Prednisone 20 mg 1x a day (usual dose of 5 mg Daily) Used for Immunosuppression for Kidney

Myfortic: 720 mg BID

Prophylaxis of organ rejection concomitantly with cyclosporine and corticosteroids in patients receiving allogeneic renal transplant Cautions: Mouth ulceration, gum hyperplasia, gingivitis, dry mouth, dysphagia, oral moniliasis, and stomatitis. Reductions in platelet counts Acyclovir-Valacyclovir: Mycophenolate may increase the serum concentration of Acyclovir-Valacyclovir. Acyclovir-Valacyclovir may increase the serum concentration of Mycophenolate. Risk C: CycloSPORINE (Systemic): May decrease the serum concentration of Mycophenolate. Specifically, cyclosporine may decrease concentrations of the active metabolite mycophenolic acid. Risk D: Consider therapy modification
Cyclosporine: 150 mg po q. am and 125 mg p.o. q.pm

Prophylaxis of organ rejection in kidney transplants, has been used with azathioprine and/or corticosteroids Cautions: Mouth sores, swallowing difficulty, gingivitis, gum hyperplasia, xerostomia (normal salivary flow resumes upon discontinuation), abnormal taste, tongue disorder, tooth disorder, and gingival bleeding. Action: Inhibition of production and release of interleukin II and inhibits interleukin II-induced activation of resting T-lymphocytes. May cause significant hyperkalemia and hyperuricemia. May cause seizures, particularly if used with high-dose corticosteroids. Encephalopathy has been reported, predisposing factors include hypertension, hypomagnesemia, hypocholesterolemia, high-dose corticosteroids, high cyclosporine serum concentration, and graftversus-host disease; may be more common in patients with liver transplant. Antifungal Agents (Azole Derivatives, Systemic): May decrease the metabolism of CycloSPORINE (Systemic). Risk D: Consider therapy modification

Limit Grapefruit Juice: May decrease the metabolism of CycloSPORINE (Systemic). Risk D: Consider therapy modification

Calcitriol 0.25 mcg (MICROGRAMS) p.o. twice weekly, Monday and Thursday

Oral, injection: Management of hypocalcemia in patients on chronic renal dialysis; management of secondary hyperparathyroidism in patients with chronic kidney disease (CKD) Effects on Dental Tx: Metallic taste and xerostomia (normal salivary flow resumes upon discontinuation). CKD stage 4: Oral: 0.25 mcg/day. Treatment should only be started with serum 25(OH) D >30 ng/mL, serum iPTH >110 pg/mL, serum calcium <9.5 mg/dL and serum phosphorus <4.6 mg/dL
Aspirin 325 mg p.o. daily

Treatment of mild-to-moderate pain, inflammation, and fever; prevention and treatment of myocardial infarction (MI), acute ischemic stroke, and transient ischemic episodes; management of rheumatoid arthritis, rheumatic fever, osteoarthritis; adjunctive therapy in revascularization procedures (coronary artery bypass graft [CABG], percutaneous transluminal coronary angioplasty [PTCA], carotid endarterectomy), stent implantation Key adverse event(s) related to dental treatment: As with all drugs which may affect hemostasis, bleeding is associated with aspirin. Hemorrhage may occur at virtually any site; risk is dependent on multiple variables including dosage, concurrent use of multiple agents which alter hemostasis, and patient susceptibility. 7-10 day

Lantus: 18 units subcutaneously daily (Long acting insulin analog) MORNING APPOINTMENTS Treatment of type 1 diabetes mellitus (insulin dependent, IDDM) to improve glycemic control Humulin sliding scale Tx of Type 1 diabetes mellitus

WARNING: Hypokalemia: Insulin (especially I.V. insulin) causes a shift of potassium from the extracellular space to the intracellular space, possibly producing hypokalemia. If left untreated, hypokalemia may result in respiratory paralysis, ventricular arrhythmia and even death. Use with caution in patients at risk for hypokalemia (eg, loop diuretic use). Monitor serum potassium and supplement potassium when necessary. Hypoglycemia: The most common adverse effect of insulin is hypoglycemia. The timing of hypoglycemia differs among various insulin formulations. Hypoglycemia may result from increased work or exercise without eating; use of long-acting insulin preparations (eg, insulin detemir, insulin glargine) may delay recovery from hypoglycemia. Profound and prolonged episodes of hypoglycemia may result in convulsions, unconsciousness, temporary or permanent brain damage, or even death. Insulin requirements may be altered during illness, emotional disturbances, or other stressors. Patients with type 1 diabetes (insulin dependent) should be appointed for dental treatment in the morning in order to minimize chance of stressinduced hypoglycemia.

Catapres 0.2 mg transdermal patch once weekly (CLONIDINE) Transdermal patch: Management of hypertension (monotherapy or as adjunctive therapy) Significant xerostomia (normal salivary flow resumes upon discontinuation), orthostatic hypotension, and abnormal taste. Ethanol: Avoid ethanol (may increase CNS depression). Herb/Nutraceutical: Avoid dong quai if using for hypertension (has estrogenic activity). Avoid ephedra, yohimbe, ginseng (may worsen hypertension). Avoid valerian, St John's wort, kava kava, gotu kola (may increase CNS depression).

IRON: 325 mg p.o. daily prevention, treatment of iron deficiency anemia Vitamin D 50,000 units po daily

Omeprazole 20 mg p.o. daily (STARTED DURING HOSPITALIZION DUE TO STRESS DOSE STEROIDS)

Short-term (4-8 weeks) treatment of active duodenal ulcer disease or active benign gastric ulcer; treatment of heartburn and other symptoms associated with gastroesophageal reflux disease (GERD); short-term (4-8 weeks) treatment of endoscopically-diagnosed erosive esophagitis; maintenance healing of erosive esophagitis; long-term treatment of pathological hypersecretory conditions; as part of a multidrug regimen for H. pylori eradication to reduce the risk of duodenal ulcer recurrence Effect on Dental Tx: Taste perversion, dry mouth, esophageal candidiasis, and mucosal atrophy (tongue). Amphetamines: Proton Pump Inhibitors may increase the serum concentration of Amphetamines. Specifically, data indicate that Proton Pump Inhibitors may increase the rate at which Amphetamines are absorbed. Total exposure to Amphetamines is not significantly changed. Risk C: Monitor therapy

Oxycodone (5 mg po daily) pain Management of moderate-to-severe pain, normally used in combination with nonopioid analgesics OxyContin is indicated for around-the-clock management of moderate-tosevere pain when an analgesic is needed for an extended period of time. Hypotension: May cause hypotension; use with caution in patients with hypovolemia, cardiovascular disease (including acute MI), or drugs which may exaggerate hypotensive effects (including phenothiazines or general anesthetics). Amphetamines: May enhance the analgesic effect of Analgesics (Opioid). Risk C: Monitor therapy Thiazide Diuretics: Analgesics (Opioid) may enhance the orthostatic hypotensive effect of Thiazide Diuretics. Risk C: Monitor therapy Instruct patient to avoid high-fat meals when taking some products

ALLERGY: VASOTEC - To delay the progression of nephropathy and reduce risks of cardiovascular events in hypertensive patients with type 1 or 2 diabetes mellitus; hypertensive crisis, diabetic nephropathy, hypertension

secondary to scleroderma renal crisis, diagnosis of aldosteronism, idiopathic edema, Bartter's syndrome, postmyocardial infarction for prevention of ventricular failure