Anti-anginals and MI Meds Flashcards
CAD
- Leading cause of death in the US followed by cancer
Heart Disease is the #1 cause of death in men and women
Atherosclerosis
- Most common etiology of CAD
2. Caused by presence of plaque
When is the Heart Fed?
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
Angina Pectoris
- Acute chest pain due to insufficient 02 to myocardium
- Accompanies physical exertion or emotional excitement
- Causes increased myocardial 02 demand
Drug Mechanisms that help with angina?
CCB’s and Beta Blockers
Signs and SYmptoms of Angina
- Steady, intense pain in anterior chest
- Pain radiating to left shoulder, left arm, spine, jaw
- Fear of impending death
- Pallor, dyspnea, diaphoresis
- Tachycardia, Elevated BP
Duration of Angina
Pain diminishes w/ physical rest and/or stress reduction
Stable Angina
Predictable as to frequency, intensity, duration
-Usually relieved by rest
Vasospastic Angina
Caused by spasms of coronary arteries
Silent Angina
Occurs in the absence of angina pain
Unstable Angina
When episodes occur more frequently, more intense, during periods of rest
Angina Vs. MI
1 Give a CCB or Beta blocker for Angina
-Give a thrombolytic for an MI
Nitrates
- Potent Vasodilators
- Isordil
- Imudur
- Nitrostat
Nitrates
-Prototype (Nitrostat)
- Relax both arterial and venous smooth muscle; DILATE CORONARY ARTERIES
- Short acting -Terminate acute angina episode
- Long acting - decrease severity and frequency of episodes
Sublingual Nitroglycerin
-Pt teaching
- Don’t take alcohol with nitrates.
- Alcohol is a vasodilator which can lower BP to low - Do not take Erectile medication with nitrates
MI Vs. Angina
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
Nitrate Holiday
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
Nitrates
-Adverse effects
- Hypotension with Increased HR
- Dizziness
- Headache
- Flushing of face, rash
“Vasodilation effects”
Thrombolytic’s
-Window of opportunity
- Ask when did the symptoms occur?
- For CVA give medication <6 hrs after symptoms begin
MI and ACE inhibitors
- Increased survival for MI pt’s administered captopril (capoten)
ACE inhibitors can produce a dry cough
Monitor Increased Potassium levels
