13: N

N

Drug Class:

Nonsteroidal antiinflammatory

Serious Reactions

Dental Considerations

General:

• Potential increase of adverse cardiovascular events in patients at risk for thromboembolism.

• 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.

• Avoid prescribing in pregnancy.

• Avoid prescribing aspirin-containing products.

• Consider semisupine chair position for patients with arthritic disease.

• Severe stomach bleeding may occur in patients who regularly use NSAIDs in recommended doses, when the patient is also taking another NSAID, a blood thinning, or steroid drug, if the patient has GI or peptic ulcer disease, if they are 60 yr or older, or when NSAIDs are taken longer than directed. Warn patients of the potential for severe stomach bleeding.

Drug Class:

Nonselective β-adrenergic blocker

Serious Reactions

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.

• 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.

• Assess salivary flow as a factor in caries, periodontal disease, and candidiasis.

• Stress from dental procedures may compromise cardiovascular function; determine patient risk. Short appointments and a stress-reduction protocol may be required for anxious patients.

• Consider semisupine chair position for patients with respiratory distress.

Drug Class:

Gonadotropin; analog of gonadotropin-releasing hormone

Drug Class:

Topical antifungal

Drug Class:

Opioid agonist, antagonist; opioid analgesic

Serious Reactions

Dental Considerations

Drug Class:

Opioid antagonist

Serious Reactions

Dental Considerations

General:

• This drug is intended for acute use only.

• Risk of seizures reported in animal studies; be aware of this potential.

• Serious cardiovascular events have been associated with opioid reversal in postoperative patients; doses should be carefully titrated to reduce these events.

• Buprenorphine depression may not be completely reversed.

• In all cases, the establishment of a patent airway, ventilatory assistance, oxygen administration, and circulatory access should complement or precede opioid antagonist use.

• Significant opioid depression occurring in the dental office may require relocation of the patient to a medical facility for comprehensive management.

• Patients discharged from the office or emergency facility should be carefully observed for the return of opioid-induced depression.

Drug Class:

Narcotic antagonist

Serious Reactions

Dental Considerations

General:

• This drug is indicated for acute use only.

• Risk of seizures reported in animal studies; be aware of this potential.

• Serious cardiovascular events have been associated with opioid reversal in postoperative patients; doses should be carefully titrated to reduce these events.

• Buprenorphine depression may not be completely reversed.

• In all cases, the establishment of a patent airway, ventilatory assistance, oxygen administration, and circulatory access should complement or precede opioid antagonist use.

• Significant opioid depression occurring in the dental office may require relocation of the patient to a medical facility for comprehensive management.

• Patients discharged from the office/emergency facility should be carefully observed for the return of opioid-induced depression.

Jan 5, 2015 | Posted by in General Dentistry | Comments Off on 13: N
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