Hypertension, or high blood pressure, is a condition defined by persistently elevated blood pressure that puts stress on blood vessels and the heart. It has no known cause in most cases. Dental procedures can increase blood pressure and risk complications, so dental management of hypertensive patients requires modifications to reduce stress and control blood pressure. These include use of local anesthesia, sedation to reduce anxiety, scheduling afternoon appointments when blood pressure is lower, and avoiding sudden position changes to prevent reductions in blood pressure. Blood pressure is measured and hypertension is classified in stages according to levels above certain thresholds.
Hypertension or high blood pressure has become a common health problem.
•High blood pressure may cause coronary artery disease, stroke, heart failure, atrial fibrillation, peripheral vascular disease, vision loss, chronic kidney disease and dementia.
•The narrower your arteries are, the higher your blood pressure will be.
•Your blood pressure measurement takes into account how much blood is passing through your blood vessels and the amount of resistance the blood meets while the heart is pumping.
•High blood pressure generally develops over many years, and it affects nearly everyone eventually.
•Fortunately, high blood pressure can be easily detected. And once you know you have high blood pressure, you can work with your doctor to control it.
Get more details @
Hypertension. Causes, Effect. Mechanism of Hypertensive activities.
Treatment and Management of hypertension. effect of angiotensin. Investigations. kidney and hypertension. How to keep Normal Bloos Pressure. Normal Ranges of Blood Pressure. Stages Of Hypertension. Complications of Hypertension. Clinical Features of Elevated B.p. Endocrine System . Life style Modification in Hypertension. Pharmacological Therapy in Hypertension
Hypertension or high blood pressure has become a common health problem.
•High blood pressure may cause coronary artery disease, stroke, heart failure, atrial fibrillation, peripheral vascular disease, vision loss, chronic kidney disease and dementia.
•The narrower your arteries are, the higher your blood pressure will be.
•Your blood pressure measurement takes into account how much blood is passing through your blood vessels and the amount of resistance the blood meets while the heart is pumping.
•High blood pressure generally develops over many years, and it affects nearly everyone eventually.
•Fortunately, high blood pressure can be easily detected. And once you know you have high blood pressure, you can work with your doctor to control it.
Get more details @
Hypertension. Causes, Effect. Mechanism of Hypertensive activities.
Treatment and Management of hypertension. effect of angiotensin. Investigations. kidney and hypertension. How to keep Normal Bloos Pressure. Normal Ranges of Blood Pressure. Stages Of Hypertension. Complications of Hypertension. Clinical Features of Elevated B.p. Endocrine System . Life style Modification in Hypertension. Pharmacological Therapy in Hypertension
This highly energetic lecture presents the pathophysiology of S-T elevation myocardial infarction in an easy to understand style to help you best identify, triage and treat patients presenting with acute coronary syndromes. Using the latest research behind the AHA Guidelines changes, AHA National Faculty Rom Duckworth will help you better coordinate with you partners along the continuum of cardiac care. Emphasis is placed on risk factors, recognizing truly sick patients and coordinating care with hospital personnel.
Learning Objectives: Students will learn:
-The pathophysiology of S-T elevation myocardial infarction.
-The difference between STEMI, NSTEMI and unstable angina.
-Differing treatment methods and priorities for different cardiac syndromes.
-The function and importance of 12 lead ECG and prehospital diagnostic testing.
-The roles and responsibilities of EMS providers as the key element in “door-to-balloon” and “door-to-needle” time for STEMI patients.
www.romduck.com
www.RescueDigest.com
Mitral stenosis is a condition of pathological narrowing of mitral valve.
Normal square area of mitral valve is 4-6 square cm. When it is reduced to half of it, significant hemodynamic changes take place
Commonest cause is Rheumatic heart disease
Rare causes
1. Congenital – Parachute mitral valve
2. Lutembacher’s syndrome (ASD with congenital or acquired mitral stenosis).
3. Infective endocarditis with large vegetations causing obstruction.
4. Endomyocardial fibrosis.
5. Hurler’s syndrome.
6. Carcinoid –malignant.
7. Methysergide.
Hypertension, its causes, types and managementAbu Bakar
hypertention,it's causes, epidemiology, mechanism,primary and secondary hypertention, preeclampsia and eclampsia, disease related hypertention, classification, dietary plan, diagnosis, clinical presentation, drug related hypertention, treatment,
This highly energetic lecture presents the pathophysiology of S-T elevation myocardial infarction in an easy to understand style to help you best identify, triage and treat patients presenting with acute coronary syndromes. Using the latest research behind the AHA Guidelines changes, AHA National Faculty Rom Duckworth will help you better coordinate with you partners along the continuum of cardiac care. Emphasis is placed on risk factors, recognizing truly sick patients and coordinating care with hospital personnel.
Learning Objectives: Students will learn:
-The pathophysiology of S-T elevation myocardial infarction.
-The difference between STEMI, NSTEMI and unstable angina.
