Cardiac medications Flashcards
What is cardiac output?
What causes hypertension?
Hypertension can be caused by:
1. Cardiac output: known as Stroke volume X heart rate:
· Lowering stroke volume: block renin- angiotensin pathway/ ACE inhibitors or use diuretics
· Heart rate: beta blockers
- Peripheral vascular resistance:
· Blocked via calcium channel blockers: dilates blood vessels
List the 5 drugs used to treat hypertension
ACE inhibitors
Angiotensin II antagonists
Calcium channel blockers
Thiazide diuretics
Beta blockers
What is an ACE inhibitor?
What are some side effects?
What are contraindications?
• Works by inhibiting the formation of Angiotensin II by blocking the ACE enzyme which converts angiotensin I to angiotensin II
It causes:
Vasodilation
• Reduce arterial & venous pressure
• Reduce ventricular afterload & preload (not enough blood to pump around)
Decreased blood volume
• Natriuretic (excretion of Na+). As a result, this will increase potassium levels
• Diuretic
- Depresses sympathetic activity
- Inhibits cardiac and vascular hypertrophy
Contraindications
• Pregnancy
• Anaphylaxis: consistent dry cough which may affect dental treatment
The “pril” drugs belong to ………….
ACE inhibitors
What is an angiotensin II antagonist?
Inhibits the function of angiotensin II which would have otherwise inform the kidney to resorb water and NaCl to increase blood pressure
The “sartans” drugs belong to ………..
Angiotensin II antagonists
How do calcium channel blockers work?
What are side effects?
- The entry of calcium is critical for the conduction of the electrical signal that passes from muscle cellto muscle cell of the heart, and signals the cells to contract
- In the arteries, the entry of calcium into muscle cells constricts the arteries
- Thus calcium channel blockers reduce the force ofcontraction of the muscle cells anddilate arteries.
Effects: • Decrease contractility = low heart rate • Decrease conduction velocity • Smooth muscle relaxation • Vasodilation • Peripheral oedema (ankle swelling) • Tachycardia • Headache
The dental side effect of gingival hyperplasia is caused by which drug?
Calcium channel blockers
The “dipines” drugs belong to ………………
Calcium channel blockers
How does thiazide work?
What are side effects?
- Causes kidneys to remove moresodium and water from the body
- This lowers blood pressure because it lowers blood volume
- In addition, a direct effect on vascular smooth muscle i.e less responsive to vasoconstrictors
- It inhibits uric acid excretion
Side effects • Gout (uric acid) • Hypercalaemia (Ca2+) • Hypokalaemia (K+ ) • Hypomagnasemia (Mg2+) • Hyperglycaemia
How do beta blockers work?
What are side effects?
Where is it contraindicated?
- B1 receptors: increases heart rate and force of contraction
- Baroreceptors sense vessel dilation and correlate this to blood pressure
- Beta blockers block the B1 receptors in the heart, decreasing cardiac output
- Blocks CNS sympathetic outflow: inhibits renin release
Side effects:
• Bradycardia
• Hypotension, and atrioventicular (AV) nodal conduction block.
Contraindications:
• Bronchoconstriction: contraindicated in Asthma
• Hypotension: contraindicated in diabetic patient due to mask of hypoglycaemia
The “lol” drugs belong to ……………
Beta blockers
The dental side effects of postural hypotension is caused by which drug?
Beta blockers
Which medications increase BP?
· Noradrenaline reuptake inhibitors · Epinephrine · Amphetamines · NSAIDs · Corticosteroids · Oral contraceptive pill
What are nitrates used for? What are they?
· Nitrodilators are drugs that mimic the actions of Nitric Oxide (NO) by releasing NO or forming NO within tissues
Helps relieve angina
· Nitratesdilate the arteries and the veins in the heart and entire body. Holistically, this reduces the stress on the heart = improves angina
