Medications

Question 1

What do you use anti-platelets for and an example

Answer 1

reduce chance of stroke and heart attack
STEMI & NSTEMI
Coronary stents (do not stop anti-platelets for dental procedures with these)
Stable angina

Patients on dual anti-platelet therapy should be given proton pump inhibitors to prevent GI intestinal bleeding.

Aspirin, clopidogrel, dipyridamole

Question 2

What do you use statins for and example and side effect

Answer 2

Lipid lowering drugs - reduce cholesterol synthesis in liver.
For hypercholesterolaemia, prevention of atherosclerotic CV disease
Simvastatin

Side effect - dizziness, headaches.

Question 3

Beta blockers use, example and side-effect

Answer 3

Treat HIGH BP - they Lower BP
They reduce heart muscle excitability and reduce airway size.
STOP ARRHYTHMAIS - VF
Propanolol
Can cause postural hypotension and COPD & asthma contraindicator

Question 4

Diuretics use, example and side-effect

Answer 4

Treat HIGH BP and clear out excess fluid.
Used for heart failure - they cause excess urination and dehydration (offload salt and water)
Thiazide - bendroflumethiazide
Side-effect - dry mouth in elderly if excess fluid loss, gout and dehyfration

Question 5

Nitrates what they do exmaples and side effect

Answer 5

Angina relief - vasodilator
They reduce venous filling pressure.

GTN spray (short-acting)
Isosorbide mononitrate (long-acting) - prevention of angina pectoris long-term

Side-effect - headache, hypotension, arrythmias

Question 6

Calcium channel blockers

Answer 6

Hypertension treatment - Block Ca channels in smooth muscle in blood vessel walls – relaxation and vasodilation.
Nifidipine
Side-effect - gingival hyperplasia and postural hypotension.

Question 7

ACE inhibitors

Answer 7

Treat hypertension. Reduce BP - vasodilators
Heart failure
Enalapril
Side-effect - cough, potential hypotension & peripheral vascular disease

Question 8

Beta-2 agonists

Answer 8

BRONCHODILATORS - Relieve bronchoconstriction - asthma.
Short-acting = blue, salbutamol
Long-acting = green, preventative

Question 9

Corticosteroids action, example and side effect

Answer 9

reduces inflammation of bronchial walls.
Beclomethasone - brown inhaler.
Increased oral candidiasis risk

Question 10

How does warfarin work?

Answer 10

Inhibits the synthesis of Vitamin K dependant clotting factors through inhibition of vitamin K

Question 11

What CV problems should you treat warfarin with and some side-effects of it?

Answer 11

Atrial fibrillation
Heart valve disease
Heart valve replacements
Thrombophilia
DVT

Side effects - Haemorrhage

Question 12

NOAC how they work and example

Answer 12

They act as factor X inhibitors

Apixaban (twice daily), rivaroxiban (once daily)

Question 13

Benefits of NOAC’s for Dentistry

Answer 13

Predictable bioavailability
No significant dentistry drug interactions
Short duration of action (effect lost within a day - means you can carry out procedures without stopping the medication)
May only be a short course (particularly for DVT) so can just prolong extractions

Question 14

What does tranexemic acid do and what does it treat?

Answer 14

Fibrinolysis inhibitor - keeps any clot that is formed. Used to treat mild haemophilia A (factor 8 deficiency)

Question 15

What does DDAVP do and what does it treat?

Answer 15

DDAVP displaces factor 8 that is bound to the vascular wall into circulation.

Used to treat mild haemophilia A and Von Willebrand’s disease.

Question 16

What is a lichenoid reaction and what medications can cause it?

Answer 16

White substance on oral mucosa that can be scraped off.
Caused by most drugs that can cause xerostomia - NSAID’s, ACE inhibitor, proton pump inhibitor, anti-histamines.