSE!!! does NOT
  5. if someone is Pre-clampsia and eclampsia (seizures not normally associated with the patient due to pregnancy), what should be measured each visit?
    • Blood pressure
    • Hypertension common. >180 mmHg or diastolic >110 mmHg cx to treatment
  6. what is the most common oral complication of pregnancy?
    PREGNANCY GINGIVITIS (GENERALIZED GINGIVAL INFLAMMATION)
  7. what increases during pregnancy and contributes to severity?
    Prevotella intermedia
  8. how many pregnant women are affected by pregnancy gingivitis?
    25-100% in the 2nd to 8th month
  9. t/f at parturition, inflammation from pregnancy gingivitis will continue if treated
    FALSE! if UNtreated
  10. t/f inflammatory mediators may adversely affect the placenta and fetus
    true (not clearly defined)
  11. perio disease in a pregnant patient significantly ________ the risk for low birth weight and preterm birth.
    INCREASE
  12. t/f there is no convincing evidence that tx of perio disease will REDUCE the risk of low birth weight or preterm birth
    true
  13. t/f treatment of perio disease will help reduce the risk of low birth weight or preterm birth
    true
  14. pregnancy tumor occurs in what percentage of pregnant patients?
    9.6%
  15. what is a pyogenic granuloma?
    pregnancy tumor
  16. when is a pyogenic granuloma most frequently occurring?
    during the 2nd trimester
  17. where is the pyogenic granuloma going to occur?
    interdental papilla in the max anterior
  18. describe a pyogenic granuloma
    • bright red to blue
    • bleeds easily
    • usually painless
  19. t/f your teeth become soft when you are pregnant
    FALSE! the diet changes
  20. t/f there is tooth calcium lost during pregnancy from the mom
    FALSE! there is NOT
  21. t/f dietary changes may result in increased caries
    true
  22. vomiting with morning sickness and xerostomia are both ________ factors for enamel _________
    • contributing
    • demineralization
  23. t/f prenatal fluoride supplementation is recommended by AAPD or AAP
    FALSE! is NOT recommended
  24. doxycycline is contraindicated during pregnancy because why?
    think tetracycline. intrinsic staining of decidious teeth
  25. when meds are necessary during pregnancy, ________ dosages may need to be administered during critical pregnancy
    INCREASED
  26. what is the local anes of choice for a pregnant patient?
    Lidocaine
  27. t/f a vasoconstrictor keeps anesthetic localized
    true (without it, it can go throughout the bloodstream)
  28. how do drugs cross the placenta?
    by simple diffusion
  29. what category of anes can be used for pregnant women?
    CATEGORY B ONLY (lido and prilocaine)
  30. t/f lido and prilocaine can be administered up to max dosage, using aspiration, and slow administration
    true
  31. which category has the GREATES risk?
    category X
  32. MOST drugs used in dentistry is category ___
    B
  33. what is the major malformation in the first trimester that is a teratogenic effect?
    Major malformation during organogenesis
  34. what drug is available that can cause teratogenic affects for placental transfer?
    FREE, UNBOUND drugs
  35. what does prilocane affect?
    methemoglobinemia in predisposed individuals
  36. when is ASA unsafe to use on a pregnant woman?
    3rd trimester ONLY
  37. what causes premature closure of patent ductus arteriosis when taken in the third trimester?
    ASA
  38. t/f acidic drugs will enter the milk easily
    FALSE, will not enter easily
  39. what can be secreted in breast milk in concentrations similar to levels in maternal plasma (same effect for mother as for infant)
    metronidiazole
  40. when during pregnancy is the IDEAL time for elective care?
    2nd trimester
  41. what is important for OHE of a pregnant woman? 5
    • need for effective biofilm removal
    • possible gingival changes
    • myth of tooth loss and removal of enamel
    • benefits of xylitol
    • caries prevention
  42. during pregnancy, there is an increased pressure (compression) on the _______ and ______ _____ ______ causing reduced ____ _____ in the supine position
    • aorta and inferior vena cava
    • cardiac output
  43. how should a patient be placed that is pregnant in the dental chair?
    place on LEFT side at an angle of 15 degrees
  44. when should you most definitely minimize the use of diagnostic radiography?
    1st trimester
  45. when should OHE for pregnancy begin?
    EARLY
  46. what can someone rinse with after vomiting?
    sodium bicarbonate solution
  47. the menopausal patient will have a decrease in what production?
    ESTROGEN
  48. t/f there is a risk of cardiovascular disease, osteoporosis, and alzheimers increase with a menopausal woman
    true
  49. what is the severe thinning and weakening of normal bone called?
    osteoporosis
  50. what is ERT?
    estrogen replacement therapy
  51. what reduces the risk of hip fracture-greatest long-term users but may be lost after hormone is stopped?
    ERT
  52. waht are nonhormonal oral bisphosphonates? 3
    • fosamax
    • acteonel
    • boniva
  53. what are nonhormonal selective estrogen receptor modulators?
    raloxifene (Evista)
  54. what is HRT?
    hormonal replacement therapy
  55. ADEs of HRT are the formation of _____ _____ (from HRT and raloxifene), ______ BP (less common), smokers lead to _______, long term estrogen/progestin = increased risk for ____ _____, low risk dev of ______ (oral bisphosphonates), and increased risk for _____.
    • blood clots
    • increased
    • stroke
    • breast cancer
    • ONJ
    • dementia
  56. t/f xerostomia and dental caries are oral changes seen in menopause
    true
  57. what is the decreased unstimulated and stimulated submandibular and sublingual salivary flow compared with premenopausal women?
    xerostomia
  58. why do dental caries increase with menopausal women due to increased age?
    because of unfavorable microbial and xerostomic conditions
  59. what is BMS?
    burning mouth syndrome
  60. is burning mouth syndrome an oral consideration for menopausal women?
    yes
  61. what are 3 (systomatic triad) clinical features of BMS?
    • oral mucosal pain
    • dysguesia
    • xerostomia
  62. what is a treatment option for BMS?
    long term therapy of clonazepam and capsaicin
  63. what is it called when there is a presence of metallic or medicinal taste in the mouth?
    hypoguesia
  64. what is exacerbated during menopause because of reduction in saliva production and atrophic gingivitis?
    taste alterations
  65. what is the tx for taste alterations?
    it can't be reversed
  66. perio disease, osteoporosis in the jaw, and tooth loss are associated with oral changes of what?
    menopause
  67. the role of osteoporosis in _____ _____ ____ is unclear in menopause
    clinical attachment loss
  68. what might be useful for identifying postmenopausal women for low BMD (bone mineral density) or osteoporosis?
    a pano
  69. tooth loss risk is lower in women with ____
    HRT
  70. what is the most common cause of death among postmenopausal women?
    coronary artery disease
  71. cardiovascular disease is an _______ between inflammation and the formation of _________
    • association
    • atherosclerosis
  72. what can a menopausal woman take for management of osteoporosis?
    bisphosphonate therapy
  73. what should you do if a postmenopausal woman is taking bisphosphonate?
    • be alert for complications
    • ask about osteonecrosis
  74. t/f for menopause and osteoporosis, there is a tendency for pyogenic granuloma
    false! there is no risk!
  75. t/f radiographs may indicate referral
    true

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