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5 dental impacts of oral contraceptives
- 1. oral mucosa is more resistant to trauma
- 2. increased risk of dry socket during active pill (3 weeks)
- 3. patients on OC are more likely to develop gingivitis
- 4. antibiotic premed single dose will NOT interact with OCs
- 5. greater than 48 hours of dental antibiotics may decrease the effectiveness of OC (i.e. a continuous dose)
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How many hours must a patient be on dental antibiotics before the effectiveness of their OC may become decreased?
48 hours
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What are the different categories of diabetic drugs?
- 1. Sulfonylureas
- 2. Alpha-Glucosidase Inhibitors
- 3. Thiazolidinediones (TZDs)
- 4. Metformin (Glucophage, G)
- 5.Meglitinides
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Which categories of anti-diabetic drugs may cause acute hypoglycemia?
Sulfonylureas and Meglitinides
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What are 3 sulfonylureas?
- 1. glyburide
- 2. glipizide
- 3. glimepride
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Which category of antidiabetic medications is the mainstay for anti-diabetic therapy?
Sulfonylureas
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What are 2 Alpha-Glucosidase inhibitors?
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What are 2 Thiazolidinediones?
- 1. Pioglitazone
- 2. Rosiglitazone
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What are 2 examples of Meglitinides?
- 1. Nateglinide
- 2. Repaglinide
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What is the mechanism of action for sulfonylureas?
increase insulin secretion
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What is the mechanism of action of Alpha-Glucosidase Inhibitors?
they decrease carbohydrate absorption from the gut
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What is the mechanism of action of TZDs?
they are insulin sensitizers
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What is the mechanism of action for Metformin?
increase uptake of glucose and decrease gluconeogenesis
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What is the mechanism of action for Meglitinides?
they stimulate insulin secretion
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Who are the special risk patients to adverse effects of steroids?
- 1. HTN and CV disease
- 2. Peptic ulcer, gastritis or esophagitis
- 3. Osteoporosis
- 4. Diabetes Mellitus
- 5. Tuberculosis or other infections
- 6. Psychological difficulties
- 7. Glaucoma
- 8. Pregnancy
- 9. Young patients
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What are the adverse side effects of corticosteroids?
- 1. altered host response leading to infections, delayed wound healing, oral candidiasis
- 2. decreased stress tolerance
- 3. drug-drug interactions
- 4. osteoporosis in alveolar bone
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What are the risk factors for osteonecrosis?
- 1. dental extraction
- 2. dental infection or other trauma
- 3. drug therapy (corticosteroids, cancer chemo, IV bisphosphonates, and potentially intermittent injections for osteoporosis therapy and CTX)
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What drug therapies increase the risk of osteonecrosis?
- 1. corticosteroids
- 2. cancer chemotherapy
- 3. IV bisphosphonates
- 4. Intermittent injections for osteoporosis --> risk uncertain still
- 5. CTX --> risk uncertain still
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What bisphosphonates put patients at higher risk for osteonecrosis of the jaw?
- Injectables:
- 1. Pamidronate
- 2. Zoledronate
- **(Ibandronate also comes in injectable)
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What is the normal fasting blood glucose level and 2hr post-prandial level?
- Fasting: <110mg/dl
- 2hr Post-Prandial: <140
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What is the fasting blood glucose and 2hr post-prandial levels in a patient with impaired glucose metabolism?
- Fasting: 110-125 mg/dl
- 2hr Post-Prandial: 140-199 mg/dl
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What is the fasting blood glucose and 2hr post-prandial levels in a patient with Diabetes Mellitus?
- Fasting: > or = 126 mg/dl
- 2hr post-prandial: > or = 200 mg/dl
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