Patients with heart transplants who are on long-term prednisone therapy undergo cardiac biopsy without either intravenous sedation or stress doses of corticosteroids. For restorative dentistry, dental hygiene, mucogingival surgery, and simple extractions, it is not necessary to increase the patient’s corticosteroids. However, it is important that the patient has taken the usual dose. For multiple extractions or extensive mucogingival surgery, the dose of corticosteroids should be doubled on the day of surgery. If the patient is treated in the operating room under general anesthesia, stress level doses of cortisone, 100 mg intravenously or intramuscularly, should be given preoperatively.
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