British National Formulary by coll.

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200. Teeth and Jaw Brown staining of the teeth frequently follows the use of chlorhexidine mouthwash, spray or gel, but can readily be removed by polishing. Iron salts in liquid form can stain the enamel black. Superficial staining has been reported rarely with co-amoxiclav suspension. BNF 69 Periodontium Gingival overgrowth (gingival hyperplasia) is a side-effect of phenytoin and sometimes of ciclosporin or of nifedipine (and some other calcium-channel blockers). Thrombocytopenia may be drug related and may cause bleeding at the gingival margins, which may be spontaneous or may follow mild trauma (such as toothbrushing).

Org Important During the second and third trimesters drugs can affect the growth or functional development of the fetus, or they can have toxic effects on fetal tissues. Drugs given shortly before term or during labour can have adverse effects on labour or on the neonate after delivery. The BNF identifies drugs which: . may have harmful effects in pregnancy and indicates the trimester of risk . 00–17:00 Monday to Friday; urgent enquiries only outside these hours). The information is based on human data, but information from animal studies has been included for some drugs when its omission might be misleading.

Many patients wish to remain at home with their families. Although some families may at first be afraid of caring for the patient at home, support can be provided by community nursing services, social services, voluntary agencies and hospices together with the general practitioner. The family may be reassured by the knowledge that the patient will be admitted to a hospital or hospice if the family cannot cope. Drug treatment The number of drugs should be as few as possible, for even the taking of medicine may be an effort.

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