Dental Care for Heart Patients

Drugs

Blood thinners- warfarin (Coumadin) or Lovenox or Heparin - increases bleeding
Antiplatelets (Plavix) increases bleeding
NSAIDS (ibuprofen and Celebrex) increases bleeding
Herbals (garlic, ginkoba, ginseng) and diet supplements increase bleeding
Erythromycin (antibiotic) interacts with dental meds
Nizoral (antifungal) interacts with dental meds
Calcium channel blockers – end in “pine” like amiodipine (Norvasc)may have gingival enlargement)
Beta blockers- end in “olol” (examine teeth for oral lesions. May recommend sugar free gum/candy and saliva substitutes
Ask about any hypnotics (sleep meds) or pain meds taken the night before – may interfere with anesthesia so limit local anesthetics

Common Lab Values

Prothrombin Time Test (PTT) for anticoagulant therapy

  • Adult – 10-15 seconds   *** >30 seconds places client at risk for hemorrhage

Normal International Normalized ratio (INR) anticoagulant therapy

  • ≤2.5

Peak and Trough

  • Gentamycin
    Peak therapeutic level 6-10µg/ml
    Trough therapeutic level <2µg/ml
  • Tobramycin
    Peak therapeutic level 4-10µg/ml
    Trough therapeutic level 0.5-2µg/ml
  • Vancomycin
    Peak therapeutic level 30-40µg/ml
    Trough therapeutic level 5-10µg/ml

Cholesterol

  • Total <200 mg/dL
  • LDL 65-170 mg/dL
  • HDL 40-60 mg/dL
  • Triglycerides 45-150 mg/dL

Common IV Solutions and Abbreviations

Dextrose 5% in water   D5W

Normal Saline 0.9%    NS

Lactated Ringers      LR

Sterile water for injection   SWFI

Dextrose 5% with Normal saline 0.9%    D5NS

Dextrose 10%   in water      D10W

Normal saline 0.225%      1/4NS

Common IV Abbreviations

IV (intravenous) - into the vein

IM (intramuscular) - into the muscle

IC (intracardiac) - into the cardiac space (crash cart medication)

IVPB - IV Piggy back. Usually an antibiotic given in a 50,100, or 250ml bag over a few minutes.

IV push - small amount of drug injected with a syringe into the vein through a port in the IV tubing or directly with an injection. Example would be pain medication or medication to induce labor.

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