Its affect the joints tendons, ligaments, bones, and muscles. Among them are many types of arthritis, a term used for conditions that affect the joints.
Ensure comfortable chair position. Consider shorter appointments and use supports as needed (e.g., pillows, towels).
No issues.
If patient is taking aspirin or another NSAID or acetaminophen, be aware of dosing and the possibility that pain may be refractory to some analgesics; dosing and/or analgesic choices may need to be modified in consultation with the physician.
Provide antibiotic prophylaxis in accordance with ADA (2015) guidelines
Excessive bleeding may occur if major surgery performed on patients who take aspirin or other NSAIDs. Bleeding usually is not clinically significant and can be controlled with local hemostatic measures.
It’s Adverse reactions to local anesthetics are usually a reaction to epinephrine,
During allergic reaction and with a conscious patient, place in comfortable position. With unconscious patient, place in supine position.
Establish history of previous reaction after use of local anesthetic.
For severe allergic reaction (e.g., anaphylaxis), inject 0.3 to 0.5 mL of 1:1000 epinephrine through an intramuscular (into the tongue) or subcutaneous route; supplement with intravenous diphenhydramine 50 to 100 mg if needed. Support respiration, if indicated, by mouth-to-mouth breathing or bag and mask.
A seizure is a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in behavior, movements or feelings, and in levels of consciousness
This usually is not a problem if the patient is under good medical management; a supine position may not be tolerated. In patients at risk for seizure, the chair back should be in supported supine position.
It is very important to obtain adequate anesthesia to reduce stress as possible precipitant for a seizure. Epinephrine (1:100,000 and no more than two carpules) in local anesthetics generally is well tolerated.
provide good pain control to avoid stress, which may precipitate a seizure.
There is no need for antibiotic prophylaxis.
The possibility of a bleeding tendency has been noted in patients taking valproic acid (Depakene) or carbamazepine (Tegretol) as the result of platelet interference.
It’s occurs when the blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Brain cells begin to die in minutes.
Deficits from a previous stroke may warrant assistance for patient transfer to the chair, effective oral evacuation and airway management, and rigorous oral hygiene measures delivered by a health care provider.
Good pain control should be achieved during the procedure, but dose of epinephrine should be limited to two carpules
Use of acetaminophen as pain reliever is recommended; avoid the use of ASA and other NSAIDs due to increased bleeding
Avoid use of metronidazole and tetracyclines in patients taking warfarin (Coumadin) because of its decreased metabolism.
Patients taking an anticoagulant or on antiplatelet therapy are at increased risk for bleeding
Its brain disorder that leads to shaking, stiffness, and difficulty with walking, balance, and coordination
usually is not a problem if the patient is under good medical management; with symptoms of impending syncope, however, a supine position may not be tolerated. The patient taking dopamine may experience hypotension, warranting precautions with getting seated or on arising. The chair may need adjustment for adequate support to help reduce unnecessary movement or to stabilize the patient in a comfortable position.
It is very important to obtain adequate anesthesia to reduce stress, which may worsen the movement disturbance. Epinephrine (1:100,000) in local anesthetics generally is well tolerated.
provide good pain control.
No need for antibiotic prophylaxis.
Is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. In most people with the disease
Usually is not a problem if the patient is under good medical management: with symptoms of impending syncope, however, a supine position may not be tolerated. The chair may need adjustment to address patients’ concerns or fears.
Local anesthesia obtained with epinephrine (1:100,000) in local anesthetics generally is not associated with any problems.
provide good pain control.
No need for antibiotic prophylaxis.
Frequently have intense, excessive and persistent worry and fear about everyday situations. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks).
No issues.
Effective local anesthesia is essential, and oral sedation provided on the night before and just before the dental appointment with a fast-acting benzodiazepine (alprazolam,0.5 mg tab; diazepam, 2, 5, or 10 mg tab; or triazolam, 0.125 or 0.25 mg tab) will aid in the management of anxiety in a majority of cases. For the more anxious patient, inhalation sedation with nitrous oxide, intramuscular sedation (midazolam, promethazine, or meperidine), or intravenous sedation (diazepam, midazolam, or fentanyl) can be used.
The control of postoperative pain is extremely important in the anxious patient. In accordance with the procedure performed, the dentist should select the most appropriate drug for pain control (nonsteroidal antiinflammatory drugs, salicylates, acetaminophen, codeine, oxycodone, fentanyl, morphine, and others). Also, adjunctive medications such as antidepressants, muscle relaxants, steroids, and antibiotics may be indicated.
Not indicated unless acute infection is present.
Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest and can interfere with your daily functioning. Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings Schizophrenia is a serious mental disorder in which people interpret reality abnormally.
Patients taking tricyclic antidepressants or MAOIs avoid sudden changes in chair position due to postural hypotension. Support patient getting out of the dental chair.
The use of epinephrine should be limited in patients taking antidepressants or antipsychotic drugs, because hypertensive reaction (with antidepressants) or hypotensive reaction (with antipsycotics) can occur. Limit to two cartridges of 1:100,000 epinephrine (also avoid more concentrated forms of epinephrine in retraction cord or used to control bleeding).
Avoid sedative agents or use in reduced dosage (see drugs) in patients taking antidepressant and/or antipsychotic drugs.
Not indicated unless acute infection is present.
Thrombocytopenia and leukopenia may occur as side effects of medications used to treat these patients. Examine for signs of these conditions.
Addiction the person can’t resist the urge to use them, no matter how much harm the may cause.
No issues.
For cocaine and methamphetamine abusers, avoid the use of epinephrine for 24 hours after the last dose of drug.
Avoid prescribing narcotic analgesics, if possible. However, if needed, consult with patient’s primary care physician who is managing the substance abuse program.
No issues.
Patients with alcohol abuse, excessive bleeding secondary to liver disease is possible. Lab tests may be needed for confirmation.
HIV is a virus that may cause an infection, AIDS (which is short for acquired immunodeficiency syndrome) is a condition. Contracting HIV can lead to the development of AIDS. AIDS, or stage 3 HIV, develops when HIV has caused serious damage to the immune system
No issues.
Aspirin and other NSAID use can worsen bleeding in a patient who has thrombocytopenia. Avoid during thrombocytopenic episodes.
Prophylactic use not required unless severe immune neutropenia (<500 cells/μL) is present. Manage postoperative infections with usual antibiotic use.
Excessive bleeding may occur in the patient with untreated or poorly controlled disease as a result of thrombocytopenia, which fortunately is not a common finding.
Check drug interactions before use any of Analgesics or antibiotics
OdontoHamad |an H Solutions Project
Copyright © 2023 OdontoHamad - All Rights Reserved.