Term
| What does perio lead to increased secretion of that can cause heart problems? |
|
Definition
|
|
Term
| What is primary(idiopathic) hypertension? How common is it? |
|
Definition
-85% of cases
-do not know what causes it |
|
|
Term
| What is secondary hypertension related to? How common? |
|
Definition
-10%
-related to another health condition |
|
|
Term
| What is malignant hypertension? How common is it? |
|
Definition
-5%
-very high blood pressure that is hard to control |
|
|
Term
| What are some of the first line treatments for hypertension? |
|
Definition
-weight reduction
-diet change
-increase exercise
-stop smoking
-decrease stress |
|
|
Term
|
Definition
-work in kidneys, increase excretion of fluid
-increased water comes out of blood into filtrate
-loss of water from blood causes decreased blood volume
-lower blood volume puts less pressure on blood vessels(lower blood pressure) |
|
|
Term
| What are the 2 types of diuretics? Where do they work? |
|
Definition
1.thiazide- distal nephron
2.loop-loop of henle
3.potassium-sparing work in the distal nephron
4.osmotic |
|
|
Term
| How do thiazide diuretics work? |
|
Definition
-prevent reabsorption of Na+ from filtrate
-water stays in filtrate with Na+ |
|
|
Term
| What is an example of a thiazide diuretic? |
|
Definition
| hydrochlorothiazide(Hydrodiuril) |
|
|
Term
| How do loop diuretics work? |
|
Definition
| prevent active transport of Na+ out of filtrate |
|
|
Term
| What are 2cdrug examples of a loop diuretic? |
|
Definition
1.furosemide(Lasix)
2.bumetanide(Bumex) |
|
|
Term
| How does a potassium diuretic work? |
|
Definition
-weak
-have reduced K+ loss
-decreased absorption of Na+ |
|
|
Term
| What are 2 examples of potassium diuretics? |
|
Definition
1.spironolactone(Aldactone)
2.triamterene(Dyrenium) |
|
|
Term
| How do osmotic diuretics work? |
|
Definition
| do not work on ion, prevent reabsorption of water by administering things that cannot be reabsorbed |
|
|
Term
| What is a drug example of a osmotic diuretic? |
|
Definition
|
|
Term
| What are 2 blockers that treat hypertension? |
|
Definition
-B blockers(selective and non selective)
-A and B blockers |
|
|
Term
| How do B-blockers reduce blood pressure? |
|
Definition
| prevent vascoconstriction and increased heart rate associated with sympathetic activation |
|
|
Term
| What is an example of a nonselective beta blocker used to treat hypertension? What is the bad thing about this drug? |
|
Definition
-propanolol(Inderal)
-more likely to interact with epinephrine |
|
|
Term
| What are 3 examples of a B-1 specific blocker drugs that treat hypertension? |
|
Definition
1.metoprolol(Lopressor, Troprol-XL)
2.nebivolol(Bystolic)
3.bisoprolol(Monocor) |
|
|
Term
| How do a/b blockers treat hypertension? Who is this better for? 2 examples |
|
Definition
-reduced peripheral resistance and b blocker function -better for ppl that b-blockers alone do not work well for
-labetalol(Trandate) & carvedilol(Coreg) |
|
|
Term
| How do Ca2+ channel blockers work to reduce hypertension? |
|
Definition
-prevent movement of Ca2+ into muscle cells
-relaxes vascular smooth muscle
-decreases contraction rate of heart |
|
|
Term
| What are some drug examples of Ca2+ blockers? |
|
Definition
-verapamil(Isoptin)
-amoldipine(Norvasc)
-nifedepine(Procardia) |
|
|
Term
| What are some adverse reactions of Ca channel blockers? |
|
Definition
-hypotension
-heacdache
-GI distress
-cardiovascular effects
-dysgeusea
-gingival enlargement |
|
|
Term
| How do ACE inhibitors work? |
|
Definition
-liver produces angiotensinogen
-kidneys release renin, this converts angiotensinogen to angiotension I
-ACE emzymes convert angiotension I to angiotension II
-this them causes whole body vascoconstriction
**ACE inhibitors block this ACE enzyme** |
|
|
Term
| What are 3 examples of ACE inhibitors? |
|
Definition
1.enalapril(Vasotec)
2.captopril(Capoten)
3.Benazepril/amoldipine(Lotrel) |
|
|
Term
| What are some adverse reactions of ACE inhibitors? |
|
Definition
-CNS
-cardiovascular
-nephrotoxicity
-GI distress |
|
|
Term
| What preg. cat are ACE inhibitors? What drugs do they interact with? |
|
Definition
-preg cat D(causes kidney problems in infant)
-interact with NSAIDS(they increase blood pressure, countereffective) |
|
|
Term
| How do angiotension II receptor antagonists work? |
|
Definition
| block angiotension II from binding to receptors- ANTAGONIST |
|
|
Term
| What are some examples of angiotension II drugs used to treat hypertension? (5) |
|
Definition
1.olmesartan(Benicar)
2.irbesartan(Avapro, Avalide)
3.losartan(Cozaar)
4.valsartan(Diovan)
5.valsartan/amlodipine(Exforge) |
|
|
Term
| What are some adverse reactions to angiotension II receptor antagagonists? |
|
Definition
