Angina Medications

Question 1

What are the 3 major drug options for anginal ischemia and pain?

Answer 1

1. Nitrates
2. Beta-Blockers
3. Calcium channel blockers

Question 2

What are the Nitrates that you should know?

Answer 2

1. Nitroglycerin
2. Isosorbide

Question 3

Nitroglycerin is available as what?

Answer 3

sublingual tablets, translingual sprays, oral capsule, transdermal patches, topical ointment, and IV injection

Question 4

What are the common uses for Nitrates?

Answer 4

-angina pectoris
-acute heart attacks (myocardial infarctions)

Question 5

Nitrates mechanism of actions

Answer 5

Once nitrates are absorbed, the body converts them to nitric oxide. (In order for this conversion to occur, your body needs plenty sulfhydryl groups.) Once converted to nitric oxide, the body turns into something called cyclic GMP. Cyclic GMP is what causes the therapeutic effect. It causes widespread vasodilation.
-When all the veins in your body relax and fill with blood, less blood returns to the heart. Since the heart has less blood to pump, it needs less oxygen. This helps improve the imbalance between oxygen demand and supply.

Question 6

Nitrates mechanism of actions

Answer 6

Once nitrates are absorbed, the body converts them to nitric oxide. (In order for this conversion to occur, your body needs plenty sulfhydryl groups.) Once converted to nitric oxide, the body turns into something called cyclic GMP. Cyclic GMP is what causes the therapeutic effect. It causes widespread vasodilation.
-When all the veins in your body relax and fill with blood, less blood returns to the heart. Since the heart has less blood to pump, it needs less oxygen. This helps improve the imbalance between oxygen demand and supply.

Question 7

Nitrates Side Effects

Answer 7

-Orthostatic Hypotension
-Headaches (most common)
* aspirin or acetaminophen may help with this

Question 8

How should nitrates be stored?

Answer 8

-protected from moisture
-Clients should make sure the lids are closed tightly and store them at room temperature. Also, remember to check the expiration date.

Question 9

Clients taking sustained release and transdermal nitrate formulations should have how many drug-free hours?

Answer 9

at least 8
-nitroglycerin patch should be removed in evening

Question 10

What drug cannot be taken with Nitrates? Why?

Answer 10

erectile dysfunction drugs (PDE5 inhibitors)
- it can cause life threatening hypotension