Pharmacology & Medications in Implantology Flashcards

A patient develops urticaria (hives) and facial swelling shortly after receiving amoxicillin prophylaxis before implant surgery. This presentation is most consistent with:

Answer: An IgE-mediated (Type I) allergic reaction requiring immediate intervention

Urticaria and angioedema appearing shortly after drug administration represent a classic IgE-mediated anaphylactic reaction requiring prompt treatment, typically epinephrine.

Prolonged antibiotic use after implant surgery may necessitate prescribing a supplemental antifungal agent. Which antifungal is most commonly used for oral candidiasis in this scenario?

Answer: Nystatin oral suspension

Nystatin oral suspension is the first-line topical antifungal for oral candidiasis (thrush) that can develop after broad-spectrum antibiotic disruption of oral flora.

What is the primary advantage of using acetaminophen (paracetamol) over NSAIDs for post-implant pain management in patients with peptic ulcer disease?

Answer: Acetaminophen does not inhibit COX enzymes and therefore does not irritate the gastric mucosa

Unlike NSAIDs, acetaminophen does not inhibit cyclooxygenase in the gastric lining, so it does not reduce the protective prostaglandin layer of the gastric mucosa.

A patient on long-term corticosteroid therapy is being evaluated for implant surgery. The primary concern regarding their steroid use is:

Answer: Adrenal suppression and potential for adrenal crisis under surgical stress

Long-term corticosteroids suppress the hypothalamic-pituitary-adrenal axis; under the stress of surgery, the adrenal glands may not produce adequate cortisol, risking an adrenal crisis.

Which medication class is known to potentially impair osseointegration by interfering with bone remodeling at the cellular level?

Answer: Long-term systemic corticosteroids

Systemic corticosteroids suppress osteoblast differentiation and activity while promoting osteoclast activity, which can impair the bone formation required for osseointegration.

When documenting a patient's medication history before implant surgery, which class of supplement is most important to identify due to its antiplatelet effects?

Answer: Fish oil (omega-3 fatty acids) and garlic supplements

Omega-3 fatty acids and garlic both have clinically significant antiplatelet properties that can increase bleeding time and surgical hemorrhage risk.

What is the minimum inhibitory concentration (MIC) relevant to antibiotic selection for peri-implant infections?

Answer: The lowest concentration of an antibiotic that inhibits visible bacterial growth in vitro

MIC is the lowest drug concentration that visibly inhibits bacterial growth in laboratory testing, and selecting an antibiotic that achieves tissue levels exceeding the MIC ensures therapeutic efficacy.