Anti- Angina Flashcards
MOA nitroglycerin
1) increase heart blood supply by increase in O2 and collateral BF to ischemic myocardium–> decrease coronary vasospasm and increase artery dilation
2) decrease demand by decreasing cardiac work and decrease preload by venodilation
When to use nitroglycerin
symptomatic
situations leading to angina
What if you don’t get relief after first dose of nitro
wait 5 min and give 2nd dose. Repeat for 3rd dose
S/E nitroglycerin
HA, flushing, tolerance, hypotension, peripheral edema
What can occur after 24 continuous hours of nitro? How to prevent?
Tachyphylaxsis; give patient an 8hr nitro break
C/I nitro
SBP<90, RV infarction
Who DOES NOT get nitro
patient on sildenafil (viagra)–> hypotension
MOA BB
1) increase heart blood supply by increase in O2 via prolonged filling time
2) decrease demand by decreasing oxygen need during exercise and stress
Negative chronotrope and inotrope
When to use BB
S/P MI
BB best for anti-angina
metoprolol, atenolol, propranolol, nadolol
MOA CCB
1) increase heart blood supply by increase coronary vasodilation and prolong filling time–> prevention and termination of coronary vasospasm
2) decrease demand by decreasing contractility and HR (AV block) and decrease afterload
CCB best for anti-angina
diltiazem and verapamil (long acting)
MOA aspirin
prevent platelet aggregation and activation via inhibition of cyclooxyrgenase–> decrease thromboxane 2
Caution with aspirin
active PUD, HSN and bleeding disorders
