CMC Competency #2 Exam with
Complete Solutions
What drugs do we have to avoid NSAIDs? - Correct Answers-Beta-Blockers
Anti-Platelets (Clobidogrel with/without Aspirin)
DOACs
Valproic acid (seizure drug)
Methotrexate (MS)
Lithium (depression)
What drugs do we avoid epinephrine? - Correct Answers-Digoxin
SSRIs (can cause bruxism)
Tricyclic Antidepressants (Imipramine)
MAO Inhibitors (Phenelzine)
Non-Selective B-Blockers (Limit epi to 2 carps)
Non-Selective Beta blockers + Epinephrine
How Do You Manage This? - Correct Answers-Limit epinephrine to 2 carpules
What are the anti-platelet drugs we should know? - Correct Answers-Aspirin
Clopidogrel (Plavix)
Prasugrel (Effient)
Ticagrelor (Brillinta)
What are the anti-coagulants we should know? - Correct Answers-Warfarin (Coumadin,
Jantoven)
Apixaban (Eliquis)
Dabigatran (Pradaxa)
Rivaroxaban (Xarelto)
What drugs result in gingival hyperplasia? - Correct Answers-Calcium Channel Blockers
(amlodipine, nifedipine)
Phenytoin
Cyclosporine
When should we avoid NSAIDs? - Correct Answers-Coagulation problems
Advanced Liver Disease (Limit if non-severe)
Cirrhosis
Hemostatic Abnormalities
Stage 3-5 Kidney Disease
, Mild liver disease
Dental considerations - Correct Answers-Treated with same choice of drugs as healthy
patients
Advanced Liver Disease (Including Cirrhosis & Alcoholic liver disease)
Dental considerations - Correct Answers-Treat infections aggressively
Avoid NSAIDs & Metronidazole
Limit acetaminophen to 2g/day
Limit aspirin
ACE Inhibitors can cause.... - Correct Answers-Orthostatic Hypotension
Systemic Equivalent Doses of Steroids for Adrenal Insufficiency (Addisons Disease) -
Correct Answers-Hydrocortisone 20mg
Cortisone 25mg
Prednisone 5mg
Methylprednisolone 4mg
Triamcinolone 4mg
Dexamethasone 0.75mg
Primary Adrenal Insufficiency (Addison's Disease)
Non-surgical (routine) dental treatment management? - Correct Answers-No steroid
supplementation
Primary Adrenal Insufficiency (Addison's Disease)
Minor surgery management? - Correct Answers-25mg hydrocortisone (5-6mg
prednisone) on day of surgery
Primary Adrenal Insufficiency (Addison's Disease)
Moderate surgery management? - Correct Answers-50-75mg of hydrocortisone at the
day of surgery & at least 1 day post-op
Primary Adrenal Insufficiency (Addison's Disease)
Complete Solutions
What drugs do we have to avoid NSAIDs? - Correct Answers-Beta-Blockers
Anti-Platelets (Clobidogrel with/without Aspirin)
DOACs
Valproic acid (seizure drug)
Methotrexate (MS)
Lithium (depression)
What drugs do we avoid epinephrine? - Correct Answers-Digoxin
SSRIs (can cause bruxism)
Tricyclic Antidepressants (Imipramine)
MAO Inhibitors (Phenelzine)
Non-Selective B-Blockers (Limit epi to 2 carps)
Non-Selective Beta blockers + Epinephrine
How Do You Manage This? - Correct Answers-Limit epinephrine to 2 carpules
What are the anti-platelet drugs we should know? - Correct Answers-Aspirin
Clopidogrel (Plavix)
Prasugrel (Effient)
Ticagrelor (Brillinta)
What are the anti-coagulants we should know? - Correct Answers-Warfarin (Coumadin,
Jantoven)
Apixaban (Eliquis)
Dabigatran (Pradaxa)
Rivaroxaban (Xarelto)
What drugs result in gingival hyperplasia? - Correct Answers-Calcium Channel Blockers
(amlodipine, nifedipine)
Phenytoin
Cyclosporine
When should we avoid NSAIDs? - Correct Answers-Coagulation problems
Advanced Liver Disease (Limit if non-severe)
Cirrhosis
Hemostatic Abnormalities
Stage 3-5 Kidney Disease
, Mild liver disease
Dental considerations - Correct Answers-Treated with same choice of drugs as healthy
patients
Advanced Liver Disease (Including Cirrhosis & Alcoholic liver disease)
Dental considerations - Correct Answers-Treat infections aggressively
Avoid NSAIDs & Metronidazole
Limit acetaminophen to 2g/day
Limit aspirin
ACE Inhibitors can cause.... - Correct Answers-Orthostatic Hypotension
Systemic Equivalent Doses of Steroids for Adrenal Insufficiency (Addisons Disease) -
Correct Answers-Hydrocortisone 20mg
Cortisone 25mg
Prednisone 5mg
Methylprednisolone 4mg
Triamcinolone 4mg
Dexamethasone 0.75mg
Primary Adrenal Insufficiency (Addison's Disease)
Non-surgical (routine) dental treatment management? - Correct Answers-No steroid
supplementation
Primary Adrenal Insufficiency (Addison's Disease)
Minor surgery management? - Correct Answers-25mg hydrocortisone (5-6mg
prednisone) on day of surgery
Primary Adrenal Insufficiency (Addison's Disease)
Moderate surgery management? - Correct Answers-50-75mg of hydrocortisone at the
day of surgery & at least 1 day post-op
Primary Adrenal Insufficiency (Addison's Disease)
