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68wm6 p2 Dis of M&E

Disorders of the Mouth and esophagus

What percentage of americans are affected by Cold Sores, Canker Sores, Aphthous Ulcers? 20% - 50%
What size do Cold Sores, Canker Sores, Aphthous Ulcers range? 0.5cm - 3cm
What is the treatment of aphthous ulcers in people with normal immune systems? amlexanox (Aphthasol) anti-inflammatory
Adverse effects of amlexanox (Aphthasol) *Transient pain *Stinging and/or burning at the site of application
Less than 1% of PTs on amlexanox (Aphthasol) experience what adverse effects? *Contact mucositis. *Nausea. *Diarrhea.
In the event that a rash or contact mucositis occurs from the use of amlexanox (Aphthasol), what should be done? Discontinue use
When should amlexanox (Aphthasol) first be used? ASAP after noticing symptoms of an aphthous ulcer.
amlexanox (Aphthasol) should be used how often? four times daily, preferably following oral hygiene after breakfast, lunch, dinner, and at bedtime
True or False: When the symptoms of aphthous ulcers heal, amlexanox (Aphthasol) use can be discontinued. True.
If significant healing or pain reduction has not occurred whithin how long, what must be done? 10 days, consult dentist or physician.
The acid that causes erosion in dental carries is produced by the breakdown of what by bacteria? Carbohydrates
True or False: Candida is a normal flora of the mucous membranses of the mouth, intestinal tract, vagina and skin of healthy people True.
Aside from newborns, who else is candidiasis often seen in? Patients with leukemia, DM, ABX, or on steroids
What is the prefered treatment of candidiasis in infants and vaginal infections? nystatin (Mycostatin)
What are the treatments of candidiasis? *nystatin (Mycostatin) *ketoconazole (Nizoral) *amphotericin B *1/2 strength hydrogen peroxide/saline rinses
In adults with candidiasis, what foods should be eaten and what toothbrushes used? eat soft foods and use soft-bristled toothbrush
How long can amphotericin B be found in the urine AFTER discontinuation? Up to 7 weeks after.
List 3 side effects of amphotericin B. *CNS: headache. *CV: hypotension. *GI: diarrhea, nausea, vomiting. *GU: nephrotoxicity. *F&E: hypokalemia
What is the dosage and frequency of amphotericin B PO? 1-4 mg q 4 hours
What should the PT be instructed to do while taking amphotericin B? Instruct patient to swish medication around in mouth as long as possible before swallowing.
How should PTs with dentures be instructed to take Nystatin? Presoak dentures in nystatin suspension
What are the side effects of Nystatin? *GI: D/N/V. *Derm: contact dermatitis.
What may indicate the need to discontinue the use of Nystatin? Increased irritation.
How should PO Nystatin be administered? Suspension should be administered by placing half a dose on each side of the mouth.
For how long after symptoms disappear should Nystatin be taken to prevent relapse? Continue for 48 hours after symptoms have disappeared and cultures are negative
What are the contraindications of ketoconazole (Nizoral)? *Pregnancy or lactation. *Concurrent triazolam.
What are the adverse reactions of ketoconazole (Nizoral)? *CNS: dizziness, drowsiness. *EENT: photophobia. *GI: drug-induced hepatitis, n/v/d. *GU: decreased male libido, menstrual irregularities.
How can you administer ketoconazole (Nizoral) to prevent nausea and vomiting? administer with meals or snacks
What must not be administered within 2 hours of taking ketoconazole (Nizoral)? histamine H2 antagonists or antacids
What are the adverse effects of topical anesthetics? *CNS: confusion, drowsiness, dizziness, nervousness, tremor. *EENT: (mucosal) decreased or absent gag reflex. *GI: nausea and vomiting. *Local: stinging, burning, contact dermatitis, erythema.
What drugs when used while taking topical anesthetics can lead to increased cardiac depression and toxicity? *phenytoin *amiodarone *quinidine *procainamide
What is the dosage and administration of topical anesthetics for oral surfaces? 20 mg as 2 sprays/quadrant (not to exceed 30 mg/quadrant)
60% of PTs who c/o GERD have what? delayed gastric emptying
How much of the population is affected somewhat by GERD? 45%
GERD pain can mimic what? Angina
How long can the pain from GERD last after meals? 20min to 2hrs
Define Odynophagia: Painfull swallowing
What percentage of adult asthmatics may have GERD? >80%
What are the diagnostic tests that can confirm GERD? *Barium swallow *Endoscopy with biopsy *Esophageal-monitoring test
Test that measures how often and for how long stomach acid enters the tube that leads from the mouth to the stomach (Esophagus) Esophageal pH monitoring
Simple GERD may be resolved if the PT does what? Avoid problem foods or beverages, stop smoking, or lose weight.
Severe GERD can cause what? Asthma attacks *Severe chest pain *Bleeding *Chronic irritation of the esophagus.
Drugs of choice in the treatment of GERD Prilosec & Prevacid
What drug is given for moderate to severe GERD? Reglan
What does Reglan do? Increases peristalsis without simulating secretions
What is Fundoplication? A procedure that is performed to wrap the gastric fundus around the lower esophagus and suturing it is in place
GERD diet instructions *4-6 small meals per day *Thoroughly chew food *No snacks/meals 2-3h before HS *Reduce foods with caffeine *Low fat, adequate PROTEIN diet
How should a GERD patients bed be placed? Head of bed elevated 6-8 inches, and dont sleep in flat position.
What is the primary symptom of Achalasia? Difficulty swallowing
Due to absence of peristalsis of the esophagus int the PT with Achalasia, the PT may experience the sensation of what? food sticking to the lower portion of the esophagus
True or False: One treatment of Achalasia is FORCEFUL dilation of the esophagus True
What can a PT with Achalasia do to increase the peristalsis movement to the lower esophageal spincter? Drink fluids with meals. The pressure exerted by the fluids will assist food into the stomach.
Created by: Shanejqb