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RENAL DISEASES
LIVER DISEASES
Antibiotics safe in liver disease
Pen VK: Normal dose
Amoxycillin
Amoxycillin with clavulanic acid
Clindamycin: Normal dose with Hepatitis Clarithromycin: Normal dose with normal kidney function Metronidazole: Normal dose with mild liver disease Doxycycline: Normal dose IV Vancomycin: Normal dose
cefadroxil
ANTIBIOTICS WITH ALERTS Ampicillin and cloxacillin: Use caution/avoid Azithromycin: Avoid Clindamycin: 50% dose with Cirrhosis Metronidazole: 50% dose with moderate or severe liver disease Tetracycline HCL: Avoid
Pen VK: No dose alteration needed 2)Amoxicillin: No dose adjustment 3)Azithromycin: Avoid Azithromycin in patients with Liver disease 4)Clindamycin: a)Hepatitis: Full dose can be used with non-acute, non-fulminant hepatitis b)Cirrhosis: Decrease Clindamycin total dose by 50% 5)Metronidazole (Flagyl) a)Mild Liver Disease: Prescribe the normal dose b)Moderate & severe Liver Disease: Decrease the total dose by at least 50% c)Decreased dose of Flagyl used if both liver and kidney are affected: 250 mg q12h 6)Tetracycline HCL: Avoid Tetracycline HCL with Liver Disease 7)Doxycycline: No dose change needed with kidney/live/kidney & liver disease
PREGNANCY AND LACTATION
DRUGS : Analgesics RECOMMENDATION DURING PREGNANCY
RECOMMENDATION DURING LACTATION
Paracetamol Compatible through out Compatible
Indomethacin Avoid at conception, during first 10 week of gestation and after 32 weeks of gestation
Compatible.
Diclofenac Avoid at conception, during first 10 week of gestation and after 32 weeks of gestation
Compatible.
Ibuprofen Same as indomethacin and diclofenac
Compatible
Naproxen Same as indomethacin and diclofenac
Compatible
Ketoprofen Same as indomethacin and diclofenac
Compatible
Ketorolac
Same as indomethacin and diclofenac
Compatible
CBC, ESR INR PT Aptt BT CT Liver function tests Urine routine
Recommendation of Antibiotics and Analgesics in Medically Complex Dental Patients
CARDIOVASCULAR DISEASES
PRESURGICAL EVALUATION PROTOCOL
DIABETES
INR
ARTIFICIAL PROTHESIS: JOINT REPLACEMENT
All antibiotics can be used Expect Macrolide AZITHROMYCIN as it affects conduction system NSAIDS should not be used with digoxin Paracetamol and tramadol safest for pain
All antibiotics are safe . Caution in bleeding diathesis ceftriaxone, cefoperazone,can cause bleeding
All antibiotics can be used
in diabetic patients safely.
NSAIDS: caution should
be excercised can cause
hypoglycaemia.
Paracetamol, tramadol is
safe