Pharmacology in Dentistry Flashcards

What is the pharmacological management of trigeminal neuralgia as first-line in UK practice?

Answer: Carbamazepine (Tegretol) — sodium channel blocker reducing ectopic nerve firing — first-line per NICE/BNF

Carbamazepine is first-line for trigeminal neuralgia (TN) per NICE and BNF. It stabilises neuronal membranes by blocking sodium channels, reducing the ectopic firing in the trigeminal nerve responsible for lancinating pain.

What is the clinical indication for prescribing aciclovir in dentistry?

Answer: Primary herpetic gingivostomatitis (HSV-1) — aciclovir 200 mg five times daily for 5 days, ideally started within 72 hours of onset, especially in immunocompromised patients

Aciclovir (guanosine analogue inhibiting viral DNA polymerase) is indicated for primary herpetic gingivostomatitis, particularly in immunocompromised patients or severe presentations. Early initiation within 72 hours maximises benefit.

What is 'drug-induced gingival overgrowth' and which drug classes commonly cause it?

Answer: Gingival enlargement caused by phenytoin (anticonvulsant), ciclosporin (immunosuppressant), and calcium channel blockers (e.g., amlodipine, nifedipine) — exacerbated by poor plaque control

Drug-induced gingival enlargement (DIGO) is caused by three main drug classes: anticonvulsants (phenytoin), immunosuppressants (ciclosporin), and calcium channel blockers. The mechanism involves altered fibroblast collagen metabolism.

What is the clinical use of tranexamic acid mouthwash in dental practice?

Answer: To control post-extraction haemorrhage in patients on anticoagulants — tranexamic acid inhibits fibrinolysis, stabilising clots

Tranexamic acid (5% mouthwash, or crushed tablets dissolved in water) is used post-extraction in anticoagulated patients to inhibit fibrinolysis, preventing breakdown of the blood clot and controlling haemorrhage.

A patient is prescribed metronidazole 400 mg TDS for a periodontal condition. What is the recommended duration?

Answer: 7 days (or up to 7 days maximum for acute infections)

Metronidazole for acute dental/periodontal infections is prescribed for 7 days (400 mg TDS in adults). Shorter courses (3–5 days) may be used for specific indications. Prolonged courses are not recommended due to resistance risk.