Dental management of the medically compromised patient | Questions and Answers with complete solution

reaction to drugs or sedation? - - IV injection of LA - facial palsy due to LA - LA allergy - CV reactions to LA - hypotention due to antihypertensive simple faint? - - most common in young people - lie patients flat with their legs raised - slowly move chair into upright position asthma? - - aspirin and NSAIDs can cause an acute asthmatic episode - ventolin (4 puffs, 4 minutes, 4 puffs) epilepsy? - - pt taking phenytoin (dilantin) = lead to gingival hyperplasia - take a note of types of attacks, causes and frequency diabetes? - - normal blood [glucose] = 3.5 - 12 mMol - pt with uncontrolled diabetes = prone to infection / poor wound healing - pt taking insulin = may have hypoglycaemic reaction - hypoglycaemic shock more dangerous than hyperglycaemic shocks because brain gets starved of glucose preventive measure of diabetes? - - identification of diabetes patients - consult with GP - pt on insulin = be aware of hypoglycaemia (ensure pt have had a good meal, early morning appointments, have sugar available in clinic)- pt with infected wounds might need higher dose of insulin treatment plan modification for diabetes? - - well controlled pt are okay for dental tx - administer antibiotics for surgical procedures to promote healing - well balanced diet within 2 hrs of a dental appointment - food to be made available if appt lasts over 2 hrs oral complications for diabetes? - - periodontal disease progresses rapidly - periodontal abscesses - gingival proliferations - poor healing - prone to infection - oral ulcers - xerostomia emergency dental tx for diabetes? - - in patients with infection, insulin dose control needed - uncontrolled pts = refer for consultation and management of condition