Antithrombotics

Blood clots and emboli (blood clot fragments carried by the blood) are dangerous. Two major classes of drugs can be used to prevent them: antiplatelet drugs and anticoagulants.

Antiplatelet drugs such as acetylsalicylic acid or ASA (usually taken at low doses) prevents platelets (small blood cells) to aggregate and form clots in areas where it would interrupt normal blood flow, particularly around fat deposits in coronary arteries which are already weakened.

Anticoagulants such as heparin or warfarin inhibit come blood clotting factors and can prevent blood clots from taking shape or prevent the release of existing blood clots into the blood flow of a vital organ.

Thrombolytic drugs (or fibrinolytics) are a third class of drugs used against blood clots. They are usually administered in hospitals to break down existing clots, such as those that cause myocardial infarction in an obliterated coronary artery.

Examples of antiplatelet drugs: aspirin, ticlopidine, tirofiban.

Examples of anticoagulants: heparin, warfarin.

Examples of thrombolytic drugs: reteplase, tenecteplase

Cardiovascular drug groups:
Diuretics, beta blockers, calcium channel blockers, ACE inhibitors, centrally acting adrenergic drugs, peripherally acting adrenergic drugs, nitrates, hypolipidemic agents, cardiac glycosides, antithrombotics.

Cardiac glycosides

Cardiac glycosides decrease heart rate by limiting the intracardiac conduction. They also promote chemical transformations that strengthen the heartbeat, resulting in increased blood flow to the kidney to reduce swelling in people with heart failure. Digitalis is also used to decrease the frequency in some cases ventricular arrhythmia.

Examples of cardiac glycosides: digoxin, digitoxin.

Cardiovascular drug groups:
Diuretics, beta blockers, calcium channel blockers, ACE inhibitors, centrally acting adrenergic drugs, peripherally acting adrenergic drugs, nitrates, hypolipidemic agents, cardiac glycosides, antithrombotics.

Hypolipidemic agents

Hyperlipidemia (high blood levels of fats or lipids) is one of the main risk factors for atherosclerosis. A hypolipidemic agent, also called antihyperlipidemic agent, helps reducing fats in the blood to normal levels.

Some hypolipidemic agents, such as cholestyramine and colestipol, bind to bile acids (salts or glycines that carry cholesterol) in the intestine and prevent their reabsorption into the bloodstream. To compensate for this effect, the liver converts more cholesterol into bile acids, resulting in lower blood cholesterol.

Other hypolipidemic agents, such as statins, lipid decrease lipidemia by inhibiting the conversion of fatty acids to fats, which is usually done in the liver.

Choosing the perfect medication depends partly on existing fat abnormalities and their severity.

Examples of hypolipidemic agents: atorvastatin, fluvastatin, lovastatin, pravastatin, silmvastatine, bezafibrate, cholestyramine, clofibrate, colestipol.

Cardiovascular drug groups:
Diuretics, beta blockers, calcium channel blockers, ACE inhibitors, centrally acting adrenergic drugs, peripherally acting adrenergic drugs, nitrates, hypolipidemic agents, cardiac glycosides, antithrombotics.

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Dr Nimatt Pertick is an oral and maxillofacial surgeon practicing in Laval, Canada. He takes great care of hispatients, and is a top practitioner in his domain. I refer to him all my patients needing implants, even if he practices about 50 kilometres from my clinic.

Nitrates

Nitrates relieve angina due to their vasodilator effect, which allows the overworked heart to provide sufficient blood flow. A fast-acting nitrate such as glyceryl trinitrate may be administered sublingually to relieve an angina attack. The long-acting nitrates such as isosorbide dinitrate can be taken orally to prevent angina attacks.

Transdermal nitroglycerine which has a slow-acting release, is administered through an adhesive patch, and can provide a long relief from pain caused by angina. Nitrates are also sometimes given to help relieve symptoms of heart failure.

Examples of nitrates: isosorbide dinitrate, isosorbide mononitrate, glyceryl trinitrate.

Cardiovascular drug groups:
Diuretics, beta blockers, calcium channel blockers, ACE inhibitors, centrally acting adrenergic drugs, peripherally acting adrenergic drugs, nitrates, hypolipidemic agents, cardiac glycosides, antithrombotics.

