Hypertension Patient
Hypertensive patients should have their BP taken prior to significant dental procedures. Although an extensive review by Bader et al. (2002) concluded that epinephrine in local anesthetic VERY rarely resulted in adverse outcomes, many practitioners believe that hypertensive patients should receive no more than 0.04mg of epinephrine. However, remember the importance of pain control when treating hypertensive patients, as it will increase BP significantly.
Complications of antihypertensive treatment in orthostatic hypotension, xerostomia, dry mouth, gingival overgrowth, lichenoid reactions, and burning mouth symptoms. It is also important to be aware of patients taking non-potassium sparing diuretics, as epinephrine use can potentially decrease potassium, leading to dysrhythmias. Also, long term use of NSAIDs by decrease the effectiveness of certain antihypertensive agents; this is less of a problem with short term NSAID use.
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