What is the best explanation for his excessive bleeding

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Question - John is a 63-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.

Why did John not disclose the natural supplements on his medical history along with his other medications?

What is the best explanation for his excessive bleeding?

What recommendations should the hygienist make about his dietary supplements?

What do you tell John about the drug interactions with herbal products?

What natural products would be appropriate for the dental hygienist to recommend to improve Jim's gingival condition?

John Justifies the use of herbal products by claiming that they must undergo the same FDA approval process as prescription medications. How do you respond?

What is St. Johns' wort, and what is it used to treat? Include dental hygiene implications.

What is Ginkgo used to treat and has the FDA approved this use? Include the dental adverse effects.

Reference no: EM133287322

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