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Drugs effecting the CVS - Coggle Diagram

- - - - ADR/Dental Implications
        
        Common: myalgia, Rare: Rhabdomyolysis
        
        Avoid macrolides, metronidazole, and azole antifungals as there is a risk of statin toxicity
  - - - ADR/Dental Implications
        
        prevent absorption of vitamins and tetracycline, vitamin k is important in forming clots properly.
        
        nausea, indigestion, flatulence, constipation
  - - - ADR/Dental Implications
        
        Orthostatic hypotention
- - - - MOA
        Form Nitric Oxide, reduce levels of Ca2+, dilating the vessels
        
        ADR/Dental Implications
        
        headaches, hypotension, fainting
        
        Reflex tachycardia
        
        can be prevented if taken with beta-blockers
  - - - MOA
        Inhibits Na+ and K+ channels
- - - - MOA
        Have a negative ionotropic effect and reduce heart rate
        
        Non-Selective
        
        e.g. Propranolol, Nadolol
        
        e.g carvedilol mostly for CHF
        
        ADR/Dental Implications
        
        Bronchospasms, can worsen variant angina
        
        Using NSAIDs for a period of more than 5 days can reduce efficacy of beta-blockers
        
        Selective
        
        Angina: e.g. Atenolol, Metoprolol
        
        Caution when using with LAs containing vasoconstrictors,
    - - e.g. Nifedipine, Amlodipine, Verapamil, Diltiazem
        
        ADR/Dental Implications
        
        Cause reflex tachycardia, except Diltiazem
        
        Can cause gingival enlargement
        
        Verapamil and Diltiazem don't allow macrolides to be metabolized, can lead to toxicity
        
        Verapamil and Diltiazem don't allow metabolisation of benzodiazepines resulting in longer duration of sedation
        
        commonly: dizziness, headaches, hypotension, ankle edema, flushing
  - - - e.g. Bendroflumethiazide, Chlortalidone
        
        MOA
        lower BP by reducing blood volume, venous return, cardiac output, Peripheral resistance
        
        ADR/Dental
        Implications
        
        Hypokalemia, diabetes mellitus, high uric acid
      - Weak diuretic
        
        mainly for hypertention
    - - Strong diuretic
        
        e.g furesomide
        
        MOA
        decrease pre-load on the heart, useful for acute congestive heart failure
        
        ADR/Dental Implications
        
        Increased urination can disturb long dental procedures
    - - Weak diuretic
  - - - e.g. Doxazosin
        
        MOA
        Selectively binds and blocks the vascular a1 receptor, Induces vasodilation
    - - e.g.Minoxidil
    - - First line for CHF
        
        e.g. Lisinopril, Monopril
        
        MOA
        Prevent synthesis of Angiotensin II
        
        ADR/Dental
        Implications
        
        Hypotension, dry cough (due to increased bradykinins), Angioedema, Proteinuria, Neutropenia
    - - e.g. Losartan
        
        MOA
        Similar properties to ACE inhibitors, Without cough as side effects (not prevent bradykinin degradation)
    - - MOA
        dilates resistance vessels
        
        ADR/Dental
        Implications
        
        Reflex tachycardia and increase salt/water retention
        
        can take beta-blocker to help with tachycardia, and diuretics to prevent salt/water retention
  - - - MOA
        Decreases peripheral vascular resistance, Decreases production of Dopamine/Noradrenaline /Adrenaline
        
        ADR/Dental
        Implications
        
        sedation, depression,
        postural hypotension,
        dry mouth
- - - - e.g. Spironolactone, Epleronone
        
        MOA
        Inhibiting aldosterone prevents
        cardiac remodeling
    - - e.g. Dopamine, Dobutamine, Inodilators (Milrinone)
        
        MOA
        Affect myocardial contractility, and increase heart rate
      - short term
  - - - ADR/Dental
        implication
        
        GIT side effects, arrhythmia (life threatening)
        
        Avoid taking with: Macrolides, Tetracycline (can induce arrhythmia). Epinephrine, Anticholinergics (induce digoxin toxicity, arrhythmia due to decreased metabolism)
        
        Hypokalemia (ADR of Thiazide diuretics), hypomagnesemia, and hypercalcemia are at risk of Digoxin toxicity
        
        counteracted with digibind, or Atropine (anticholinergic) in case of AV block
  - - - ADR/Dental Implications
        
        inhibits metabolism of lidocaine
        
        interacts with Fentanyl, can cause bradycardia, sinus arrest, and hypotension