-
List the adverse effects of Thiazide Diuretics
- Slight Xerostomia
- Low K+ and Na+
- Oral mucosal lesions
- High uric acid and Blood sugar
- NSAIDs decrease effectiveness
-
List the diagnostic criteria for hypertension
- Normal = <120 and <80
- Prehypertension = 120-139 or 80-89
- Stage 1 Hypertension = 140-159 or 90-99
- Stage 2 Hypertension = 160+ or 100+
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List the adverse effects of Loop Diuretics
- Severe Xerostomia
- Oral lichenoid lesions
- Low K+
- High uric acid and Blood sugar
- Dehydration
- NSAIDS decrease effectiveness
-
List the adverse effects of ACE inhibitiors
- "Burning mouth Syndrome" w/in the first 3 months
- Angioedema w/in the first 3 months
- Chronic dry cough in 4-12% of pts.
- Chronic NSAIDs decrease effectiveness
- Orthostatic Hypotension
- Drug induced oral lesions
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ARBs lack the _______ adverse effect shown in ACEi's
cough
-
ARB's end in_____________.
sartan
-
ACEi's end in_____________.
pril
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Some K+ sparing diuretics are:
- Amiloride
- Spironolactone
- Eplerenone
- Triamterene
-
Thiazide diuretics:
- Chlorothiazide
- Hydrochlorothiazide
-
Loop Diuretics:
- Furosimide
- Torsemide
- Bumetanide
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What are the 2 major dental implications of Ca2+ channel blockers?
- Gingival overgrowth, 5-10% of pts.- need strict plaque control and "power chlorohexadine" bedtime rinse
- Interacts with Fentanil- causes extreme hypotension
-
alpha-1 agonists lead to
Vasoconstriction
-
beta-1 agonist leads to
Increased heart rate and contractility
-
beta-2 agonist leads to
vasodilation
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How many carpules of anesthetic with epi should be administered to a patient on propanolol?
- 2.5 carpules of 1:100,000 per 2 hour visit
- (nonselective beta-blocker)
-
How many carpules of anesthetic with epi should be administered to a patient on atenolol?
- up to 5 carpules of 1:100,000 per 2 hour visit
- (selective beta-1 blocker)
-
What are some considerations to take when treating a pateint with hypertension?
- morning appointments
- avoid lengthy appointments
- avoid intravascular injections
- avoid retraction cord with epinephrine
- use anxiolytics when indicated, benzodiazepines, NO2
-
At what blood pressure should a patient be refered to a physcian before any treatment can be done.
> 160 or >110
-
At what BP reading should a patient be refered to a physician but doesn't limit starting dental treatment?
- Prehypertensive pts up to stage 1 hypertension
- (121-159 and 81-109)
- Stage 2 patients should be refered before treatment
-
What is a potential interaction between beta blockers and epinephrine?
-
At what BP reading should a patient be sent to the ER?
- Systolic at or above 200
- Diastolic at or above 120
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