A DOCS Education member writes:
I have an 81-year-old female patient scheduled for two crowns. She weighs 134 lbs and had a knee replacement in 12/2015. She is allergic to Penicillin VK and Tetracycline, and has HBP (which is controlled), hyperthyroidism, anemia, kidney disease and spinal stenosis. She is taking HCTZ, Cholestyramine, Synthroid, difluprednate, Furosemide, omeprazole, glucosamine/chondrotin, Premarin, fluticasone, Lorezepam (.5mg 2X daily for anxiety), metoprolol succinate, aspirin (325mg 2 tabs/day),biotin, gingko bilboa, green tea slim tabs, d-alpha tocopherol, coq10, beta carotene, and ascorbic acid.
My first concern is I had planned to use Lorazepam for her case but she already takes it independently for anxiety. Secondly, she informs me she has urgent explosive diarrhea with her colitis. How do I best handle these issues?
Dr. Jerome Wellbrock, DOCS Education faculty member, responds:
I would seriously consider not sedating this patient. Age, medications, medical conditions, especially the explosive diarrhea all should be red flags.
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