-fewer than ACE inhibitors(works downstream)
-CNS effects
-GI distress
-teratogenicity |
|
|
Term
| What is an a-receptor blocker used for hypertension treatment? |
|
Definition
|
|
Term
|
Definition
| causes peripheral vasodilation through action on a-receptors via CNS mediated pathway |
|
|
Term
| What is a hypertension medication used during pregnancy? How does it work? |
|
Definition
-hydralazine(Apresoline)
-direct vasodilator of arterioles |
|
|
Term
|
Definition
| decreased blood flow to the myocardium that causes pain |
|
|
Term
| Where is the pain for angina typically felt? |
|
Definition
| left chest, left arm, left shoulder, back, neck, mandible |
|
|
Term
| What are the treatments for angina? |
|
Definition
|
|
Term
| What can acute angina attack be caused by? |
|
Definition
| stress, anxiety, exercise |
|
|
Term
| What are the treatment for acute angina? |
|
Definition
| nitroglycerin and related drugs |
|
|
Term
| How does nitroglycerin work? How is it administered? |
|
Definition
-smooth muscle vasodilators that increase blood supply to the myocardium
-typical administration is sublingial or spray(onset in 1-2 mins) |
|
|
Term
| What are the adverse reactions and drug interactions of nitroglycerine? |
|
Definition
-severe headache, hypotension, syncope
-PDE5 inhibitors for erectile dysfunction (viagra, cialis are vasodilators) |
|
|
Term
| What are some phophylactic treatments for angina? |
|
Definition
-Ca channel blockers
-b-blockers
-ranolazine(Ranexa)-vasodilator
-daily aspirin regimen(81 mg) |
|
|
Term
| Is ranolazine(Ranexa) as effective as nitroglycerine? |
|
Definition
| no, but it can help prevent an angina attack |
|
|
Term
| What can we pretreat patients with to reduce the risk of an angina attack? |
|
Definition
|
|
Term
| What do we do if our patient has an angina attack? |
|
Definition
-ask if they have used PDE5 in last 24 hours
-give up to 3 treatments at 5 min intervals until pain subsides
-take to ER if it is not better by the |
|
|
Term
| What is congestive heart failure? |
|
Definition
-ventricles are stretched out due to structural abnormalities, injection, or infection
-cannot effectivly pump blood
-reduced cardiac output and circulation |
|
|
Term
| What is left side failure? Right side failure? |
|
Definition
left-pulmonary edema
right-peripheral edema |
|
|
Term
|
Definition
| when the left ventricle fails blood backs up into the left artery and lungs, this makes fluid from the blood build up in the lungs |
|
|
Term
| What is peripheral edema? |
|
Definition
| when the RV fails blood backs up into the circulatory system, causes fluid in tissues |
|
|
Term
| What is a common drug to combat heart failure? |
|
Definition
|
|
Term
| How does digoxin(Lanoxin) work?> |
|
Definition
-increases strength of heart contractibiliy(does not increase oxygen demand)
-can push accumulated blood out of heart |
|
|
Term
| What does this cause? What is the intial response from taking digoxin? |
|
Definition
-increase cardiac output, heart muscle may recover
-initial response is tachycardia followed by bradycardia as heart becomes more efficient |
|
|
Term
| What does digoxin(Lanoxin) decrease? Does it effect the kidneys? |
|
Definition
-edema
-no direct effect of kidneys |
|
|
Term
| What are some adverse reactions to digoxin(Lanoxin)? |
|
Definition
-GI distress
-cardic arrhythemias(especially when used in combination with diuretics)
-neurologic signs
-drug interations(epinephrine) |
|
|
Term
| What are some dental practice modifications we need to make for patients taking digoxin(Lanoxin)? |
|
Definition
-monitor pulse
-be aware of and prepared for GI distress
-use epinephrine sparingly
-increased gag and salivation |
|
|
Term
| What are some other drugs used to treat heart failure? |
|
Definition
-ACE inhibitors
-Angiotension II receptor blockers
-B blockers
-loop diuretics
-aldosterone antagonists |
|
|
Term
| How do aldosterone antagonists work? What are 2 examples of this? |
|
Definition
-prevents fluid retention in the body
-spironolctone(Aldactone), epelrenone(Inspra) |
|
|
Term
| What is a cardiac arrhythmia? What can they lead to? |
|
Definition
-abnormal beating of the heart(atrial or ventricular)
-can lead to brady or tachycardia |
|
|
Term
| What does the mechanism of action of the drug used to treat arrhythmias depend on? |
|
Definition
| type of arrhythmia being treated |
|
|
Term
| How do class I drugs that treat arrhythmias work? What are some examples? |
|
Definition
-block Na+ channel opening
-quinidine, procainamide (Pronestyl), lidocaine(Xylocaine) |
|
|
Term
| How do class II drugs that treat arrhythmias work? |
|
Definition
| b-blockers that decrease sympathetic action on the heart |
|
|
Term
| How do class III drugs that treat arrhythmias work? examples? |