-Differing treatment methods and priorities for different cardiac syndromes.
-The function and importance of 12 lead ECG and prehospital diagnostic testing.
-The roles and responsibilities of EMS providers as the key element in “door-to-balloon” and “door-to-needle” time for STEMI patients.
www.romduck.com
www.RescueDigest.com
Mitral stenosis is a condition of pathological narrowing of mitral valve.
Normal square area of mitral valve is 4-6 square cm. When it is reduced to half of it, significant hemodynamic changes take place
Commonest cause is Rheumatic heart disease
Rare causes
1. Congenital – Parachute mitral valve
2. Lutembacher’s syndrome (ASD with congenital or acquired mitral stenosis).
3. Infective endocarditis with large vegetations causing obstruction.
4. Endomyocardial fibrosis.
5. Hurler’s syndrome.
6. Carcinoid –malignant.
7. Methysergide.
Hypertension, its causes, types and managementAbu Bakar
hypertention,it's causes, epidemiology, mechanism,primary and secondary hypertention, preeclampsia and eclampsia, disease related hypertention, classification, dietary plan, diagnosis, clinical presentation, drug related hypertention, treatment,
hypotension and hypertention emergencies in the dental officevahid199212
this presentation shows how to treat Hypo tension and Hypertension in medical emergencies in the dental office. includes Vasovagal syncope.postural hypo-tension.hypertension as a medical complex.
Perioperative Management of Hypertensionmagdy elmasry
Hypertension is most common medical reason for postponing surgery.How important is peri-operative hypertension?Hypertensive comorbidities associated with adverse perioperative outcomes .New Guidelines for managing patients with high blood pressure before surgery
Consequences of anesthesia on blood pressure regulation.
SYSTEMIC HYPERTENSION AND SCOPE OF HOMOEOPATHY
Dr. Smita Brahmachari
Abstract:
Hypertension (HTN) is an enormous health problem and is one of the biggest health challenges in the 21st century. Although the condition is common, readily detectable, and easily treatable, it is usually asymptomatic and often leads to lethal complications if left untreated. The prevalence of HTN is increasing rapidly in India driven by diverse health transitions. Apart from health implications it has huge societal, developmental and economic costs to resource constrained health systems, particularly developing nations like India. Further, hypertension is also a leading cause for hospitalizations and outpatient visits.
Reducing systolic and diastolic BP can decrease cardiovascular risk and this can be achieved by non-pharmacological (lifestyle measures) as well as pharmacological means (medicines). Homoeopathic system of medicine particularly individualized constitutional approach has significant beneficial effects on patients suffering from HTN and thus widely used in length and breadth of our nation as an alternative public health approach in curbing the increasing prevalence of HTN because of its cost effectiveness and minimal side effects.
In current scenario with rising burden of HTN posing a serious health threat to health care system of India, the present article makes a sincere attempt to present before its readers how to timely and effectively address a case of HTN at primary level health care set-up with homoeopathic medicines.
Author : The author has done her post-graduation from National Institute of Homoeopathy, Kolkata in the subject Homoeopathic Repertory. She is presently working as Medical Officer in Dept. of ISM &Homoeopathy under Govt. of NCT Delhi.
E-mail id: smita.brahmachari@rediffmail.com.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
2. Essential hypertension becomes more common as age advances and genetic influences, obesity, excessive salt intake and a variety of other factors are contributory. Hypertension is secondary to defined diseases, particularly renal or endocrine disorders, in about 10-20 percent of hypertensive cases and occasionally can be secondary to the use of oral contraceptives.
3. Acute emotion, particularly anger and anxiety, can cause transient rises in blood pressure by release of catecholamines (epinephrine and norepinephrine) and about 40 percent of hypertensive patients have raised levels of circulating catecholamines (epinephrine and norepinephrine) and may therefore have abnormal sympathetic activity.
