Dental Management of Patients taking Digitalis

Definition:

Digitalis is a Cardiac Glycoside drug prescribed for patients with Congestive Heart Failure (CHF) Or Atrial Fibrillation.

Mechanism of action of Digitalis:
- It binds and Inhibits the Magnesium and Adenosine Triphosphate Dependent Na+ and K+ ATPase.
- The increase the influx of calcium ions.
- Then it Enhances the myocardial contractility.

Contraindications:
- Local Anesthesia with Epinephrine.
- Aspirin (As it decreases Digitalis absorption and displaces it at the protien binding sites).
- NSAIDs (As they decrease renal clearance of Digitalis).
- Macrolides and Tetracycline (As they increase the serum levels of digitalis causing toxicity).

What is safe with Digitalis .... ?
- Anesthesia: Mepivacaine.
- Analgesics: Acetaminophen (Alone, with Codeine, with Hydrocodone Or with Oxycodone)
- Antibiotics: Penicillins, Cephalosporins and Clindamycin.

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:: World Of Dentistry :: TEAM