ORE Part 1 Pharmacology in Dentistry 3

Question 1

What is the mechanism of corticosteroid action in reducing post-surgical swelling?

Accepted Answer

Inhibit phospholipase A2 (via lipocortin) preventing arachidonic acid release, reducing both prostaglandin and leukotriene production — potent anti-inflammatory effect

Answer

Corticosteroids (e.g., dexamethasone) induce lipocortin production, which inhibits phospholipase A2. This blocks the release of arachidonic acid, preventing the synthesis of both prostaglandins and leukotrienes, providing broader anti-inflammatory effects than NSAIDs.

Question 2

What is the advantage of nystatin over fluconazole for treating oral candidiasis?

Accepted Answer

Nystatin is not absorbed systemically and acts topically, avoiding drug interactions (e.g., with warfarin, statins) while fluconazole is systemic and has significant interactions

Answer

Nystatin (polyene antifungal) acts locally in the mouth without systemic absorption. Fluconazole (triazole) is systemic — it inhibits CYP enzymes and has clinically important interactions with warfarin, statins, and other drugs.

Question 3

What opioid is commonly prescribed for moderate-to-severe dental pain?

Accepted Answer

Codeine phosphate (30–60 mg) combined with paracetamol, or dihydrocodeine as alternatives in UK primary dental care

Answer

In UK primary dental care, codeine phosphate (mild opioid) combined with paracetamol is used for moderate dental pain. Stronger opioids are reserved for hospital settings or specific circumstances under specialist care.

Question 4

A patient is prescribed tetracycline for an oral infection. What dental concern must be discussed?

Accepted Answer

Tetracyclines cause permanent yellow-brown staining of developing teeth — contraindicated in pregnancy, breastfeeding, and children under 12

Answer

Tetracyclines chelate calcium in developing dental hard tissues, causing intrinsic yellow-brown staining and occasionally hypoplasia. They are absolutely contraindicated under 12 years, in pregnancy, and during breastfeeding.

Question 5

What is the significance of prescribing erythromycin with a patient taking warfarin?

Accepted Answer

Erythromycin inhibits CYP3A4 causing increased warfarin levels, raising INR and bleeding risk — requires INR monitoring and possible warfarin dose reduction

Answer

Erythromycin is a moderate CYP3A4 and CYP1A2 inhibitor, reducing warfarin metabolism and elevating INR. Clinically significant bleeding risk increase means enhanced INR monitoring is required when these drugs are co-prescribed.

ORE Part 1 Practice Test

ORE Part 1 Practice Test

ORE Part 1 Pharmacology in Dentistry 3