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Which medications are most effective for moderate to severe post-operative dental pain?

The following question was posted by a practising dentist: There is quite a bit of variation in the office with respect to drugs dentists like to prescribe for post-operative pain. Which pain medications are the most effective for moderate to severe pain and have the least number of side effects? Dr. Mark Donaldson from the University of Montana and the Oregon Health & Sciences University provided this initial response: The goal should be: “the most effective dose for the shortest period of time.”  We want to get our patients out of pain as quickly as possible. Two good recent articles come to ...

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What is the QT-Prolonging effect of Epinephrine on Patients Taking SSRIs?

The following question was submitted by a practicing dentist: What may happen with patients who have a prolonged QT due to their SSRI or Prozac medication when they are administered a local anesthetics-containing epinephrine? The following response is provided by Dr. Joonyoung Ji, resident in the Department of Dental Anesthesia at the University of Toronto Main take-away message Epinephrine, stress, and using more than one psychotropic increases the QT interval. The majority of patients have significant medical co-morbidities in reported cases of arrhythmia associated with psychotropics. Therefore, limiting the use of epinephrine to under 40 mcg or no more than 2 cartridges of ...

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