Hypertension and management of hypertensive patient in dentistry. Drug interaction and pre & postoperative consideration

Bindu Bisht

D.J College Of Dental Science And Research, India.

Abstract

Most of the times dentist plays the significant role in dignosing undetected hypertension in dental patient beside this Hypertensive drugs have oral manifestation and adverse effect on oral health .Many hypertensive drugs interaction causes serious life threatning complications. NSAID (aisprin and indomethacin in particular)reduce the antihypertensive effects of ACE inhibitors by blocking bradykinin mediated vasodilatation. NSAID inhibit the diuretic effects of thiazides and loop diuretics and antagonize the antihypertensive effect of β-Blockers . Use of guanethidine (an adrenergic neuron blocker and an antihypertensive drug ) on long term basis produces the sensivity to an exogenously administered epinephrine as present in local anaesthetic injection results in hypertension and cardiac arrhythmias.Non selective β-Blockers (propranolol) or mixed α and β-Blockers may rather enhance the pressure response to vasoconstrictor epinephrine resulting in hypertension

Avoid giving cephalosporin in dental infection cases to the patients on loop diuretics as it may increase the risk of renal toxicity of the cephalosporin secreted through kidneys

There are many adverse effect of hypertensive drugs on oral health, In a research among the gingival hyperplasia patients using antihypertensive drugs 71.1% were taking calcium channel blocker, 21.5% were taking ACE Inhibitors, and 7.4% were taking beta-blockers Antihypertensive drugs clonidine , α -methyldopa and prazocin causes xerostomia .ACE inhibitors causes dry cough in some patients. Dry cough during the dental treatment which affect the dental treatment success. A dry cough possibly the result of accumulation of bradykinin in the bronchial mucosa.

Conclusions:

By taking complete patient medical history and accurate treatment planning we ensure first step towards success of dental treatment and patient well being using diagnostic tools and test to accurately judge the medical condition i.e. taking blood pressure measurement ,potassium deficiency test, etc. taking consideration of time slot while giving dental appointment ,drug interaction consideration while prescribing NSAID or other antibiotics or giving LA cogitation of hypertensive condition during dental treatment may increase the percentage of success of treatment.

Biography:

Dr.Bindu Bisht, member of Indian society of dental traumatology, BDS, tobacco cessation counselor, practicing doctor in private practice. Practical experience of 7 years in dentistry, oral health counseling. Experienced in management of patient. Actively looking for Opportunities in advanced health care group. experienced dental surgeon with demonstrated history of working in health care industry, skilled in patient management, endodontics , extraction , prosthetics, cosmetics dentistry

Recent Publications:

1. Research in maxillofacial surgery

2. Dental opioid prescribing rates after the up-scheduling of codeine

3. Exposures to Dental Products, Stomatological Preparations, and in Dental Care and Toothache reported to the PIC Erfurt

4. Preventive effect of fluvastatin on the development of medication-related osteonecrosis of the jaw

5. Long-term impact of oral surgery with or without amoxicillin on the oral microbiome-A prospective cohort study