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Medicine

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Cardiology

Question
18 out of 18
 

In a patient of heart disease antibiotic prophylaxis for dental extraction is



A Amoxicillin
B Imipenem

C Gentamicin
D Erythromycin

Ans. A

Amoxicillin

Prevention

1. Amoxicillin 2g orally 1h before dentistry. This suitable for those who have not received penicillin in the last month, including those with prosthetic valves (If penicillin allergic, clindamycin 600mg orally 1 hrs before surgery).

2. If past endocarditis, IV gentamicin and amoxicillin.

Risk of infective endocarditis in various lesion:

High Risk

Moderate Risk

Low Risk

Prosthetic heart valve, Tetralogy of Fallot, PDA, Coarctation of aorta

MVP + M.R.

ASD

VSD, Mitral regurgitation

MVP without MR

Tables 124–8High-Risk Cardiac Lesions for Which Endocarditis Prophylaxis Is Advised before Dental Procedures

1. Prosthetic heart valves

2. Prior endocarditis

3. Unrepaired cyanotic congenital heart disease, including palliative shunts or conduits

4. Completely repaired congenital heart defects during the 6 months after repair

5. Incompletely repaired congenital heart disease with residual defects adjacent to prosthetic material

6. Valvulopathy developing after cardiac transplantation Tables 124–7. Antibiotic Regimens for Prophylaxis of Endocarditis in Adults with High-Risk Cardiac Lesions.

1. Standard oral regimen - Amoxicillin: 2 g PO 1 h before procedure

2. Inability to take oral medication- Ampicillin: 2 g IV or IM within 1 h before procedure

3. Penicillin allergy

a. Clarithromycin or azithromycin: 500 mg PO 1 h before procedure

b. Cephalexin: 2 g PO 1 h before procedure

c. Clindamycin: 600 mg PO 1 h before procedure

4. Penicillin allergy, inability to take oral medication

a. Cefazolin or ceftriaxone: 1 g IV or IM 30 min before procedure

b. Clindamycin: 600 mg IV or IM 1 h before procedure

Cardiology Flashcard List

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