title: The impact of cardiovascular drugs on the efficacy of local anesthesia in dentistry.
abstract: OBJECTIVE
  Drugs used chronically by patients with diseases of the cardiovascular system (group C of the ATC classification) may act on adrenergic receptors and/or certain ion channels, which gives them the potential to interact with the action of local dental anesthetics. The aim of the study was to investigate the effect of systemically administered chronic cardiovascular medication (oral route) on the efficacy of intraoral local anesthesia in patients with diseases of the cardiovascular system.
  
  
  METHODS
  This was a prospective cohort study which analyzed the efficacy of local terminal anesthesia (onset of anesthesia, duration anesthetized area) in the upper jaw of 70 patients: 40 patients on medication for cardiovascular system disorders and 30 patients who were not using these drugs (the control group). The following cardiovascular drugs were used: beta blockers, angiotensin converting enzyme inhibitors, calcium channel blockers, vasodilatators, diuretics, angiotensin receptor blockers, antiarrhythmics, statins and alfa blockers.
  
  
  RESULTS
  The onset of anesthesia on the vestibular side was faster in those taking cardiovascular drugs (40.50±19.87 s) than the control patients (58.93±31.07 s; P = 0.004) and duration of anesthesia on this side was shorter. Although the difference was not significant, it was evident that on vestibular and palatal side the anesthetized area was more rapidly reduced in the patients taking cardiovascular drugs. The duration of cardiovascular therapy also had a significant impact on the anesthetized area.
  
  
  CONCLUSIONS
  Drugs acting on cardiovascular system may influence the effect of local anesthetics used in dentistry, possibly through interaction with autonomic receptors and ion channels.
authors.affiliation: Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Serbia.
authors.forename: Мarko J
authors.initials: МJ
authors.lastname: Milosavljevic
authors.affiliation: Department of Pharmacology, Faculty of Medical Sciences, University of Kragujevac and Clinical Center Kragujevac, Serbia.
authors.forename: Slobodan M
authors.initials: SM
authors.lastname: Jankovic
mesh_terms: D000328:Adult; D000779:Anesthetics, Local; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy*; D002908:Chronic Disease; D004347:Drug Interactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014081:Tooth Extraction / Q000379:methods*; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D002317:Cardiovascular Agents
keywords: beta blockers; calcium channel blockers; cardiovascular agents; dental anesthesia; local anesthesia