General

1. Monitor vital signs at every appointment because of cardiovascular and respiratory side effects.

2. Have the patient sit up slowly and remain seated for at least two minutes after being supine in order to minimize the risk of orthostatic hypotension.

3. Decreased saliva flow can put the patient at risk for dental caries, periodontal disease, and candidiasis.

4. Early morning and shorter appointments, as well as methods for addressing anxiety levels in the patient, can help to reduce the amount of stress that the patient is experiencing.

5. Note any evidence of physical or psychologic dependence. Assess frequency and quantity of refills. Consultation with Primary Care Provider

1. Consultation may be required in order to assess level of disease control and the patient's ability to tolerate stress.

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