Common medical conditions and prescribed drugs课件.pptxVIP

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