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Common Medical Conditions and Prescribed DrugsAnders Nattestad;Achieve a basic understanding of medical conditions and drugs relevant to dentistry
Make evidence-based decision of use of drugs in dentistry
; HYCD/APAPLipitorNorvascToprol XLSynthroidZoloftAmoxicillinLexaproAlbuterolZocor
;A drug can be characterized by
Its salesname (for example Coumadin)
The actual drug (in this example: Warfarin)
Its pharmacological category (in this example: Anticoagulant, Coumarin Derivative)
Of these three pieces of information, the most important one is the pharmacological category;Anticoagulant
Coumarin Derivative (Coumadin/warfarin)
Antiplatelet agent (Plavix/Clopidogrel)
Salicylate (Aspirin/Acetylsalicylic Acid)
Antihypertensive
Beta 1 blocker (Atenolol)
Calcium channel blocker (Norvasc/Amlodipine)
ACE inhibitor (Lisinopril) or ARB (Cozaar)
Diuretics (Hydroclorothiazide (HCTZ))
Anti-anxiety
Benzodiazapines (Valium/Diazepam or better Xanax/Alprazolam)
Nonbenzodiazepine Anxiolytics and Hypnotics (Diphenhydramine)
Barbiturates (Pentobarbital)
;Overall recommendation/Guidelineson medically complex patients;Overall recommendations
Do not be intimidated by a complex medical history and a very long list of drugs
Take one disease and one drug at the time
Use Dr. Jacobsen’s document:/docs/patientProtocol/Medically_Complex.pdf
Ask for advice when needed and…;Medical consult?;AMI in the last months
Stroke in the last months
Uncontrollered non-compliant diabetics
Blood pressure above 180/110*
HIV/AIDS with CD4 50* and/or platelet count 60,000*
INR 3.5* and need tx with bleeding such as extractions
Undiagnosed and untreated chest pain;38 year old Caucasian female
Chief complaint: I need the rest of my teeth removed and get dentures
Med Hx:
Previous IV drug abuse
Artificial heart valves placed in 2001 due to endocarditis
HTN
Medications: Methadone, Norvasc, Atenolol, Ambien and Coumadin
Vital signs: BP 176/80, pulse 105
Pt. is very anxious;;Guidelines - Prophylactic
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