Anti-Angina Flashcards

1
Q

stable angina

A

consistent presentation, effort induced
relieved by rest/nitroglycerin

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2
Q

cause/mechanism of stable angina

A

caused by reduction in blood flow from coronary atherosclerosis
increasing demand causes ischemia, demand increased by emotion or physical activity increasing cardiac workload

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3
Q

unstable angina

A

Increasing frequency/inconsistent onset of chest pain, less effort to precipitate symptoms
Not relieved by rest/nitroglycerin

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4
Q

cause/mechanism of unstable angina

A

caused by blockage of coronary arteries by blood clots

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5
Q

Prinzmetal angina

+what eases symptoms

A

angina due to coronary artery spasm
Unrelated to activity/BP/HR, chest pain at rest
Eased with vasodilators, nitroglycerin, Ca channel blockers

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6
Q

list organic nitrates

A

nitroglycerin
isosorbide dinitrate
isosorbide mononitrate

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7
Q

list beta blockers for angina

A

cardio selective
metoprolol
atenolol

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8
Q

list calcium channel blockers for angina

A

verapamil
nifedipine
diltiazem

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9
Q

list sodium channel blocker for angina

A

ranolazine

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10
Q

MOA of organic nitrates

A

release nitric oxide –> increase CGMP –> relax vascular smooth muscle
acts to reduce myocardial oxygen demand for angina by relaxing arteries and veins

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11
Q

MOA of beta blockers

A

inhibit beta 1 adrenergic receptors to decrease HR and contractility

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12
Q

MOA of calcium channel blockers

A

stop calcium transport across the membrane to shut down processes demanding oxygen and creating ischemia
results in arterial dilation and lower BP

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13
Q

MOA of sodium channel blockers

A

inhibit sodium current to improve O2 supply, blocks Na to relax the heart and modulate Ca levels

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14
Q

side effects of organic nitrates

A

Headache
OH
Hypotension
Facial flushing
Tachycardia
nausea

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15
Q

side effects of beta blockers

A

At high doses act on pulmonary system Beta 2 receptors - bronchospasm
Fatigue
Bradycardua
hypotension
blunted HR response to exercise

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16
Q

side effects of calcium channel blockers

A

Constipation
Reflex tachycardia
Worsen HF w increased contractility
Edema
Flushing
Headache
Dizziness

17
Q

side effects of sodium channel blockers

A

Dizziness
Headache
Constipation
QT interval prolonged

18
Q

PT considerations for angina medications

A
  1. monitor BP for OH
  2. monitor angina symptoms
  3. regular aerobic exercise to reduce angina symptoms
  4. recognize side effects
  5. pt education on taking meds
19
Q

risk factors for angina

A

age
family hx
smoking
sedentary
meds
stress
HTN
DM
kidney disease
obesity
dyslipidemia

20
Q

nitrates pharmacokinetics

A

metabolized significant portion in first pass metabolism at liver
taken sublingually/transdermal to avoid GI system for fast acting