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BDS 2 BAMS > Cardiovascular System > Flashcards

Flashcards in Cardiovascular System Deck (78)
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name some reversible risk factors for CVD

obesity, exercise, smoking, diet


name some irreversible risk factors for CVD

genetics, family history, age, gender


what onsets of CVD are reversible

hypertension, hyperlipidaemia, diabetes


what are the two stages of prevention and what is more likely

primary - preventing before onset of disease
secondary - making modifications after disease eg stroke, MI, claudification, secondary is more likely


what stage of prevention is a dentist important in

primary, the dentist see's patients for regular check ups when they are healthy, health promotion is crucial in primary prevention


what are the different ways to prevent disease

lifestyle change - exercise, stop smoking, change diet
or drugs - need to weigh up the benefit of the drug and see if it is worth the risks


what drugs are involved in preventing onset of diseaes

lipid lowering, anti-platelets, anti-coagulants


what drugs are involved in reducing the symptoms of disease

ACE inhibitors, diuretics, beta blockers


name an anti-platelet drug and how does it work

aspirin, prevents platelet aggregation. damages platelets irreversibly but these only live for a week so needs to be taken daily to catch any new ones. platelets can aggregate on blood vessel walls, making the lumen narrower and restricting blood flow, resulting in hypertension. aspirin can be used in conjunction with clopidogrel however, more used, harder it is to stop bleeding


name an anti-coagulant drug and how does it work

warfarin, blocks production of vitamin K thus stops production of vitamin K dependant clotting factors (2,7,9,10)


what are some problems with warfarin and what drugs cannot be used with warfarin

initially they cause hypercoagulation so needs to be used with herparin to stop this - patient must be hospitalised. also, can interact with so many drugs via plasma proteins which alters its bioavailability, therefore, dose might need changed regularly and patient must get INR checked regularly - should be between 2-4, cannot be used with antibiotics, NSAID and anti-fungals


what are the new anti-coagulant drugs

apixaban, more expensive but a predictable bioavailability, doesnt need constant checking or INR, can use antibiotics, local and anti-fungals but still cant use NSAID


name a lipid lowering drug and how does it work

simvastatin, prevents synthesis of cholesterol in the liver, reduces atherosclerosis, long acting drug, but cannot be used with anti-fungals


name a beta blocker and how does it work

prevents adrenaline binding to beta receptors. can be specific - just beta 1 on heart - atenolol. or non-specific, act on beta 2 in lungs and brain - makes asthma worse but can improve anxiety - propanolol.


why should we be cautious with patients on beta blockers

may be difficult for them to increase their heart rate, going from lying down to sitting up. may need an extra few minutes for blood pressure to return


name a diuretics and how does it work

furosemide, prevents reabsorption of fluid at the loop of henle. can reduce fluid retention which reduces blood pressure. but can off set electrolytes which would result in arrythmias


name a calcium channel blocker and how does it work

nifedipine, prevents smooth muscle contraction resulting in vasodilation which reduces hypertension. reduces resistance in arteries. can also act on heart to slow impulses - verapamil


what dental side affect is caused by calcium channel blockers

gingival hyperplasia


name an ACE inhibitor and how does it work

lisinopril, blocks angiotensin converting enzyme which prevents production of angiotensin 2. this is a potent vasoconstrictor. also stimulates production of aldosterone which causes fluid retention. thus blocking this reduces blood pressure


name a nitrate and how does it work

GTN, acts sub-lingually so avoids first pass metabolism, dilates veins - reduce pre load and dilates resistance arteries to reduce after load - for angina or hypertension


what investigations would need to be carried out if you were cautious of a patients ability to clot

FBC to check platelet numbers and an INR


why might a patient receive a blood transfusion

to receive clotting factors, if low RCC after trauma


why must blood be checked before transfusion

cross match the blood type ABO - A - a antigens so b antibodies, if wrong blood given, will attack the antigens on the surface of RBC


why are some complications of blood transfusions

heart failure due to increased volume, wrong blood type given resulting in jaundice, fever and possible death


define ischaemia

narrowing of a blood vessel, reducing the oxygen delivery to that area


how does ischaemia occur

build up of lipid in blood, becomes deposited on blood vessel walls, forms an atherosclerotic plaque on the blood vessel, resulting in narrowing of the lumen and reducing blood flow


give examples of ischaemic disease

angina pectoralis, transient ischaemic attack in brain


how does angina occur

heart receives blood supply from coronary arteries, these have no collateral supply or anastomses. when the heart contracts and the valves open, the coronary arteries are shut off, they only receive blood supply during diastole, therefore, if the coronary arteries have atherosclerosis and the heart is working harder (less time in diastole) it receives less oxygen than it requires


what is the difference between classical and unstable angina

classical - onset with increase in demand of heart eg exercise, unstable - happens randomly, no extra pressure on heart


what are signs and symptoms of angina

symptoms - chest pain, may radiate down back and jaw, nausea, shortness of breath, angiography - blockage in coronary artery