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