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pharmacology dentistry > lecture 8 > Flashcards

lecture 8 Flashcards

1
Q

major modifiable risk factor for CV disease is ?

A

hypertension

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2
Q

HYPER TENSION increases the risk of CV diseases as?

A

(myocardial infarction,

heart failure)and stroke

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3
Q

Sustained arterial hypertension damages blood vessels of which organs ?

A

brain, kidney, heart.

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4
Q

Secondary hypertension percentage and examples ?

A

5-10%

  1. Renal artery stenosis
  2. Pheochromocytoma
  3. Drugs
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5
Q

how Glucocorticoids may lead to hypertension ?

A

they have the ability to cause sodium and water retention

this will increase the blood volume that will increase BP

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6
Q

Drug- Induced hypertension

A 
• Oral contraceptives.
 • NSAIDs.
 • Sympathomimetic
 OTC cold medication 
 • excessive doses of caffeine.
 • Glucocorticoids
 • Liquorice  عرق سوس
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7
Q

curable / non :
essential HTN
non-essential HTN

A

non curable

may be curable by either surgery or remove the drug -stop it

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8
Q

stroke time depends on

A

 Heart Rate
 Contractility
 Filling Pressure- preload

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9
Q

main drugs that reduces HTN

A 
beta &alpha blockers
RAAS
CCD (Ca)
diuretics
direct VD
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10
Q

If primary HTN , initiate lifestyle changes how ?

A

smoking cessation, weight loss, diet,

stress reduction , less alcohol

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11
Q

Diuretics adv [3]

A

safe
inexpensive
effective in preventing stroke, myocardial infarction, and heart failure.

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12
Q

Type of diuretics:

name -efficacy-example-act on

A

1) Loop Diuretics (high efficacy ): furosemide (Lasix)- loop of henle
2) Thiazides Diuretics ( moderate efficacy): Hydrochlorothiazide-DCT
3) Potassium-sparing Diuretics (low efficacy) : spironolactone-collecting duct

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13
Q

the diuretic drug that it is use in initial therapy or hypertension is ?

A

thiazides diuretics

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14
Q

Indicated in mild to moderate HT

A

just thiazides

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15
Q

in severe HTN combination drug of ?

A

sympathoplegic , Angiotensin antagonist & vasodilator drugs

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16
Q

respond to thiazide diuretics reduce the blood pressure within about

A

4–6 weeks

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17
Q

case of using loop Diuretics

A

when fluid overload in the body such as pulmonary

edema→ the cause it heart failure

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18
Q

Favorable indication for thiazide:

A

❑ HTN with osteoporosis.
❑ HTN with recurrent renal stones.
Thiazides are sometimes useful in the prevention of calcium-containing kidney stones

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19
Q

Favorable indication for loop:

A

Fluid overload: heart failure ,renal disease -pulmonary edema

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20
Q

Hypokalemia needs to be avoided

how ?

A

combining a thiazide with inhibitors of the RAS or with a K+-sparing diuretic

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21
Q

Hypokalemia (cause by loop and thiazide) increases the risk of

A

drug-induced ventricular tachycardia
the risk for ischemic ventricular fibrillation
the leading cause of sudden cardiac death
major contributor to cardiovascular mortality in treated hypertensive patients.

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22
Q

S.E of loop diuretics :[3]

A

Hypocalcaemia. (inhibit Ca2+ reabsorption)
Hypokalemia.
Ototoxicity: transient and occur with rapid IV infusion

23
Q

case of using loop Diuretics

A

when fluid overload in the body such as pulmonary edema→ the cause it heart failure

24
Q

______diuretics are commonly used in HTN

A

thiazide

25
Q

Spironolactone :
is_____ _/agonist
benefit
S.E

A

~aldosterone antagonist
~diminishing the cardiac remodeling that occurs in heart failure
~Hyperkalemia-gynecomastia in males and menstrual irregularities in females-nasea

26
Q

gynecomastia in males and menstrual irregularities in females is a side effect of _____ drug

A

Spironolactone

27
Q

Some ___ blockers have been shown to reduce mortality after MI, in
patients with heart failure

A

beta

28
Q

In severe HTN _blockers are especially useful in preventing the reflex
tachycardia that often results from treatment with direct vasodilators

A

β

29
Q

______ is recommended therapy for hypertension when concomitant heart disease is present ( stable angina, SVT, post MI)

A

β blockers

30
Q

contraindications of beta blockers?

A

asthma patient

31
Q

Cardio-selective beta blockers are used for asthma patient

A

metoporolol
atelol
nebivolol

32
Q

patients with hypertension and heart failure we use

A

metoprolol

33
Q

example of single-pill combination

A

Tenoretic

34
Q

Tenoretic is combination of

A

Tenormin + diuretic Thiazide

35
Q

the management of heart failure as[ have both β-blocking and vasodilating effects]
1- cardio-selective blocker(beta1blocker) :
2-Non-selective (beta and alpha1) :
3-

A

1-Nebivolol,

2-Labetalol & Carvedilol

36
Q

beta blocker Favorable indication:

A
  • Hyperthyroidism.
    • Essential tremor
    • Migraine
37
Q

Verapamil+ B-Blocker causes ? may lead to ?

A

-ve inotropic and chronotropic effects.

This canlead to cardiac arrest

38
Q

DM patients shouldn’t be given____ , because it will increase the hypoglycemia.

A

beta blocker

39
Q

bronchial asthma patients shouldn’t be given ______ because it leads to bronchoconstriction

A

beta blocker spc 2

40
Q

some patients bradykinin can lead to angioedema that can be treated by ?

A

Ep

41
Q

first-line in hypertensive diabetic patients is ?

A

ACEi /ARB

42
Q

Indications of ACE inhibitors

A

1-Chronic Heart Failure (DOC)
2-Hypertension.
3-Drug of choice in progressive renal insufficiency, diabetic nephropathy.(nephroprotective
effect of ACEI).
• Slow the progression of diabetic nephropathy and decrease albuminuria

43
Q

Contraindications of ACEi

A

1- Pregnant women (they are fetotoxic drugs, lead to renal toxicity in fetus).
2- Bilateral renal stenosis

44
Q

for hypertension and angina

A

CCD DRUGS

45
Q

to treat angina and supraventricular tachyarrhythmia and prophylaxis of migraine and cluster headaches

A

Verapamil (Non-dihydropyridine)

46
Q

The most common tocolytic agents used for the treatment of preterm labor

A
  • Nifedipine(Dihydropyridine)
47
Q

Therapeutic uses of CCB

A

 Hypertension
 Angina
 Arrhythmias

48
Q

drug may cause gingival hyperplasia

A

(Nifedipine )

49
Q

Verapamil and diltiazem should be avoided in patients with

A

congestive heart failure or

with AV block

50
Q

treatment of mild-moderate hypertension in pregnancy

A

methyldopa

51
Q

Clonidine is used in case of

A

resistance hypertension

52
Q

Treatment of hypertension complicated by ___disease

A

renal

53
Q

_____is similar to clonidine, but with reduced adverse effects

A

Moxonidine

54
Q

Topical _____ is used as a stimulant to hair growth for correction of baldness

A

minoxidil

pharmacology dentistry (14 decks)

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