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                                                        DR. DAN PETERSON

                                                                      1415 SAGE STREET ~ GERING, NEBRASKA 69341 
      Call: 308-436-3491           

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To all our patients who have taken Fen-Phen or Redux:

     The U.S. food and Drug Administration states that as many as 32 percent of users of Fen-Phen or Redux may have developed cardiac valve damage, placing them at risk for bactermia-induced infective endocarditis

     Endocarditis is an inflammation that occurs when bacteria carried in the blood lodges on the damaged valves or in the lining of the heart.

      Some dental procedures can allow the entrance of bacteria in the bloodstream.  Simple dental procedures like cleaning, placing orthodontic bands and scaling as well as more invasive procedures like root canals, and extractions may require antibiotic treatment before the dental procedure.

The Department of Health and Human Services issued the following recommendations:

bulletAll people exposed to fenfluramine or dexfenfluramine for any period of time, alone or in combination with agents, should undergo a medical history and cardiovascular examination by their doctor to determine the presence or absence of cardiopulmonary signs an symptoms.
bulletAn echocardiographic evaluation should be performed on such exposed people who exhibit cardiopulmonary signs (including a new murmur) or symptoms suggestive of valvular disease (e.g. dyspnea)
bulletDoctors should strongly consider performing echocardiography on all people-regardless of whether they have cardiopulmonary signs or symptoms-who have been exposed to fenfluramine or dexfenfluramine for any period of time, either alone or in combination with other agents, before the patient undergoes any invasive procedure for which antimicrobial endocarditits prophylaxis is recommended by the 1997 American Heart Association guidelines.  Any echocardiographic findings that meet the 1997 guidelines for prophylaxis-regardless of whether they are attributable to possible fenfluramine or dexfenfluramine use-should be recognized as indications for antibiotic prophylaxis.  For emergency procedures for which cardiac evaluation cannot be performed, empiric antibiotic prophylaxis should be administered according to the 1997 AHA guidelines.

    This warning affects dental care.  Any dental procedure which could cause significant bleeding may require you to take pre-treatment antibiotics depending on the cardiac evaluation results.  Current guidelines from the American Heart Association include preventive antibiotic treatment without legitimate medical cause.  The new guidelines are to aid patients in diminishing the adverse effects of preventive antibiotic treatment which include development of resistance to antibiotics.

Before your next dental appointment, please advise us if you have taken fen-phen or Redux.

February 06, 2008

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PLEASE NOTE: The information contained herein is intended for educational purposes only.  It is not intended and should not be construed as the delivery of dental/medical care and is not a substitute for personal hands on dental/medical attention, diagnosis or treatment.  Persons requiring diagnosis, treatment, or with specific questions are urged to contact your family dental/health care provider for appropriate care.
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