Jim H. is a 65-year-old patient who is coming to the dental office for periodontal maintenance. He had a mild myocardial infarction a year ago and states on his medical history that he is taking Cardizem CD, Toprol, Hyzaar, and Plavix (an antiplatelet medication). The dental hygienist observes during the intraoral examination that his plaque is quite heavy, and although his periodontal disease had been well controlled, his gingiva is now quite inflamed. On performing the periodontal probing, an excessive bleeding response is seen that does not stop for many minutes. The dental hygienist asks him whether he is taking any other medications, and he says that he does take some “natural” supplements—garlic, ginkgo biloba, and St. John’s wort to make him feel better after his heart attack. 1) . Why did Jim not disclose the natural supplements on his medical history along with his other medications?, a. He was afraid that his physician might be angry., b. He considers them safe and nontoxic because they are natural., c. He does not consider anything that is nonprescription important., d. b and c only, e. a and c only, Which is the best explanation for his excessive bleeding?, Poor oral hygiene, Plavix, Toprol, Drug interaction among Plavix, garlic, and ginkgo biloba, Which recommendations should the dental hygienist make regarding his dietary supplements?, All of the above, Purity and potency of the product is unknown, and the dosage is not standardized., When taking conventional medications and herbal supplements, determining which medications or supplements were actually responsible is difficult., Package labeling may be incomplete or inaccurate., Little information is available on drug interactions with herbal supplements., Which natural products would be appropriate for the dental hygienist to recommend to improve Jim’s gingival condition?, Essential oil mouth rinses, Acemannan hydrogel, Xylitol, Triclosan, b and d only, Oil of cloves (eugenol).

Jim Case study chapter 4

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