The Dentist's Quick Guide to Medical Conditions

Mea Weinberg, DDS, MSD, RPh, is a practicing periodontist and licensed pharmacist, giving her unique experience and insight into medical conditions and their impact on dental treatment. She is a clinical associate professor of periodontology and implant dentistry at New York University. Dr. Weinberg has authored and co-authored numerous journal articles and has co-authored three books, including The Dentist’s Drug and Prescription Guide (Wiley, 2012).

Stuart Segelnick, DDS, MS, is in private practice in Brooklyn, New York, and a clinical associate professor of periodontology and implant dentistry at the New York University College of Dentistry. Dr. Segelnick contributed as a consulting editor for The Dentist’s Drug and Prescription Guide (Wiley, 2012).

Joseph Insler, MD, is Fellow, Department of Psychiatry, Boston University.

Samuel Kramer, DDS, is a clinical assistant professor of endodontics at New York University College of Dentistry.

Contributors x

Foreword xi

Preface xii

1 Gastrointestinal disorders 1

A. Peptic ulcer disease 1

B. Gastroesophageal reflux disease 4

C. Irritable bowel syndrome 6

D. Inflammatory bowel disease 7

a. Crohn’s disease 7

b. Ulcerative colitis 10

E. Diverticular disease 11

F. Acute pancreatitis 12

G. Celiac sprue 13

H. Pseudomembranous colitis 13

2 Medical conditions of the respiratory system 17

A. Respiratory diseases 17

a. Asthma 17

b. Chronic obstructive pulmonary diseases 23

c. Pulmonary tuberculosis 24

d. Obstructive sleep apnea 27

3 Disorders of the urinary system 30

A. Acute renal injury and chronic kidney disease 30

B. Kidney dialysis 37

C. Kidney transplant 39

D. Polycystic kidney disease 42

E. Benign prostatic hypertrophy 42

4 Diseases of the endocrine system 46

A. Diabetes 46

B. Thyroid diseases 50

C. Adrenal gland disorders 53

5 Disorders of the cardiovascular system 59

A. Hypertension 59

B. Angina Pectoris 68

Clinic 68

C. Myocardial infarction 70

D. Heart failure 73

E. Arrhythmias 75

F. Valvular heart disease 78

G. Epinephrine in cardiac patients 79

6 Pregnancy, lactation, and oral contraceptives 82

A. Pregnancy and lactation 82

B. Oral contraceptives 89

7 Disorders of the liver and gallbladder 93

A. Liver disease 93

a. Alcoholic liver disease and cirrhosis 98

b. Hepatitis 99

c. Liver transplant 103

B. Gallstones 105

8 Diseases of the neurological system 109

A. Parkinson’s disease 109

B. Multiple sclerosis 113

C. Seizures 116

9 Psychiatric disorders 125

Introduction 125

A. Antipsychotics 126

a. Typical antipsychotics 127

b. Atypical antipsychotics 128

c. Anticholinergic medications 128

B. Antidepressants 132

a. Monoamine oxidase inhibitors 133

b. Tricyclics and tetracyclics 134

c. Selective serotonin reuptake inhibitors 135

d. Selective serotonin norepinephrine reuptake inhibitors (SNRIs) 136

e. Others 136

f. Summary: Dental interactions and side effects 136

C. Mood stabilizers 138

a. Lithium 139

b. Valproic acid (Depakote) 140

c. Lamotrigine (Lamictal) 140

d. Carbamazepine (Tegretol) 141

e. Oxcarbazepine (Trileptal) 141

D. Alcohol and other drugs with addictive potential 142

a. Alcohol 142

b. Sedatives and hypnotics 143

c. Opioids 143

d. Cocaine 145

10 Hematologic disorders and drugs that cause bleeding 149

A. Brief overview of the coagulation process 149

a. Thrombocytopenia 152

b. Thrombocytopathy 153

c. Antiplatelet medications 153

B. Bleeding disorders: Coagulation disorders 154

a. von Willebrand disease 154

b. Hemophilias 155

c. End-stage liver disease 156

d. Anticoagulation medications 157

11 Blood dyscrasias 171

A. Red blood cell disorders 174

a. Anemia 174

b. Myeloproliferative disorders 181

B. White blood cell disorders 182

a. Leukemia 182

b. Lymphoma 186

c. Multiple myeloma 187

12 Musculoskeletal and connective tissue disorders 193

A. Osteoporosis 193

B. Osteoarthritis 197

C. Rheumatoid arthritis 198

D. Gout 201

E. Fibromyalgia syndrome 203

F. Systemic lupus erythematosus 205

G. Sjögren’s syndrome 208

13 HIV and oral health care 214

14 Radiation and chemotherapy 237

Appendices

Appendix A Antibiotic prophylaxis of the dental patient 252

Appendix B Common dental drug interactions 255

Appendix C Summary of tables/boxes 266

Appendix D Interpretation of common laboratory values 270

Index 274

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