Medical Management: Summary Pages through Hematologic Flashcards
dental modifications for epilepsy patients
-Short appointment times
-Reduce anxiety and stress.
-Emphasize plaque control to prevent Dilantin hyperplasia.
-Choose fixed, all-metal prostheses to prevent dislodging/minimize fracture.
-Alcohol may precipitate a seizure. If alcohol consumption is suspected,
the patient should not be treated.
potential emergency situations for epilepsy patients
seizure, syncope, cardiac depression, cardiac arrest
dental modifications for MS/CP/Parkinson’s disease patients
- Schedule shorter appointments.
- Use mouth props.
- Transfer by wheelchair.
- Emphasize oral hygiene and disease prevention to control and
eliminate oral infection.
drugs to avoid for MS/CP/Parkinson’s disease patients
Nitrous Oxide
potential emergency situations for MS/CP/Parkinson’s disease patients
airway obstruction
dental modifications for patients with arthritis, rheumatism, swollen joints
- Schedule afternoon appointments, since joints may be stiff in the morning
- Schedule shorter appointments.
- Change chair position/use additional physical supports to ensure comfort.
- Mouth props may be necessary if the TMJ is affected
- A patient may have a limited range of opening the mouth.
- Home care modifications
dental modifications for patients with heartburn/stomach ulcers
- Reduce anxiety.
- Salivary substitutes or products designed to replenish salivary
enzymes may be necessary.
drugs to avoid for stomach ulcers/hearburn patients
- aspirin or nonsteroidal anti-inflammatory drugs
(NSAIDs) - If severe xerostomia (dry mouth) exists, do not recommend OTC or Rx mouth rinses with high alcohol content.
dental modifications for hepatitis/jaundice/liver disease
- Do not perform routine elective care on a patient with active hepatitis.
- Because most hepatitis carriers are undetectable by medical Hx,
use standard precautions when treating every patient. - If liver damage is suspected, minimize administration of drugs metabolized by
the liver and reduce the dosage if these drugs must be used.
drugs to avoid in patient’s with liver damage
acetaminophen, narcotics, barbiturates,
and any other drugs or those specified by the patient’s physician. Minimize amount of local anesthetic
potential emergency situations for those with liver damage
Non-cardiac: Hemorrhaging
modifications for liver transplant patients
Premed is required
Provide emergency Tx only for 3 months following transplantation.
After 3 months most patients will have a stable transplant. Reinforce oral
hygiene procedures for disease prevention.
drugs to avoid in liver transplant patient
Drugs and medications specified by the patient’s physician
dental modifications for diabetes patients
- Avoid tissue trauma.
- Minimize stress (it could have an anti-insulin effect)
- Schedule frequent recall appointments with emphasis on disease prevention.
- Schedule appointments soon after meal time to avoid the
possibility of hypoglycemia (insulin shock). - Complications of diabetes such as hypertension, angina, kidney failure, and
congestive heart failure may require treatment modification
drugs to avoid in diabetes patients
- Use of a general anesthetic necessitates the omission of food prior
to administration which may interfere with the scheduled use of
insulin. - Epinephrine in larger doses may produce anti-insulin action.
potential emergency situations for diabetic patients
Non-cardiac: Diabetic Coma (hyperglycemia) Insulin Shock (hypoglycemia)
dental modifications for thyroid disease
If a large goiter is present, position the patient upright to avoid breathing difficulties.
drugs to avoid in poorly controlled hyperthyroidism
- Atropine increases the HR and could precipitate a thyroid storm.
- Epinephrine acts as a cardiovascular stimulant. Hyperthyroidism already
stimulates the cardiovascular system. Therefore, epinephrine could precipitate
arrhythmia or thyroid storm.
drugs to avoid in poorly controlled hypothyroidism
CNS depressants (barbiturates, tranquilizers) given in normal doses to a patient with hypothyroidism may be overdoses because of his/her extreme sensitivity to the depressant actions of these drugs
potential emergencies for hypothyroid/hyperthyroid patients
Non-cardiac: Hyperthyroidism—thyroid storm or crisis
Cardiac: Hypothyroidism—congestive heart failure
dental modifications for TB patients
- Because most patients with infectious diseases are undetectable
through information on Med Hx, use standard precautions. - Treat patients with active TB in a hospital setting if possible and
limit treatment to emergency care.
drugs to avoid in TB patients
none
potential emergency situations for TB patients
none
dental modifications for emphysema/COPD patients
- Schedule late morning or afternoon appointments.
2. Place the patient in an upright position in the dental chair.
