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Biomedical subjects

Peter L Jacobsen

Publications and source records attributed to Peter L Jacobsen.

5 recordsLinked to original sources
PubMed2005

Clinical management of the dental patient taking multiple drugs.

Adverse drug reactions (ADRs) occur often in elders often due to polypharmacy. Those over 65 currently comprise 13% of the population but consume approximately a third of all drugs prescribed. Increased care when prescribing certain drug classes and careful monitoring of the patient can prevent many ADRs. This article examines four questions that should be addressed when providing dental care for an older patient taking multiple medications. These include: (1) what are the medical conditions that necessitate the medications, (2) what impact do these medical conditions have on the provision of care, (3) what are the oral side effects of the medications, and (4) how will the patient's current list of medications alter the dentist's prescribing patterns for drugs used in dentistry?

Adverse Drug Reaction Reporting Systems↗
PubMed2005

Managing the care of patients with bisphosphonate-associated osteonecrosis: an American Academy of Oral Medicine position paper.

BACKGROUND: This position paper addresses the prevention of bisphosphonate-associated osteonecrosis (BON) and the management of care of patients with cancer and/or osteoporosis who are receiving bisphosphonates and who have BON or are at risk of developing it. METHODS: The authors reviewed the literature available on this newly described oral complication. Information of interest included bisphosphonates, the medications associated with this oral complication; the patient population at risk of developing BON and the diseases being treated with this class of medications; the clinical presentation of the oral lesions; guidelines for managing the care of patients who develop BON; the prevention of this complication based on current knowledge; and recommendations for routine dental treatment of patients receiving bisphosphonates. RESULTS: There is strong evidence that bisphosphonate therapy is the common link in patients with BON. The pathobiological mechanism leading to BON may have to do with the inhibition of bone remodeling and decreased intraosseous blood flow caused by bisphosphonates. People at risk include patients with multiple myeloma and patients with cancer metastatic to bone who are receiving intravenous bisphosphonates, as well as patients taking bisphosphonates for osteoporosis. The risk of developing complications appears to increase with time of use of the medication. There are no guidelines based on evidence, and the clinical management of the oral complication is based on expert opinion. CONCLUSION: Prevention of BON is the best approach to management of this complication. Existing protocols to manage the care of patients who will receive radiation therapy or chemotherapy may be used until specific guidelines for BON are developed.

Antineoplastic Agents↗
PubMed2003

Sinusitis as a source of dental pain.

Sinusitis is a common medical problem that can occasionally manifest as dental pain. If the patient is experiencing dental pain in the maxillary posterior teeth, then it is appropriate for the dentist to rule out sinusitis as a source of the problem before proceeding with definitive dental treatment. Often there is an obvious odontogenic source of the pain, and this should be resolved first, but in other situations it is difficult to determine the cause of the symptoms. In some patients, the source of the pain is so equivocal that it may be necessary to treat the patient for sinusitis to eliminate this as the source of the dental pain (Table 7). In this process, the dentist has one of 2 options: either refer the patient to a physician or treat the sinusitis. The option chosen regarding patient management is made by the dentist and depends on the particular clinical situation and the dentist's training and experience.

Amoxicillin-Potassium Clavulanate Combination↗