Cardiovascular drugs

Question 1

primary prevention

Answer 1

stopping the disease before it happens
patient is risk assessed and decision made if medical intervention needed
often patients not willing enough to change lifestyle

Question 2

secondary prevention

Answer 2

occurs after event - patient modifies lifestyle and preventative drugs

Question 3

anti platelets

Answer 3

decreased platelet aggregation therefore increased bleeding time at time of trauma as no platelet plug is formed
examples = aspirin, clopidogrel

Question 4

anti coagulants

Answer 4

inhibit the clotting cascade, bleeding time at point of trauma will be unaffected as platelet plug sitll formed however since there will be no clotting cascade the pllug will not be stabilised and will breakdown over a few hours
local haemostatic measures should be used if performing invasive/ traumatic dentistry e.g an extraction
example = warfarin

Question 5

local haemostatic measures

Answer 5

designed to promote blood coagulation
fibrinogen activator
LA with vasoconstrictor

Question 6

warfarin

Answer 6

common anti coagulant
always assume drugs interact with warfarin until proven otherwise
initially on warfarin hypercoagulation can occur as some clotting factors inhibited faster than others so for the first couple of days heparin may be used in conjunction to combat this

Question 7

INR

Answer 7

international normalised ratio
measures how long blood takes to clot
state of health = 1

Question 8

what should warfarin patients INR be

Answer 8

between 2 - 4

Question 9

NOAC

Answer 9

new oral anti coagulants
no significant reactions with any other drugs
short half life so effects dont last
often only a short course of treatment

Question 10

statins

Answer 10

lipid lowering drugs
inhibit cholesterol synthesis in the liver
example = atorvastatin

Question 11

beta blockers

Answer 11

either selective - only act on beta 1 receptors or non -selective - work on both beta 1 and beta 2 receptors
prevent increased heart rate - however decrease heart efficiency and make asthma worse
risk of postural hypertension when getting out of dental chair
examples = atenolol (all end in - olol)

Question 12

diuretics

Answer 12

remove salt and water from the body therefore reduce plasma volume and cardiac workload

Question 13

Nitrates

Answer 13

short acting often for emergency management of angina pectoris
long acting often for prevention of angina pectoris
act by dilating veins and resistance arteries

Question 14

calcium channel blockers

Answer 14

hypertension and migraine treatment - lower blood pressure
block Ca channels in smooth muscle - preventing calcium from entering the cells of the heart and arteries. Calcium causes the heart and arteries to squeeze (contract) more strongly. By blocking calcium, calcium channel blockers allow blood vessels to relax and open.
can cause gingival hyperplasia if poor OH

Question 15

ACE inhibitors

Answer 15

(angiotensin converting enzymes)
inhibit conversion of angiotensin 1 to angiotensin 2 therefore inhibiting the aldosterone dependent resorption of salt and water therefore reduces BP
examples = enalapril (end in pril)