Medical Considerations Flashcards
Abnormal bleeding
Avoid NSAIDs
Use local hemostatic agents
Avoid invasive procedures
Adrenal issues
Supplemental corticosteroids
Check BP
Avoid NSAIDs
Always check with GP
Anemia
Determine form and severity and check with GP if treatment possible
Arthritis
Possible lack of manual dexterity
Ensure patient is comfortable
Shorter appts
Asthma
Avoid NSAIDs and narcotics
Pt must bring inhaler on visits
Rinse mouth with water after every inhaler use to avoid candida
Birth control pills
More likely to develop dry socket
Can interact with ABs to reduce effectiveness of BC
COPD
Measure O2 during treatment
Treat semi-supine/upright
Nitrous oxide C/I
Keep oxygen at ready
Diabetes HbA1c effect
Unknown: Get A1c and blood glucose
<6.5%: Continue normally
7 - 9%: Possible ABs for invasive procedures
>10%: Get medical consult; recall 1 week post-op to verify healing
Diabetes blood glucose
<70 mg/dl: Give sugar in-office
80 - 120: No modification
120 - 180: possible AB
>200: Medical consult
Epilepsy
Determine frequency
Plan rdv shortly after taking medication
Expect gingival overgrowth from drugs
Angina
Limit to 2 cartridges with epi or no epi
Have nitro and O2 ready
AB prophylaxis when?
Prosthetic valves
History of IE
Congenital heart disease (heart defects)
Arrythmia
Avoid epi
Heart failure
Avoid supine
Avoid NSAIDs
Avoid epi
Monitor BP
MI
Avoid treatment if less than 6 months ago
Avoid NSAIDs and epi
Hypertension
Avoid NSAIDs for >2 weeks
Monitor BP
Determine if pt is compliant with his medication
BP readings and protocol
<180/110: use max 2 cartridges of epi
>180/110: Defer treatment
Consider sedative or nitrous (consult GP first)
Kidney problems
Avoid NSAIDs
Provide treatment day after dialysis
Good oral care to prevent infection
Avoid drugs metabolised in kidney
Hypothyroidism
Avoid narcoticsH
Hyperthyroidism
Avoid epi if poorly controlled
When is epi c/i?
BP >200/110
Severe CV disease (angina, MI)
B-blockers
TCA
