L
Drug Class:
Nonselective adrenergic β-blocker and selective α1-blocker; antihypertensive
Serious Reactions
! Labetalol administration may precipitate or aggravate CHF because of decreased myocardial stimulation.
! Abrupt withdrawal may precipitate ischemic heart disease, producing sweating, palpitations, headache, and tremors.
! May mask signs and symptoms of acute hypoglycemia (tachycardia, B/P changes) in patients with diabetes.
Dental Considerations
General:
• Monitor vital signs at every appointment because of cardiovascular side effects.
• Patients on chronic drug therapy may rarely have symptoms of blood dyscrasias, which can include infection, bleeding, and poor healing.
• Assess salivary flow as a factor in caries, periodontal disease, and candidiasis.
• Limit dose of vasoconstrictors, or avoid use of vasoconstriction.
• After supine positioning, have patient sit upright for at least 2 min before standing to avoid orthostatic hypotension.
• Limit use of sodium-containing products, such as saline IV fluids, for patients with a dietary salt restriction.
• Stress from dental procedures may compromise cardiovascular function; determine patient risk.
• Short appointments and a stress-reduction protocol may be required for anxious patients.
Serious Reactions
Dental Considerations
General:
• Assess salivary flow as a factor in caries, periodontal disease, and candidiasis.
• Morning appointments and stress-reduction protocol may be needed for anxious patients.
• Be prepared to manage seizures and/or nausea.
• After supine positioning, allow patient to sit upright for 2 minutes to avoid occurrence of dizziness.
Drug Class:
Antiviral, nucleoside analogue
Mechanism of Action
Therapeutic Effect: Interrupts HIV replication, slowing the progression of HIV infection.
Indications and Dosages
Chronic Hepatitis B
PO
Dosage in Renal Impairment
Dosage and frequency are modified on the basis of creatinine clearance.
Creatinine Clearance | Dosage |
50 ml/min or higher | 150 mg twice a day |
30–49 ml/min | 150 mg once a day |
15–29 ml/min | 150 mg first dose, then |
100 mg once a day | 5–14 ml/min |
150 mg first dose, then | 50 mg once a day |
Less than 5 ml/min | 50 mg first dose, then 25 mg once a day |
Serious Reactions
Drug Class:
Indications and Dosages
Seizure Control in Patients Receiving Enzyme-Inducing Antiepileptic Drug (EIAEDS), But Not Valproic Acid
Seizure Control in Patients Receiving Combination Therapy of EIAEDS and Valproic Acid
Conversion to Monotherapy for Patients Receiving Valproic Acid
Serious Reactions
! Abrupt withdrawal may increase seizure frequency.
! Serious rashes, including Stevens-Johnson syndrome, requiring hospitalization and discontinuation of treatment have been reported.
Dental Considerations
General:
• Morning appointments and a stress-reduction protocol may be required for anxious patients.
• Determine type of epilepsy, seizure frequency, and quality of seizure control.
• Evaluate respiration characteristics and rate.
• Assess salivary flow as factor in caries, periodontal disease, and candidiasis.
• Patients on chronic drug therapy may rarely have symptoms of blood dyscrasias, which can include infection, bleeding, and poor healing.
Drug Class:
Uses
For long-term treatment of acromegaly in patients who fail to respond to surgery and radiotherapy.
Precautions and Contraindications
There are no contraindications listed in the manufacturer’s labeling.
Serious Reactions
! Bradycardia, hypo- and hyperglycemia, gallstones, decreases in thyroid function, renal impairment, and hepatic impairment have occurred.
Drug Class:
Serious Reactions
Dental Considerations
General:
• Consider semisupine chair position for patient comfort because of GI effects of disease.
• Question the patient about tolerance of NSAIDs or aspirin related to GI problem.
• Patients with GERD may have oral symptoms, including burning mouth, secondary candidiasis, and oral signs of dental erosion.
• Assess salivary flow as factor in caries, periodontal disease, and candidiasis.

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