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Drug Class:
Glaucoma
Accommodative Esotropia, Diagnosis
Accommodative Esotropia, TreatmentPrecautions and Contraindications
Active uveal inflammation, angle-closure glaucoma, hypersensitivity to echothiophate products
Dental Considerations
General:
• Determine why patient is taking the drug.
• Avoid drugs with anticholinergic activity, such as antihistamines, opioids, benzodiazepines, propantheline, atropine, and scopolamine.
• Avoid dental light in patient’s eyes; offer dark glasses for patient comfort.
• Question glaucoma patient about compliance with prescribed drug regimen.
Drug Class:
PsoriasisDrug Class:
Mechanism of Action
Therapeutic Effect: Interrupts HIV replication, slowing the progression of HIV infection.
HIV Infection (in Combination with Other Antiretrovirals)
Dental Considerations
General:
• Examine for oral manifestations of opportunistic infection.
• Monitor vital signs at every appointment because of cardiovascular and respiratory side effects.
• Consider semisupine chair position for patient comfort because of GI side effects of drug.
• Assess salivary flow as a factor in caries, periodontal disease, and candidiasis.
• Short appointments and a stress-reduction protocol may be required for anxious patients.
Drug Class:
Acute Migraine HeadacheSerious Reactions
! Cardiac reactions (including ischemia, coronary artery vasospasm and MI) and noncardiac vasospasm-related reactions (such as hemorrhage and CVA) occur rarely, particularly in patients with hypertension, diabetes, or a strong family history of coronary artery disease; obese patients; smokers; males older than 40 yr; and postmenopausal women.
Dental Considerations
General:
• This is an acute-use drug; it is doubtful that patients will seek dental treatment during acute migraine attacks.
• Be aware of the patient’s disease, its severity and its frequency, when known.
• Monitor vital signs at every appointment because of cardiovascular side effects.
• Assess salivary flow as a factor in caries, periodontal disease, and candidiasis.
• Consider semisupine chair position for patient comfort if GI side effects occur.
Drug Class:
Mechanism of Action
Therapeutic Effect: Relieves ocular itching associated with allergic conjunctivitis.
Allergic ConjunctivitisDrug Class:
Antiviral, nucleoside reverse transcriptase inhibitor
Mechanism of Action
Therapeutic Effect: Interrupts HIV replication, slowing the progression of HIV infection.
Uses
Treatment of HIV-1 infection in adults; used in combination with other antiretroviral medications
HIV Infection (in Combination with Other Antiretrovirals)
Dosage in Renal Impairmentemtricitabine + rilpivirine + tenofovir disoproxil
em-tri-site′-uh-been, ril-pi-vir′- een, & te noe fo veer
Drug Class:
HIVSerious Reactions
! Lactic acidosis and severe hepatomegaly have been reported with nucleoside analogues (e.g., tenofovir), including fatal cases. Safety and efficacy during coinfection of HIV and HBV have not been established; acute, severe exacerbations of HBV have been reported following discontinuation of antiretroviral therapy.
enalapril maleate
(Alphapril[aus], Amprace[aus], Apo-Enalapril[can], Auspril[aus], Renitec[aus], Vasotec)
Do not confuse enalapril with Anafranil, Eldepryl, or ramipril.
Drug Class:
Angiotensin-converting enzyme (ACE) inhibitor
Indications and Dosages
Hypertension Alone or in Combination with Other Antihypertensives
Adjunctive Therapy for CHF
Dosage in Renal Impairment
Serious Reactions
! Excessive hypotension (“first-dose syncope”) may occur in patients with CHF and in those who are severely salt or volume depleted.
! Angioedema (swelling of face, lips) and hyperkalemia occur rarely.
! Agranulocytosis and neutropenia may be noted in patients with collagen vascular diseases, including scleroderma and systemic lupus erythematosus and impaired renal function.
! Nephrotic syndrome may be noted in those with history of renal disease.
Dental Considerations
General:
• Monitor vital signs at every appointment because of cardiovascular side effects.
• After supine positioning, have patient sit upright for at least 2 min before standing to avoid orthostatic hypotension.
• 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 use of sodium-containing products, such as saline IV fluids, for those patients with a dietary salt restriction.
• Use vasoconstrictors with caution, in low doses and with careful aspiration.
• Stress from dental procedures may compromise cardiovascular function; determine patient risk.
• Short appointments and a stress-reduction protocol may be required for anxious patients.
Consultations:
• Medical consultation may be required to assess patient’s ability to tolerate stress.
• In a patient with symptoms of blood dyscrasias, request a medical consultation for blood studies and postpone dental treatment until normal values are reestablished.
• Take precautions if dental surgery is anticipated and sedation or general anesthesia is required; risk of hypotensive episode.
HIV Infection (in combination with other antiretrovirals)
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