Tiêu đề INBDEBooster Study Notes (2025) - Oral Medicine.pdf ✅

Oral Medicine 3 INBDE Booster | Booster PrepTM Cardiac Conditions and CPR For cardiac patients, know when to give antibiotics, avoid epinephrine, manage chest pain and emergencies, and safely treat those on blood thinners to keep dental visits smooth and safe. 1 Antibiotic Prophylaxis One of the questions you’ll be asking your patients before starting treatment is if they have any cardiac conditions that may require antibiotic prophylaxis. It is important to remember that antibiotic prophylaxis is only required for patients with prosthetic heart valves and a history of infective endocarditis. It is not needed for patients with structurally abnormal heart valves (ex: valve prolapse). Even if a patient has a condition requiring antibiotic prophylaxis, they won’t always need antibiotics before every dental visit. Prophylaxis is only necessary for procedures that manipulate the gingival tissue, periapical area, or oral mucosa, because these allow bacteria to enter the bloodstream (ex: orthodontic band placement, SRP, ortho band placement) For a procedure like a simple Class I restoration, antibiotic prophylaxis would not be required. Antibiotics help prevent oral bacteria from spreading to vulnerable heart structures during such procedures. Prophylaxis is required for patients with repaired congenital heart defects if the repair: • Involved prosthetic material or devices • Is within 6 months post-surgery • Occurred with residual defects at or near repair site A few commonly repaired congenital heart defects encountered in the clinic include: • Atrial stepal defect - hole in the atrial septum that separated the left and right atria, commonly see in patients with Down syndrome. • Tetralogy of Fallot - group of congenital heart abnormalities, including ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy, and overriding aorta, commonly seen in newborns with cyanosis and oxygenation issues. Broadly speaking, any patient preparing for cardiac surgery must have all oral infections eliminated prior to surgery. This means we should perform restorations and extractions before surgery. This helps reduce the risk of harmful bacteria entering the bloodstream and ensure safer surgical outcomes for the patient. 2 Antibiotic Prophylaxis Prescriptions Now that we have discussed the types of patients who require antibiotic prophylaxis, let’s discuss prescription guidelines: • If a patient has no medication allergies, prescribe 2 grams of amoxicillin taken 1 hour before treatment • If a patient has a penicillin allergy, prescribe 2 grams of cephalexin, 500 grams of azithromycin, or 100 mg of doxycycline taken 1 hour before treatment • If a patient has complex cardiac history, always consult with the patient’s cardiologist first