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单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,林聰勝,革民國腔顎一象,面外科專科醫師,口腔顎面外,牙醫診所,口外臨床指,警師,醫大口腔醫學,院任助理教授,Ankylos臺灣區教,育訓練講師,南台灣牙醫植體,中华民国口腔颚面外科专科医师林聰勝,革民國腔顎一象,面外科專科醫師,口腔顎面外,牙醫診所,口外臨床指,警師,醫大口腔醫學,院任助理教授,Ankylos臺灣區教,育訓練講師,南台灣牙醫植體,Considerations of systemic,disease in OMFS,林聰勝,Considerations of systemic disease,in OMFs,Rheumatic fever and rheumatic heart,disease.infective endocarditis(2g PC,Congenital heart disease.infective,endocarditis,prolong bleeding,time(thrombosis in small vessels,Surgical corrected cardiovascular,lesions.anticoagulant prolong bleeding,time,endocarditis,Considerations of systemic,disease in OMFS,林聰勝,Considerations of systemic disease,in OMFs,Rheumatic fever and rheumatic heart,disease.infective endocarditis(2g PC,Congenital heart disease.infective,endocarditis,prolong bleeding,time(thrombosis in small vessels,Surgical corrected cardiovascular,lesions.anticoagulant prolong bleeding,time,endocarditis,Considerations of systemic disease,in OMFs,Artificial heart valves.anticoagulant,prolong bleeding time,endocarditis,Premedication amoxicillin 2g,child,50mg/kg,Heart transplant:suppression of immune,anticoagulant,high steroid,may need,supplementation,AHA Prevention of Infective,Endocarditis guideline(2007),Conclusions!The major changes in the updated recommendations include the,Committee concluded that only an extremely small number of,of infective endocarditis might be prevented by antibiotic prophyll,procedures even if such prophylactic therapy were 100%effective(2)Infective,endocarditis prophylaxis for dental procedures is reasonable only for patients with,lying cardiac conditions associated with the highest risk of adverse outcome,docarditis.(3)For patients with these underlying cardiac conditions,rophylaxis is reasonable for all dental procedures that involve manipulation of,ngival tissue or the periapical region of teeth or perforation of the oral mucosa.(4),Prophylaxis is not recommended based solely on an increased lifetime risk of,acquisition of infective endocarditis(5)Administration of antibiotics solely to prevent,endocarditis is not recommended for patients who undergo a genitourinary or,gastrointestinal tract procedure.These changes are intended to define more clearly,when infective endocarditis prophylaxis is or is not recommended and to provide,more uniform and consistent global recommendations,Table 5.Regimens for a Dental Procedure Situation Agent Regimen,Single Dose 30 to 60 min Before Procedure,Adults,Children,Oral Amoxicillin,g,Urable to take oral medication,2 g IM or IV50mg/kg IM orV,Cefazolin or ceftriaxone,1 g IM orV50mg/kg IM or IV,Allergic to penicillins or ampicillinloral Cephalexin*OR Clindamycin,OR Azithromycin or clarithromycin 2 g 600 mg 500 mg 50 mg/kg 20,mg/kg 15 mg/kg Allergic to penicillins or ampicillin and unable to take,oral medication Cefazolin or ceftriaxone OR Clindamycin 1 g IM or IV,600 mg IM or IV 50 mg/kg IM or IV 20 mg/kg IM or IV IM indicates,intramuscular;IV,intravenous.*Or other first-or second-generation oral,cephalosporin in equivalent adult or pediatric dosage.Cephalosporins,should not be used in an individual with a history of anaphylaxis,angioedema,or urticaria with penicillins or ampicillin,Considerations of systemic disease,in OMFs,Angina pectoris.,stress and anxiety,MI,sudden death.,nitroglycerin,Myocardial infarction.arrest,congestive,heart failure,bleeding for anticoagulant,pacemaker cause infective endocarditis,6month saver,morning,short visit,diazapam for stress,anticoagulant cause,bleeding,no electric if pacemaker,Considerations of systemic disease,in OMFs,Arrythmia.,stress,cardiac arrest,pacemaker/no electric,Congestive heart failure.bleeding for,thrombosis in vessels,CVA.short of,breath,AIDS.,infection,bleeding,DM.infection,poor wound healing,avoid hypoglycemia,Considerations of systemic disease,in OMFs,Hyperthyroidism.,thyroid storm,avoid,epinephrine,Hypothyroidism.hypothyroid coma,sensitive to narcotic,tranquilizer,Anaphylaxis.vital sign,epinephrine,(Bosmin)to tongue,Leukemia.infection,bleeding,delayed,healing,Considerations of systemic disease,in OMFs,Radiation.mucositis xerostomia,loss of,taste,constricture of muscle,infection(candida,sensitive of teeth cervical caries,osteonecrosis.trismus,Chemotherapy.bleeding for bone marrow,suppression,infection,anemia,leukopenia,Osteoporosis.FoXamax.BRONJ(bisphosphonte,related osteonecrosis of jaws),
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