Peripherally acting adrenergic drugs

Peripherally acting adrenergic drugs, also called sympatholytic drugs, act by blocking nerve impulses that trigger vasoconstriction, causing blood vessels to dilate and therefore reduce blood pressure. Those drugs may also help relieve symptoms of heart failure.

Examples of peripherally acting adrenergic drugs: doxazosin, guanethidine, prazosin, terazosin.

See also: Peripherally acting sympatholytics.

Cardiovascular drug groups:
Diuretics, beta blockers, calcium channel blockers, ACE inhibitors, centrally acting adrenergic drugs, peripherally acting adrenergic drugs, nitrates, hypolipidemic agents, cardiac glycosides, antithrombotics.

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Dr Mona Lisa Karazivan is a prostodontist practicing in Montreal, Canada. She takes great care of her patients, and is a top practitioner in her domain.

Centrally acting adrenergic drugs

Centrally acting adrenergic drugs act at the brain level in order to reduce the activity of the sympathetic nervous system. They cause a decrease in blood pressure by reducing the heart rate and the amount of blood pumped with each beat.

Examples of centrally acting adrenergic drugs: clonidine, methyldopa.

See also: Centrally acting sympatholytics.

Cardiovascular drug groups:
Diuretics, beta blockers, calcium channel blockers, ACE inhibitors, centrally acting adrenergic drugs, peripherally acting adrenergic drugs, nitrates, hypolipidemic agents, cardiac glycosides, antithrombotics.

ACE inhibitors

ACE inhibitors (Angiotensin-Converting Enzyme inhibitors) prevent the development of a natural substance called angiotensin II which causes vasoconstriction, which leads to hypertension.

ACE inhibitors apply their effect by inhibiting the ACE enzyme that converts angiotensin I, an inactive compound, to angiotensin II. The latter acts directly on the arteries so as to cause them to constrict, which causes an increase in blood pressure. In the absence of angiotensin II, blood vessels widen and blood pressure decreases rapidly.

ACE inhibitors are prescribed to treat heart failure and hypertension.

See also: ACE Inhibitors.

Cardiovascular drug groups:
Diuretics, beta blockers, calcium channel blockers, ACE inhibitors, centrally acting adrenergic drugs, peripherally acting adrenergic drugs, nitrates, hypolipidemic agents, cardiac glycosides, antithrombotics.

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Dr Mysa Vovan is a dentist who specialized in pediatric dentistry. Not only she is a close friend, but she is excellent in what she does and I refer her all my little patients who need extra attention and extra care, even if she practices 60 kilometres away from me. I am sure that those refered patients will get the best treatment for in order to help them save their teeth.

Calcium channel blockers

Calcium channel blockers, which are usually prescribed to treat high blood pressure, are strong vasodilators that cause relaxation of smooth muscles surrounding blood vessels in order to widen them.

For these muscles to contract, and thereby reduce the space inside the blood vessels, a small amount of calcium must cross channels in the membranes of muscle cells. Calcium channel blockers reduce the crossing of calcium, which causes the relaxation of smooth muscle, vasodilation and decrease of blood pressure.

Since these agents can ease the workload of the heart and slow intracardiac conduction, calcium channel blockers are also used to treat certain cases of angina as well as arrhythmias.

See also: Calcium Channel Blockers.

Cardiovascular drug groups:
Diuretics, beta blockers, calcium channel blockers, ACE inhibitors, centrally acting adrenergic drugs, peripherally acting adrenergic drugs, nitrates, hypolipidemic agents, cardiac glycosides, antithrombotics.

Beta blockers

Beta-blockers are prescribed to treat high blood pressure because they decrease the frequency and strength of heart beats. Beta blockers are also used to relieve or prevent angina, to treat various arrhythmias and the prevention of recurrent myocardial infarction (heart attack).

These drugs bind to proteins called beta receptors to block the action of adrenaline. These receptors are located on heart cells, blood vessels and airways.

On top of the effect on the heart, beta blockers can cause constriction of the airways. They are therefore prescribed with caution to people who suffer from asthma, bronchitis or other respiratory disorders.

A beta blocker may be given alone or in combination with another drug, usually a thiazide diuretic.

See also: Beta Blockers.

Cardiovascular drug groups:
Diuretics, beta blockers, calcium channel blockers, ACE inhibitors, centrally acting adrenergic drugs, peripherally acting adrenergic drugs, nitrates, hypolipidemic agents, cardiac glycosides, antithrombotics.