Operative tins 297

Menadiol sodium diphosphate

Sig: Take 3 to 6 mg. daily, orally or parenterally, prior to surgery. As an antidote for an anticoagulant, 75 mg. is administered intramuscularly.

When an implant penetrates a hematopoietic marrow area and the bleeding persists after suturing, menadione can be helpful. Menadione is a synthetic compound with vitamin K activity, which is related to the formation of prothrombin, a vital factor in blood clotting. It is indicated where hypothrombinemia exists.

If the patient suffers from improper clotting caused by other factors—such as a low platelet count, as in purpura, or insufficient thromboplastinogen, as in hemophilia   menadione will be of no value. Such patients should be avoided or hospitalized if any surgery is contemplated.

Menadione (2 mg.)

Tablets: Dispense fifteen. Sig: Take one tablet daily.

The action, use, and dosage of menadione sodium bisulfite (Hykinone) are similar to those of menadiol sodium diphosphate.

Oral secretion control agents

If the patient has dry mouth, or xerostomia, pilocarpine nitrate may be prescribed, because any protrusion into the oral cavity of an implant can be quite distressing and harmful to the dry tissues.

Pilocarpine nitrate (300 mg.)

Distilled water, q.s.

Mix.

Sig: Take 5 drops three times per day and increase 1 drop per day until oral condition is improved. Do not exceed 30 drops per day.

To control secretions during local or general anesthesia, either of these agents is advised:

Atropine sulfate (0.5 mg.)

Tablets: Dispense six.

Sig: Take one tablet 1 hour before dental appointment.

Tincture of belladonna (300 ml.)

Sig: Take 10 drops 1 hour before a dental operation; repeat if necessary.

Antihistamines

Histamine is usually liberated when a tissue is damaged, and an allergic reaction may produce wide-scale histamine release. The most common symptoms of an allergic reaction are generalized and local itching, rashes, sweating and weakness, a feeling of coldness, edema, headache, and sometimes

difficulty in breathing. If the attack is very severe, a subcutaneous injection of 0.1 to 0.5 ml. of 1:1,000 epinephrine with massage will generally bring rapid cessation of the symptoms, provided the patient is not allergic to the epinephrine.

The following are three of the most popular agents for the control of allergic phenomena. All three of these drugs often cause drowsiness, and the patient should be warned about this in case he is driving home.

Tripelennamine hydrochloride (50 mg.)

Tablets: Dispense ten.

Sig: Take one tablet every 4 hours.
Diphenhydramine hydrochloride (50 mg.)

Capsules: Dispense ten.

Sig: Take one every 4 hours.

Chlor-Trimiton (8 mg.)

Tablets: Dispense ten.

Sig: Take one every 4 hours.

Laxative

For constipation following dental operations, the following may be useful:

Extract of cascara sagrada (300 mg.)

Tablets: Dispense twelve.

Sig: Take one tablet before retiring, when needed.

Salves used with implants

Sometimes an ointment or salve has been introduced into the implant socket along with the implant (Fig. 7-84). For example, Metimyd, an ophthalmic ointment containing prednisolone acetate and sodium sulfacetamide, and Calendula Ointment, a homeopathic remedy, have been used to

Fig. 7-84. The spirals of a post type implant may be packed with an antiinflammatory lubricant.