Cirrhosis and Hepatocellular Carcinoma for Dental Clearance

You are asked to review a 58-year-old woman in preadmission clinic. She has been referred for assessment prior to dental clearance with extractions in two weeks. Past Medical History Cirrhosis secondary to non-alcoholic fatty liver disease Hepatocellular carcinoma Type 2 diabetes mellitus Medications Carvedilol 6.25 mg daily Furosemide 80 mg daily Lactulose 30 mL three times daily Metformin 1 g daily Pantoprazole 40 mg daily Rifaximin 550 mg twice daily Spironolactone 200 mg daily Vital Signs Height 1.60 m Weight 82 kg BMI 32 kg/m2 HR 68 bpm BP 105/62 mmHg SpO2 92% on room air Temp 36.7 degrees C