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. Avoid direct dental light in the patient's eyes. Keep dark glasses available for patient comfort.

4. Dental procedures, such as radiographs or impressions, may be difficult because of an increased gag reflex.

5. Vasoconstrictors should be used with caution, in low doses, and with careful aspiration. Use of gingival retraction cords with epinephrine should be avoided.

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