• Neato@kbin.social
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    1 year ago

    Local anesthetics with vasoconstrictors should be used with care in patients taking methamphetamine because they may result in cardiac dysrhythmias, myocardial infarction, and cerebrovascular accident.

    Dang.

    • thedrivingcrooner@lemmy.world
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      1 year ago

      I had to be put under with local anaesthesia for a septoplasty and they said I couldn’t take Vyvanse. I wasn’t going to anyway, it increases your blood pressure. But still good that they tell you.

    • brimnac@lemmy.world
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      1 year ago

      I’m happy the other person hasn’t had issues, but my dentist called me to let me know they couldn’t put me under because of my prescription… which is Adderall and Vyvanse.

      May have just been the Adderall, maybe it was both, but I don’t like going under anyway and was going to use local anesthesia, regardless.

      • Dr Cog@mander.xyz
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        1 year ago

        Adderall and Vyvanse are essentially the same drug. You’re on both?

        • TheTimeKnife@lemmy.world
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          1 year ago

          They are related drugs with similar profiles, but they are not the same drug. Vyvanse is Lisdexamfetamine, which is a pro-drug, that your body converts into dextroamphetamine. This can have a big impact on some people, either making the drugs more or less tolerable. Actual metabolic rates for drugs can be significantly different from person to person.

          • Dr Cog@mander.xyz
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            1 year ago

            Yes, but Adderall is dextroamphetamine, the drug Vyvanse turns into.

            I’m familiar with the pharmacology and their respective mechanisms, just stating that they’re essentially the same drug

            • TheTimeKnife@lemmy.world
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              1 year ago

              They are not the same drug, reread what I said. You can’t be very familiar with pharmacology if you don’t understand prodrugs. They turn into almost Adderall, which isn’t straight dextroamphetamine. This changes how they effect the body, you can say “essentially the same” all you want, but it’s not true when it comes to how they actually impact people. Differing metabolic rates due to naturally different levels of metabolizing enzymes causes prodrugs to have more variance in their peak blood serum levels, it causes later onset of effect and can cause large variance in duration of effect. This can be very helpful or even dangerous for some people. They are not perfectly interchangeable, even if most people find them pretty similar.

              • grysbok@lemmy.sdf.org
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                1 year ago

                Thank you. Adderall (amphetamine + dextroamphetamine) gave me intolerable side-effects at the minimum effective dose for me. That’s my doctor moved me to dextroamphetamine, which has been lovely. They are not the same.

              • Dozzi92@lemmy.world
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                1 year ago

                Unrelated comment: I’m interested in following this exchange, but it’s collapsed, dunno if the pic embeds here or what. I click, jerboa crashes, rinse and repeat. I dunno, just felt like talking about. Dunno if anyone else has had similar dysfunction.

        • brimnac@lemmy.world
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          1 year ago

          Yup. Adderall alone was too much, Vyvanse alone was too little. A max dosage of one and a smidge if the other during the middle of the day if needed?

          Just right.

          Edit: to go with what the other person said - my metabolism is really fast and I typically run “hot.”

          • Dr Cog@mander.xyz
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            1 year ago

            Interesting approach. I myself use a non -stimulant (atomoxetine) daily with a supplement of Adderall as needed

    • kite@lemmy.world
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      1 year ago

      I’ve been put under multiple times and am on vyvanse, no one has ever said anything to me about it and I’ve never had issues.

      I can’t say that I’ve ever had it raise my blood pressure, either, like @thedrivingcrooner (no idea if I did that mention right) said they were told, but I have excruciatingly low blood pressure normally so it’s possible the doctors just didn’t consider it a potential issue in my case. I wish it would raise my blood pressure lol.

    • can@sh.itjust.works
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      1 year ago

      I had the same thought. I always disclose my meds first, but if you’re taking them but not prescribed I’d still tell them.

  • Etterra@lemmy.world
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    1 year ago

    I wonder about other amphetamines. Because there’s some things you can take turn into amphetamines when your body processes them, IIRC. There are also medications that are in the same family. I suspect that while people do usually tell their dentist what medications they’re taking when prompted, some people are kind of flaky and forget, while other people might have a reason in their head not to. But, not everybody thinks to disclose stuff like “supplements” which are unregulated, variably legal, and could also pose a health risk if they qualify for this particular scenario. Good of them to tell people that though. I never knew that and I’ve gotten lots of dental work done, although, I’ve never done hard drugs.

    • TommySalami@lemmy.world
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      1 year ago

      Hell, they still prescribe meth in some instances. It’s called Desoxyn. Adderall, a drug so commonly used right now there’s a shortage (or was, very recently), is a strong amphetamine. They’re used for a quite a lot medically, and all have similar effects on the body by definition.

      The issue at play here is amphetamines are doing a number on vasoconstriction and heart contractility, which then boosts heart rate and BP. This increases the chance of all that fun stuff like ischemic/hemorrhagic stroke, heart attack, or a dangerous dysrhythmia. When you add in anesthesia that has similar effects (vasoconstriction), you massively increase the odds of a complication. Thats without considering the already existing damage likely present in those abusing drugs of this sort.

      • wwaxwork@lemmy.world
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        1 year ago

        Not a lot of people realise that the lidocaine you get at the dentists also contains epinephrine to make it last long. Which can play merry hell with your blood pressure. I can’t have epinephrine for other medical reasons besides the way it messes with your blood pressure and honestly I prefer it, I’m numb long enough to do the surgery and it’s all gone in half an hour or so instead of a numb face for half the day.

        • brygphilomena@lemmy.world
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          1 year ago

          Lidocaine and epi are an interesting combo. There is a lot of literature on where and when they can be used in conjunction and where they absolutely cannot be used together. Anesthesia is a very complex subject and super intriguing.

    • SimplyATable@lemmy.world
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      1 year ago

      I always mention vitamins and stuff, just in case. No matter what, I will not lie to my doctor in any situation, it’s one of my rules of life

  • MisterEspinacas@lemmy.world
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    1 year ago

    Wow, I guess you know what part of the city you’re in when you have that appointment with this dentist.

    • grysbok@lemmy.sdf.org
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      1 year ago

      It’s a fairly standard thing for dentists to advertise, at least where I am. I’ve been to multiple dentists that had similar signs or very prominent warnings on the paperwork you sign in the waiting room. These were all suburban dentists.

      • MisterEspinacas@lemmy.world
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        1 year ago

        Wow! I have been absent from the United States for a long time (I’m assuming this is from the USA, where I’m from). What a thing! I had no idea this was typical back home. I guess it’s a good thing. I mean, it prevents death, right?

          • MisterEspinacas@lemmy.world
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            1 year ago

            Ah! I get it, then. I guess I was reading this poster as a kind of warning to recreational drug users because I didn’t put my pharmacology hat on. Thanks for the clarification. The more I interact with people on this thread, the more I see how it makes sense to post warnings like this.

        • Dozzi92@lemmy.world
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          1 year ago

          It’s specific to certain parts of the USA. Probably parts of California and Alabama, if I had to guess. The USA is very big and very diverse, which you know because you’re from there, so to suggest it’s a USA thing is oddly qualified.

          Where I live, I’ve never seen this. Does meth exist around here? Sure. Is it rampant? No. We do heroin round these parts, and we die from the fentanyl in it.

          • MisterEspinacas@lemmy.world
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            1 year ago

            I wasn’t referring to the posting of the sign as a practice, I was referring to the photo, meaning that I assume that the photo was taken in the USA. Yes, I am originally from the USA. Maine, to be exact. I haven’t been back home in about ten years. Anyway, I was referring to the place where the photo was taken, not the local customs.