Angina Flashcards
Which medications help improve cardiac oxygen supply through vasodilation?
Nitrates and CCBs
What is the mechanism of action of nitrates?
Promote vasodilation of the veins and sometimes arterioles thus reducing preload and afterload
What are adverse effects of nitrates?
headaches, orthostatic hypotension, reflex tachycardia
What is a consideration with nitrates?
Patients can become nitrate tolerant so they should not be used continuously
What happens if nitrates are discontinued too quickly?
It can cause vasospasm and possible precipitate a heart attack
How should transdermal nitrates be ordered?
With at least an 8 hour nitrate-free time frame to reduce tolerance
What are teaching points for patients on nitrates?
They need to carry the short-acting doses for breakthrough with them at all times.
Storage in a dark, room temperature room
Paste/stripe measurement technique
Why are beta blockers useful for angina?
They decrease vascular resistance and afterload, thus decreasing cardiac oxygen demand
Why are calcium channel blockers useful for angina?
They promote smooth muscle dilation which reduces vascular resistance and decreases afterload thus decreasing cardiac oxygen demand
Why are ACE-I useful for angina?
They inhibit angiotensin 1 from converting to angiotensin 2 which promotes vasodilation and decreases vascular resistance thus reducing cardiac oxygen demand
Why are aspirins useful for angina?
They reduce platelet aggregation thus reducing plaques thus allowing more elasticity of the vessels
Why are statins useful for angina?
They help reduce LDL-C levels which promotes a reduction on ASCVD risk and atherosclerosis thus reducing atherosclerotic plaques and promoting elasticity of the vessels.
What is the first line drug therapy for stable angina?
Beta blockers
What medication could also be used as a first line drug for stable angina?
ACE-Inhibitors, used most often to help prevent MI
When are long-acting nitrates indicated?
Patients are intolerant to beta blocker therapy
