Card Set Information
what is it called when a cell dies as normal part of life and not occur in malignancy?
_____ is associated with aplification of oncogens
malignancy is associated with _______ of ______
amplification of oncogenes
what does the cell cycle phase-specific chemotherapeutic agents kill?
cells progressing through active phases of reproductive cell cycle
t/f in malignant cells apoptosis occurs
false, no cell death-malignant cells continue to grow
what drug inhibits proliferation of breast cancer cells?
what is an example of a monoclonal antibody therapy?
what are the ADE of chemothereapy agents? 4
suppression of bone marrow
what happens with chemotherapy agents for suppression of bone marrow?
increased susceptibility to infection
what gasterointestinal disturbances are ADE with chemotherapy agents
what are the cutaneous manifestations of chemo agent?
alopecia (NOT AFFECT dental tx)
what are the oral manifestations of chemo agents?
what is the term used to describe physiologic programmed cell death?
what is the most common oral complication with chemo?
what are the four major concerns with mucositis?
what is the most feared complication of chemo?
what is an oral manifestation that is most frequently cuased by DAN viruses?
Herpes simplex VIRUS infections
what oral manifestation of chemo may reduce platelet formation, inducing thrombocytopenia
what oral manifestation contributets to pt discomfort and risk of infection and can contribute to oral candidiasis and opportunistic bacterial phatogens?
what are the oral manifestations of chemo? 6
neurologic compolications of pain and neruopathy
what are the neurologic complications of pain and neuropathy? 3
nucositis, zerostomia and infection
what results in osteonecrosis of jaw, severe oral complications, reduced ability to receive adequate doses of chemotherapy?
poor oral health
what must be done BEFORE chemotherapy?
thorough oral exam with clinical and radographic eval
Before chemo a dental exam should be done with _____ and _____ care
surgical and restorative care
what DH tx should be done before chemo?
periodontal exam and tx, with oral instructions
during therapy all surgical procedures and hygiene appointment treated _____ days before ____
what helps to reduce symptoms of mucositis?
topical agents-viscous lidocaine, diphenhydramine syrup, Aluminum hydroxide (milk of manesia, Mylanta)
what drug is contraindicated with mucositis
COX 1 inhibitors
what are the most appropriated drugs for mucositis?
ACETAMINOPHEN and opioid receptor agonists in combination
what saline solution is neutral and least damaging mouth wash to tell pt to use for mucositis?
1/2 teaspoon salt in 8 oz water
carefully remove dental plaque with soft bristle brush, avoid products irritating to soft tissues, clean teeth every ____ hours, _____ from wearing removable prostheses, eat _____ ____ diet
soft bland diet
how often sould oral cleansing be preformed?
every 2-4 hours
what antimicrobial agent should be used with a pt on chemo therapy?
nonalcohol chlorhexidine .12%
what is the most frequently recommeded agent for fungal infection?
what drug is no longer recommeded in myelosuppression?
what is the drug of choice in the management of oropharyngela candidiasis ossociated with chemotherapy
what is the platelet count that toothbrush may be too traumatic?
what should you do when the platelet count is <20,000/mm3 instead of toothbrushing?
swab areas with SPONGE soeaked in NON-ALCOHOL clorhexidine
what should be avoided with xerostomia?
fruit juices and hard or spicy foods
what should you recommend for a pt with xerostomia
sip water, rinse mouth frequently, chew xylitol containing gum
rinse serveral times/daily with mild saline solution
what is the treatment (drug) for xerostomia?
pilocarpine (Salagen)-must have residual salivary gland function
what is the first part of the dental examine for pain and neuropathy?
rule out/eliminate infectious source of pain
what can be given to pt with pain and neuropathy who is clenching and bruxing
what drug is used to treat pt with mild to moderate pain and neuropathy?
nonopioid analgesic (acetaminophen)
what drugs are used to treat moderate to severe pain with a pt that has pain and neuropathy?
nonopioid in combination with codeine, oxycodone, hydrocondone and dihydrocodeine
antibiotic prophylaxis should be considered to prevent infection in patients whose neutrophil count is less than?
t/f malignant cells proliferate in isolation
FALSE! the DO NOT!
what are the three mechanism of action of cytotoxic agents?
inhibit DNA synthesis and integrity
inhibit microtubule funciton
what two ways do cytotoxic agetns work?
cell-cycle phase specific
cell-cycle phase nonspecific
what is chemotherapy designed to initiate?
apoptosis (physiologic cell death)
what are three commonly anticancer agents?
what is a synthetic compound incorporated into DNA
what are the DNA damaging agents?
alkylating agents-chlorambucil, cyclophosphamide, estramustine, mechlorethamine, melphalan, carmustine, altretamine, losmustine, busulfan
platinum compounds-carboplatin, cisplatin, oxyliplatin
what interferes with cell functions of survival (hormonal anticancer drugs)?
additive or ablative
t/f alopecia affects dental tx
false! it does NOT
what is the process of interfering with cellular function causing death?
what are any family of genes that normally encode proteins involved in cell growth?
what is the ability of a cell to move from the original tissue to distatn sites not normally containing cells of tha ttype
what drugs are associated with mucostis? 3
when does mucositis deveolop following chemo?
when does mucositis resolve post chemo?
what is essential for phagocytosis of bacteria?
t/f teeth nonrestorable or with severe perio involvement should be removed before chemo tx
what is cx with mucositis?
what is the best choice for mucositis?
APA and opoid receptor agonist combo
how often should you use salt and water mixture?
2-3x/day 5-6 days-helps kill bacteria
____ is no longer recommended in mylosuppression
what is the drug of choice for resistant cases ofHSV or VZV
what drus are used for milder immunosuppression viral infections? 3
what is preemptive or treatment for CMV (viral infection)
ganciclovir or foscarnet
what is an acceptable saliva substitute that replicates the feel of saliva?
linseed oil (numoisen)
what is the oral doseform availabe for xerostomia tx for a pt with sjogrens