You're in — here's your Chairside Quick-Reference.

The four patients most likely to change your treatment plan, on one page. Read it below, and press Ctrl / ⌘ + P to print or save it for your operatory. We've also emailed you this link so it's always in reach.

1 · The Cardiac Patient

• Stable disease first. Defer elective care until the patient is stable. Keep epinephrine low — a practical ceiling is about 0.04 mg (roughly two cartridges of 1:100,000).
• Endocarditis prophylaxis is for four groups only: a prosthetic heart valve or prosthetic repair material; prior infective endocarditis; specific congenital heart disease; a heart transplant that develops valve problems.
• Not indicated for mitral valve prolapse, rheumatic heart disease, a bicuspid valve, calcified aortic stenosis, stents, bypass, or pacemakers.
• When it is indicated: amoxicillin 2 g, 30–60 min before. Penicillin-allergic: azithromycin or clarithromycin 500 mg, or doxycycline 100 mg.

2 · The Diabetic Patient

• Hypoglycemia is the emergency. Book morning visits; confirm they ate and took their usual medications.
• Rule of 15: 15 g of fast carbohydrate, recheck in 15 minutes, repeat until above 70. If they can't safely swallow, it's glucagon. When in doubt, treat the low.
• A1c context: under 7 is good control; 7–8 fair; above 8–9 poor.
• Epinephrine is fine; don't reflexively premedicate; ask about GLP-1 medications (aspiration risk).

3 · The Dialysis & CKD Patient

• Treat the day after dialysis, not the same day.
• Protect the access arm — no blood-pressure cuff, venipuncture, or IV in it. A fistula needs no antibiotic prophylaxis.
• Avoid NSAIDs — use acetaminophen; avoid meperidine.
• Anticipate bleeding and lean on local measures.

4 · The Pregnant Patient

• Don't defer needed care. The second trimester is the comfortable window.
• Left lateral tilt for supine hypotensive syndrome.
• Lidocaine and articaine are fine; acetaminophen is preferred; avoid NSAIDs; a lead apron for imaging is fine.

The through-line: stabilize first, protect the vulnerable system, choose the drug that respects the organ, and position the patient for safety.

Educational quick-reference for licensed dental professionals; not a substitute for clinical judgment. © A–Z Bite Club.