4. When the patient has a history of hypertension there is the possibility of both congestive heart failure or angina pectoris. It is natural to think of stroke first when confronted with a history of hypertension, and it is true that hypertension, diabetes, and cerebral hemorrhage are commonly linked, but the fact is that 65 percent of hypertensives die of heart disease, whereas 20 percent demonstrate predominantly cerebral complications, except in hypertensive African American persons. African Americans tend to develop hypertension earlier in life. It is frequently more severe, and resulting in a higher mortality at a younger age, more commonly from stroke than from coronary artery disease. Since hypertension is one of several predisposing factors for premature coronary disease, it is important to look for other factors that may add to that risk, especially hyperlipidemia and cigarette smoking. Diabetes and physical inactivity likewise are important. MANAGEMENT IN CLINICAL DENTAL SITUATIONS<br />Dentists have a unique opportunity to detect cases of hypertension since patient visits at routine intervals are encouraged. It is a professional responsibility of a dental clinician to inform the patient of their hypertensive state and to offer medical advice, including appropriate referrals. <br />There are no recognized oral manifestations of hypertension but antihypertensive drugs can often cause side-effects, such as: <br />xerostomia, <br />gingival overgrowth, <br />salivary gland swelling or pain, <br />lichenoid drug reactions, <br />erythema multiforme, <br />taste sense alteration, and <br />paresthesia. <br />Dental clinician must focus on the actions, interactions and adverse effects of the antihypertensive medications, as well as the overall management of blood pressure of the patient in the dental chair. (see Medications) <br />The appropriate modifications for differing stages of hypertension is outlined in the algorithm presented below. (see ALGORITHM) There are, however, several areas of general dental management to be considered in the hypertensive patients. <br />1. ANESTHESIAA. Local Anesthesia<br />Dental patients with hypertension are best treated under local anesthesia being sure that the anesthesia is complete so that no anxiety induced elevation of blood pressure occurs. The use of vasoconstrictors such as epinephrine in local anesthetic agents is known to have negligible influences on blood pressure in hypertensive patients, according to numerous clinical studies. Data in regard to epinephrine-containing local anesthetics has consistently shown that blood pressure and heart rate are minimally affected by the typically low dose and short duration of the drug use in dentistry, both in healthy and those with existing cardiovascular conditions. Nonetheless, the use of epinephrine-containing anesthetics in patients with uncontrolled hypertension, and elective dental procedures are contraindicated. According to Muzyka & Glick (JADA 1997), <br />quot;
the benefits of the small doses of epinephrine used in dentistry, when administered <br />properly,far outweigh the cardiovascular disadvantagesquot;
<br />The use of aspirating syringes in local anesthetics is imperative to avoid intravenous, intrarterial, intraligamentary and intrabony injections, which could potentially precipitate further anxiety and thus rise in pressure and possible arrhythmias. <br />B. General Anesthesia<br />All antihypertensive drugs are potentiated by general anesthetic agents, especially barbiturates. General anesthesia tends to cause vasodilation. A severely reduced blood supply to vital organs can be dangerous in healthy individuals, but in the hypertensive person with vascular disease there is greater risk as the tissues have become adapted to a raised blood pressure which is needed to overcome the resistance of the vessels and maintain adequate perfusion. A fall in blood pressure below the critical level needed for adequate perfusion of vital organs such as the kidneys, can therefore be fatal. Hypokalemia as a result of diuretics may be associated with arrhythmias. Some inhalant anesthetics (halothane, enfluane, and isoflurane) are similar in action to calcium slow channel antagonists and so reduce blood pressure significantly. <br />2. ANXIETY CONTROL<br />The anxiety and stress associated with dental treatment typically causes a rise in blood pressure and may precipitate cardiac arrest or a cerebrovascular accident. Preoperative reassurance and oral sedation may help in alleviating anxiety related rise in pressure. Use of sedatives the night before a procedure may also be used. <br />Relative analgesia technique using nitrous oxide (N2O) can also reduce both systolic and diastolic pressure by up to 10-15mm Hg, after approximately 10 minutes of use, preoperatively. Use of oral sedation or nitrous oxide sedation may reduce blood pressure to acceptable levels, allowing initiation of local anesthesia (with or with vasoconstrictor). <br />3. TIMING OF DENTAL APPOINTMENTS<br />The increase of blood pressure in hypertensive patient is associated with the hours surrounding awakening that peaks by midmorning. This fluctuation of blood pressure tends to be less likely in the afternoon. Afternoon appointments are recommended over mornings for this reason. <br />4. ORTHOSTATIC HYPOTENSION <br />Orthostatic hypotension may be a problem in patients using antihypertensive agents that reduce sympathetic outflow or peripheral vasodilatory actions, such as centrally acting a-2-adrenergic agonists, post-ganglionic adrenergic inhibitors, a-1-adrenergic antagonists, and diuretics. Management of orthostatic hypotension includes avoiding sudden postural changes, such as return to sitting position from the supine operating position. The patient should also be instructed to stay seated for a short period until such time that adequate cerebral perfusion has occurred. <br />5. OTHER DENTAL CONCERNS<br />Aspirin is now commonly taken by patients with hypertension to decrease associated coronary or cerebral vascular thrombotic disease, and aspirin may cause bleeding problems. Many patients with hypertension develop systolic heart murmurs, in which case prophylaxis for endocarditis <br />Algorithm for Management of Hypertensive Dental Patient<br />* SELECTIVE DENTAL PROCEDURE may include, but not limited to;<br />dental prophylaxis <br />restorative procedures <br />nonsurgical periodontal therapy <br />nonsurgical endodontic procedures <br /># EMERGENT NONSTRESSFUL DENTAL PROCEDURE may include, but not limited to dental procedures that may help alleviate pain, infection or masticatory dysfunction. e.g., simple incision and drainage of intraoral fluctuant dental abscess. The medical benefits should outweigh the risk of complications secondary to the hypertensive state, in stage III and IV hypertensive patients<br />