A severe reaction to carbamazepine: consequences for patient monitoring

Prescribing in primary dental care: general principles

Prescribing medicines is an essential part of comprehensive dental care. Behind this seemingly simple act lies a range of skills. These include understanding the physiological interaction of the medicines in the body as well as their potential for harm either to body systems or when conflicting with other medicines taken by the patient. The decision to prescribe is thus complex even before the efficacy of the drug for the dental condition is considered. This paper reviews some of the issues that the primary care practitioner must consider when prescribing, as well as practical concerns to make prescribing safe and effective.

Investigation and medical management of trigeminal neuralgia by consultant oral and maxillofacial surgeons in the British Isles

Trigeminal neuralgia is an extremely painful affliction of the face that is treated by various specialists including oral and maxillofacial surgeons. Some aspects of its management remain controversial, including screening for secondary trigeminal neuralgia, and the monitoring of treatment with carbamazepine. There is, however, little information available about current practice. A postal questionnaire was sent to 254 fellows of the British Association of Oral and Maxillofacial Surgeons (BAOMS) about v arious aspects of the management of trigeminal neuralgia. One hundred and seventy nine replies (70%) were received. Orofacial and cranial nerve examinations were undertaken by the majority of surgeons, but most did not routinely arrange computed tomograp hy or magnetic resonance imaging for all patients, nor did they refer the patient to a neurologist. In contrast with current recommendations, warnings about the adverse effects of carbamazepine were given by only a few surgeons, while most routinely monitored full blood counts.