sedation with extensive medical history

drhayes — Wed, 06 Jan 2010 23:18:28 GMT

I have a 45 year old male, 239 lbs. presents for exam and clearance prior to surgery to place an aortic mechanical valve. He requests sedation to allow treatment to be completed in one setting. Patient has moderate to advanced periodontal disease as well as several areas of decay that can be treated with composite restorations. Patient has Gitelman’s Syndrome which causes excess loss of magnesium and potassium as well as inadequate excretion of calcium from the kidneys, heart murmur since birth, and elevated cholesterol, portacath for biweekly infusions, does not smoke, no known allergies. Baseline pulse 94, O2 97%, BP 137/82. His meds are as follows: Mag-Oxide, Potassium Chloride, Amiloride, Inspra, Metoprolol, Lipitor, Cozar, and Magnesium infusions. In a medical consult his cardiologists nurse said he is OK for oral and/or IV sedation & did not have any contraindications. He would like us to just give him the Clindamycin IV day of apt. and follow with PO Amoxil 2grams a day for about 4 days after the procedure. My initial thoughts for this patient was to treat him in a couple of unsedated appointments. Any input on this case would be appreciated.

Thx

Kevin Hayes D.M.D

Welcome

DrMermigas — Mon, 04 Jan 2010 17:36:50 GMT

I would like to take this opportunity to welcome all of you who will be participating in the January 2010 course in Pittsburgh. The faculty and I are looking forward to working with you...

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Dr. Mermigas