COM Pharmacology & Medication Management 3 — Questions and Answers
Question 1: Phenytoin (Dilantin) used for seizure control is notorious for causing which orofacial side effect relevant to OMT?
- Xerostomia
- Gingival hyperplasia (Correct answer)
- Tongue fasciculations
- Mandibular prognathism
Correct answer: Gingival hyperplasia
Phenytoin induces gingival hyperplasia, which can alter tongue placement and resting posture if tissue overgrowth is significant.
Question 2: A patient reports taking benzodiazepines nightly for sleep. Which specific concern is most relevant to the COM therapist regarding orofacial muscle function?
- Increased masseter hypertrophy
- Suppression of REM sleep may mask sleep bruxism events (Correct answer)
- Hypersalivation during daytime sessions
- Permanent damage to the tongue musculature
Correct answer: Suppression of REM sleep may mask sleep bruxism events
Benzodiazepines suppress REM sleep, potentially masking nocturnal bruxism that would otherwise be detected during sleep studies.
Question 3: Corticosteroids prescribed for inflammatory conditions can affect OMT patients by causing:
- Dry mouth through reduced saliva production
- Increased muscle weakness and delayed healing of oral tissues (Correct answer)
- Macroglossia due to fat redistribution
- Permanent tongue paresthesia
Correct answer: Increased muscle weakness and delayed healing of oral tissues
Long-term corticosteroid use impairs immune response and tissue healing, and can contribute to muscle weakness affecting myofunctional exercise progress.
Question 4: Decongestants such as pseudoephedrine may temporarily benefit OMT patients by:
- Relaxing masseter muscles
- Reducing nasal congestion to facilitate nasal breathing training (Correct answer)
- Increasing salivary flow for better oral lubrication
- Decreasing tongue muscle tone
Correct answer: Reducing nasal congestion to facilitate nasal breathing training
Pseudoephedrine reduces nasal mucosal swelling, which may temporarily enable nasal breathing practice during OMT sessions.
Question 5: A patient taking lithium for bipolar disorder presents with muscle tremors. How does this affect OMT exercise planning?
- Tremors are irrelevant to orofacial musculature
- Fine motor tremors may impair tongue placement precision exercises (Correct answer)
- Lithium causes macroglossia requiring modified exercise programs
- Lithium enhances neuromuscular control, benefiting therapy outcomes
Correct answer: Fine motor tremors may impair tongue placement precision exercises
Lithium-induced tremors can compromise the fine motor tongue and lip placement tasks central to OMT.
Question 6: Which medication used for gastroesophageal reflux disease (GERD) can indirectly benefit OMT patients with tongue thrust associated with chronic cough?
- Antacids (calcium carbonate)
- Proton pump inhibitors reducing acid reflux and cough reflex (Correct answer)
- H2 blockers causing xerostomia
- Metoclopramide by increasing tongue tension
Correct answer: Proton pump inhibitors reducing acid reflux and cough reflex
Proton pump inhibitors reduce acid-induced laryngopharyngeal irritation that can trigger chronic cough and compensatory tongue thrust patterns.
Question 7: A patient is prescribed a selective serotonin reuptake inhibitor (SSRI). Which orofacial manifestation is the COM most likely to encounter?
- Gingival overgrowth
- Bruxism as a known side effect (Correct answer)
- Tongue hypertrophy
- Increased nasal secretions
Correct answer: Bruxism as a known side effect
SSRIs are associated with sleep bruxism, thought to result from serotonin-dopamine pathway interactions affecting muscle activity during sleep.
COM Pharmacology & Medication Management 3
Phenytoin (Dilantin) used for seizure control is notorious for causing which orofacial side effect relevant to OMT?