Anti-anginals and MI Meds

Question 1

CAD

Answer 1

1. Leading cause of death in the US followed by cancer

Heart Disease is the #1 cause of death in men and women

Question 2

Atherosclerosis

Answer 2

1. Most common etiology of CAD

2. Caused by presence of plaque

Question 3

When is the Heart Fed?

Answer 3

The heart receives its nutrients during diastole

-Myocardium receives blood via coronary arteries.

If HR increases there isn’t as much time for relaxation and for the heart to get nutrients and oxygen. This can cause angina

Question 4

Angina Pectoris

Answer 4

1. Acute chest pain due to insufficient 02 to myocardium
2. Accompanies physical exertion or emotional excitement
3. Causes increased myocardial 02 demand

Question 5

Drug Mechanisms that help with angina?

Answer 5

CCB’s and Beta Blockers

Question 6

Signs and SYmptoms of Angina

Answer 6

1. Steady, intense pain in anterior chest
2. Pain radiating to left shoulder, left arm, spine, jaw
3. Fear of impending death
4. Pallor, dyspnea, diaphoresis
5. Tachycardia, Elevated BP

Question 7

Duration of Angina

Answer 7

Pain diminishes w/ physical rest and/or stress reduction

Question 8

Stable Angina

Answer 8

Predictable as to frequency, intensity, duration

-Usually relieved by rest

Question 9

Vasospastic Angina

Answer 9

Caused by spasms of coronary arteries

Question 10

Silent Angina

Answer 10

Occurs in the absence of angina pain

Question 11

Unstable Angina

Answer 11

When episodes occur more frequently, more intense, during periods of rest

Question 12

Angina Vs. MI

Answer 12

1 Give a CCB or Beta blocker for Angina

-Give a thrombolytic for an MI

Question 13

Nitrates

Answer 13

1. Potent Vasodilators

• Isordil
• Imudur
• Nitrostat

Question 14

Nitrates

-Prototype (Nitrostat)

Answer 14

1. Relax both arterial and venous smooth muscle; DILATE CORONARY ARTERIES
2. Short acting -Terminate acute angina episode
3. Long acting - decrease severity and frequency of episodes

Question 15

Sublingual Nitroglycerin

-Pt teaching

Answer 15

1. Don’t take alcohol with nitrates.
   - Alcohol is a vasodilator which can lower BP to low
2. Do not take Erectile medication with nitrates

Question 16

MI Vs. Angina

Answer 16

If someone is having angina give
1 dose, wait 5 minutes give another dose

Give 3 doses 5 minutes apart and if it doesn’t go away its an MI

Question 17

Nitrate Holiday

Answer 17

You need a nitrate holiday

Put the patch on in the morning and take it off at night
If it is oral, don’t take them at night so you can get a break

Question 18

Nitrates

-Adverse effects

Answer 18

1. Hypotension with Increased HR
2. Dizziness
3. Headache
4. Flushing of face, rash

“Vasodilation effects”

Question 19

Thrombolytic’s

-Window of opportunity

Answer 19

1. Ask when did the symptoms occur?

- For CVA give medication <6 hrs after symptoms begin

Question 20

MI and ACE inhibitors

Answer 20

1. Increased survival for MI pt’s administered captopril (capoten)

ACE inhibitors can produce a dry cough
Monitor Increased Potassium levels