Farmacología Aplicada Azucena Arzate Morales

● 68 years old female patient with metabolic syndrome and thromboembolic disease.
The patient is on your practice because you have to are going to make a third molar
extraction, so you need to prescribe drugs to prevent pain and inflammation and
antibiotics (you have a patient on infection risk). Your patient is using (and you can
not change): metformine, rosiglitazone, clopidrogrel, losartan, aspirin protect,
alprazolam).

Conclusion:
The patient have a diabetic type 2, anticoagulants treatment with hypertension and
anxiety. Aspirine avoid an inflammation in combination with acetaminophen reduces
moderate pain. I opt for clindamycin (third choice) because of amoxicillin + aspirin,
either increases levels of the other by plasma protein binding competition and
erythromycin will decrease the level or effect of clopidogrel by affecting hepatic /
intestinal enzyme and which is a serious drug interaction while clindamycine and
paracetamol isnt interfere with all treatment of patient, so i think the medic changue
or select better pharmacological choices.

Drug Interactions
Farmacología Aplicada Azucena Arzate Morales

11 years old patient with acute lymphoblastic leukemia, the patient has a treatment
with dexamethasone, methotrexate, folinic acid, vinblastine, and you patient is on
your practice because he has mucositis with candida and an acute dental abscess.

Conclusion:
Mucositis is an inflamation of membranes and mucous from mouth due to treatment of cancer
(lynphoblastic leukemia - trt: methotrexate and vinblastine) and it reduces with
dexamethasone, so only prescribe paracetamol to avoid pain, to treat candida I prescribed
nistatine rinses despite isn’t in list, i recommend its using. Patient can find in mouthwashes at
drugstore or chlorhexidine oral (mouthwashes). Clyndamicine to treat abscess dental, always
less to more doses. Although in oncologycal patients, the fist step of dental hygienist is treat
and reduced oral pathologies to treat or reduce their severity. I avoid the first election
amoxiciline/clavulanic acid because of increase methotrexate levels by decreasing renal
clearance and that taking care of the patient's organic systems its important. If the patient
weight is more than 40 kg can prescribe adults dose, if doesnt follow the normal dose for kids.

Drug Interactions
Farmacología Aplicada Azucena Arzate Morales

- 39 years old male patient with epilepsy, the patient uses quetiapine, phenytoin, and
uses warfirn for the blood clots, he has acute and sever necrotizing ulcerative
gingivitis.

The best pharmacological trt for acute and sever necrotizing ulcerative gingivitis is
metronidazole, but metronidazole systemic + warfarine is a serious drug interaction because
of I prescribe metronidazole topical, is less dangerous and has located effect. Indomethacin
to treat pain and inflammation with monitor closely. Although some drugs are depressed
each other at the same time, the combination of others causes some to be regulated such as
warfarin (+indomethacina).

Drug Interactions