|
Definition
-block K+ channel opening
-amiodarone(Pacerone), dofetilide (Tikosyn) |
|
|
Term
| How do class IV drugs that treat arrhythmias work? |
|
Definition
| block Ca2+ channel opening, decreases rate of contraction |
|
|
Term
| What is VLDL, HDL, LDL? Which is good, which is bad? |
|
Definition
-very low density lipoprotein (BAD)
-high density lipoprotein (GOOD)
-low density liporpotein (BAD) |
|
|
Term
|
Definition
|
|
Term
| What is the first line treatment for hyperlipidema? |
|
Definition
| life-style changes(dietary changes, exercise, reduced alcohol, no smoking) |
|
|
Term
| What are HMA-CoA reductase inhibitors (statins) used for? |
|
Definition
| -very effective cholesterol lowering drugs that stimulate LDL receptors, therefore increasing the clearance of bad cholesterol(30-40A% decrease in LDL in 4-6 weeks) |
|
|
Term
| What are some examples of statins? |
|
Definition
-atorvastatin(Lipitor)
-pravastatin(Pracachol)
-simvastatin(Zocor)
-rosuvastatin(Crestor) |
|
|
Term
| What can simvastatin(Zocor) be used in combination with? |
|
Definition
|
|
Term
| What is the combination known as? Does this medicine reduce the chances of heart attach than the two meds alone? |
|
Definition
| Vytorin, no decreases the cholesterol more but changes for heart attack do not go down |
|
|
Term
| What are bile-acid binding resins? |
|
Definition
another drug treatment for hyperlipidemia that works in the digestive tract
-bind to preformed bile acids so they cannot be reabsorbed into small intestine
-then cholesterol is taking from circulation to make more bile acid |
|
|
Term
| What are some drug examples of bile-acid binding resins? |
|
Definition
-cholestyramine(Questran)
-colestipol(Colestid)
-colesevalam(Welchol) |
|
|
Term
| Is the patient compliance with bile-acid binding resins good? Why? |
|
Definition
| no bad side effects like diarrhea/ constipation |
|
|
Term
| What are some other drug treatments for hyperlipidemias? |
|
Definition
|
|
Term
| What is an example of niacin? What it is? How does it work? |
|
Definition
-Niaspan
-vitamine b3
-blocks fat breakdown
-decreases VLDL/LDL by decreasing trichyceride levels and increases HDL |
|
|
Term
| What are some examples of fibrates? |
|
Definition
-gemfobrozil(Lopid)
-fenofibrate(Trilipix, Tricor) |
|
|
Term
| How do fibrates work? What can they cause? |
|
Definition
-increases synthesis of enzymes that breakdown fats(decrease trigylceride levels)
-can cause gallstone formation |
|
|
Term
| Who are fibrates contradicted for? |
|
Definition
| patient with hepato or nephrotoxocity |
|
|
Term
| What is caduet? Who is it used for? |
|
Definition
-used for people with combination of cardiovascular disorders
-combination of atorvastatin (treats hyperlipidema) and amoldepine (CC blocker that treats hypertension) |
|
|
Term
| When does excessive clotting occur? What can this cause? |
|
Definition
-when the blood vessel wall becomes rough
-leads to stroke and or embolism |
|
|
Term
| What causes clotting deficiencies? |
|
Definition
| genetic disorders and certain medications |
|
|
Term
| What is an anticoagulant used to treat excessive clotting? |
|
Definition
|
|
Term
|
Definition
| -prevents formation of new clotting factors, there is no effect on the current ones who have a lifespan of about a week |
|
|
Term
| How is warfarin(Coumadin) administered? What is the onset of action like? |
|
Definition
-orally
-delayed onset and end of action |
|
|
Term
| What are some adverse reactions, drug interactions, and dental accomodations for patients taking warfarin(Coumadin)? |
|
Definition
-bleeding/hemmorhage
-aspirin(except 81 mg/day), NSAIDs, antibiotics
-we have to weigh benefits of stopping warfarin vs the risks of uncontrolled bleeding |
|
|
Term
| What is a drug that is like warfarin but not as strong that is administered with a daily 81 mg aspirin? |
|
Definition
|
|
Term
| What are some other anticoagulants used to treat excessive clotting? |
|
Definition
-enoxaparin(Lovenox)
-dipyridamole+aspirin(Aggrenox)
-bivalirudin(Angiomax) |
|
|
Term
| What is a medication for excessive clotting that is reserved for people at higher risks of heart attacks/strokes? |
|
Definition
|
|
Term
| What is an example of a medication used to treat excessive clotting that is only administered parenterraly? |
|
Definition
| heparin, administered parenteraly into stomach |
|
|
Term
| How do drugs that increase clotting work? What can they be used for? |
|
Definition
-prevent fibrin breakdown to increase clotting
-can be used for postoperative bleeding |
|
|
Term
| What are 2 drugs that increase clotting? |
|
Definition
-aminocaporic acid(EACA, Amicar)
-tranexamic acid(Cyklokapron) |
|
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