Cardiovascular Drugs

Question 1

what drugs are used to prevent further disease?

Answer 1

antiplatelets, lipid lowering, anti-arrhythmics, anticoagulants, diuretics, ACE-inhibitors

Question 2

what drugs are used to reduce symptoms of current disease?

Answer 2

diuretics, anti-arrhythmics, nitrates, calcium channel blockers, ACE-inhibitors

Question 3

what are the anti-platelet drugs?

Answer 3

aspirin, clopidogrel, dipyridamole

Question 4

what does aspirin do?

Answer 4

inhibit platelet aggregation

Question 5

what does clopidogrel do?

Answer 5

inhibit ADP induce platelet aggregation

Question 6

what does dipyridamole do?

Answer 6

inhibit platelet phosphodiesterase

Question 7

what are the effects of anti-platelet drugs?

Answer 7

significantly reduce chance of heart attack or stroke, prolong bleeding time after extraction

Question 8

how are anti-platelet drugs used?

Answer 8

in combination to increase the effect

Question 9

what are the oral anticoagulants?

Answer 9

warfarin, rivaroxiban, apixaban, dabigatran, edoxaban

Question 10

what does warfarin do?

Answer 10

inhibit synthesis of vitamin K dependent clotting factors

Question 11

what happens when initially prescribing warfarin?

Answer 11

hypercoagulation for 2-3 days so use heparin as well initially

Question 12

how is warfarin managed?

Answer 12

with INR test

Question 13

what is the desired INR value for a patient on warfarin?

Answer 13

2-4

Question 14

what are the dental cautions considering warfarin?

Answer 14

get INR test before procedures, local haemostatic measures, ID block, assume all drugs interact with warfarin

Question 15

if the patient is on a short course of new anti-coagulants what should you do?

Answer 15

postpone extractions until course stopped

Question 16

what are other drugs preventing CV disease?

Answer 16

statins, beta-adrenergic blockers, diuretics, calcium channel blockers, ACE inhibitors

Question 17

name 3 lipid lowering drugs

Answer 17

simvastatin, atorvastatin, rosuvastatin

Question 18

what do the statins do?

Answer 18

inhibit cholesterol synthesis in the liver

Question 19

what are the side effects of statins

Answer 19

myositis with some drug interactions including dental antifungals - fluconazole

Question 20

name 2 B blockers

Answer 20

atenolol, propranolol

Question 21

what do B blockers do?

Answer 21

stop arrhythmias leading to cardiac arrest and reduce heart muscle excitability, prevent increase in heart rate, reduce heart efficiency, block beta receptors in lungs

Question 22

what CVS disease can B blockers make worse?

Answer 22

heart failure due to reduced heart efficiency

Question 23

name the two types of diuretics

Answer 23

thiazide diuretics and loop diuretics

Question 24

what are diuretics used for?

Answer 24

antihypertension and heart failure

Question 25

what do diuretics do?

Answer 25

increase salt and water loss

Question 26

what are the side effects of diuretics?

Answer 26

can lead to Na/K imbalance if not monitored carefully

Question 27

what is the oral side effect of diuretics?

Answer 27

dry mouth

Question 28

what are the two types of nitrate?

Answer 28

short acting and long acting

Question 29

what is the commonly used short acting nitrate?

Answer 29

glyceryl trinitrate (GTN)

Question 30

what is the long acting nitrate?

Answer 30

isosorbide mononitrate

Question 31

what are nitrates used for?

Answer 31

short acting - emergency management of angina pectoris, long-acting - prevention of angina pectoris

Question 32

what do nitrates do?

Answer 32

dilate veins, dilate resistance arteries, dilate colateral coronary artery supply

Question 33

what is the effect of nitrates on the CVS

Answer 33

reduce preload to heart, reduce cardiac workload, reduce cardiac oxygen consumption, reduce anginal pain

Question 34

how do you administer GTN spray?

Answer 34

sublingual

Question 35

what are the side effects of nitrates?

Answer 35

headache and hypotension

Question 36

what do calcium channel blockers treat?

Answer 36

hypertension and migraines

Question 37

what do calcium blockers do?

Answer 37

block calcium channels in smooth muscle and cardiac muscle

Question 38

what is the effect of calcium channel blockers?

Answer 38

relaxation and vasodilation, slow conduction of pacing impulses

Question 39

give an example of a calcium channel blocker

Answer 39

nifedipine, amlodipine

Question 40

what can calcium channel blockers lead to?

Answer 40

gingival hyperplasia

Question 41

give 3 examples of ACE inhibitors

Answer 41

enalapril, ramapril, lisinopril

Question 42

what do ACE inhibitors do?

Answer 42

inhibit conversion of angiotensin 1 to angiotensin 2 and prevent aldosterone dependent reabsorption of salt and water

Question 43

what are the effects of ACE inhibitors?

Answer 43

reduced blood pressure, reduced excess salt and water retention

Question 44

what are the side effects of ACE inhibitors?

Answer 44

cough and hypotension

Question 45

what are the oral reactions with ACE inhibitors?

Answer 45

angio-oedema, lichenoid reaction