Blood Thinners
Your patient lists Plavix as a medication that they take on their medical history why would your patient be on Plavix?
Stoke
Your patient has a history of stomach ulcers. What OTC pain medication should they avoid taking?
NSAID's / Advil
What antibiotic family does amoxicillin belong to?
Penicillin
When prescribing an antibiotic to a women on birth control pills what should you inform her of?
That antibiotics make birth control pills ineffective.
What are the 2 main medications prescribed as a dental premed?
Amoxicillin and Clindamycin
Your patient is taking the drug Eliquis and is scheduled to come in for a scaling and root planning.
What needs to be done with the blood thinner?
Nothing
generally a SRP is minimally invasive and does not require the patient to stop blood thinners
William is a cardiac patient he is not on any blood thinners but has high blood pressure and atrial fibrillation (A-Fib) He is scheduled for a connective tissue graft. Your dentist would like to use 3 carpules of Lidocaine with Epinephrine 1:100,000 during this procedure. Who must be consulted prior to surgery and why?
The patients cardiologist. We must be given clearance to use epinephrine on this patient.
What family of drugs is Advil in?
NSAID's
Sally is allergic to Penicillin and Latex, she is coming in for an Extraction, Bone Graft and Implant on #12.
What should we give her for an antibiotic? &
What types of gloves should be used during treatment?
Clindamycin & Nitrile
Your patient is coming in today to have an impression for a occlusal guard. She normally premedicates with 4 500mg amoxicillin's prior to dental cleanings, does she need to premed today?
No
Your patient is taking Eliquis and is scheduled to come in for Extraction with Bone Graft of #7-10.
How should the Eliquis be addressed?
Written medical clearance needs to be obtained from the patients cardiologist approving the patient to be able to stop her Eliquis for 48 hours prior to surgery.
Jake is a 40 yr old overweight man. On your patient's medical history they don't list a primary care physician. They indicate on their medical history that they take no medications and have no allergies and no medical conditions. Before beginning the osseous surgery you take their blood pressure. The patient's blood pressure is 180/100. What do you do next?
Dismiss the patient
He must see his PCP to have his blood pressure addressed and get medical clearance prior to rescheduling his surgical procedure.
Which epileptic medication can cause gingival hyperplasia?
Dilantin
John is a landscaper who needed an afternoon appointment due to working long hours in the summer time. The doctor prescribes a low dose of Doxycycline to help treat his periodontal disease he will take the pills for 10 days. What should we mention to this patient regarding this medication?
Doxycycline can cause you to burn in the sun (sun sensitivity). While taking the medication you should wear sun screen and long sleeves if possible to minimize sun exposure.
This antibiotic is associated with the highest risk of causing c.diff?
Clindamycin
Your patient is on warfarin and is scheduled for an extraction, your offices policy is to have the patient pre-medicate for discomfort and pain prior to the procedure. What medication are you dispensing to them?
Tylenol
Alice is a 60-year-old woman with diabetes and high blood pressure. She states that the diabetes is not well controlled, her A1C is 13 and she takes Losartan for her blood pressure along with CoQ10. Her BP is 120/83. Alice is in for a consultation for gingival grafting number 23 through 26. What needs to happen prior to her surgery?
Her A1C will ideally get lowered to 7 or below for optimal healing conditions
What is the medication Ativan used for in the dental office.
Conscious Sedation
Sarah is a 68 year old women with a BP of 115/85, She takes citalopram, levothyroxine and Fosomax and has an allergy to Tetracycline.
She has some 5mm pockets on #2M,14D and the doctor has treatment planned her to have Arestin therapy placed in these locations at her next SRP appointment.
How should this treatment plan be altered?
Patient has allergy to the main ingredient in Arestin therapy.
We need to inform the doctor that Arestin cannot be placed and ask if there is an alternative treatment they would like to do instead.
Your patient states in their medical update that they had a recent knee replacement? They are scheduled for an initial comprehensive periodontal evaluation do they need to premed?
Yes
Your patient is on warfarin ( Coumadin) and is scheduled for a gingivectomy procedure how do we need to address the patient's blood thinner prior to treatment?
Patient does not need to stop their blood thinner prior to treatment, however the must check their INR the morning of the procedure and it must be close to 2 to minimize surgical complications in regard to bleeding.
Your patient had rheumatoid arthritis and is on biologic injection medication, they are being treated for a dental infection, what do you need to inform the patient of in term of drug interactions?
Biologics can lower the patients immune system significantly and can limit the efficiency of antibiotics. The patient should consult their rheumatologist about pausing biologic treatment while on antibiotics.
What family does the medication Medrol belong to?
Steroid
Bill has indicated that he is allergic to ibuprofen, he is scheduled to come in for a Maxillary All-On-X implant procedure. He will need something stronger than Tylenol for the pain. The doctor has ordered Percocet. What is the extra step that must be done while writing the script? and how many days worth of pills can you prescribe (max)?
You must first check MassPat to make sure that the patient does not have existing narcotic prescriptions or a history of abuse.
7 days worth of pills max
Your patient has an artificial heart valve, she is scheduled for an Impression for a crown with gingival retraction cord, does she need to premed for this impression?
Yes