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Pharmacology > Antianginal > Flashcards

Antianginal Flashcards

1
Q

Role of coronary arteries

A

deliver oxygen to the heart muscle

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2
Q

what is myocardial ischemia?

A

damaged heart tissue from inadequate oxygen supply

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3
Q

What is angina pectoris?

A

chest pain as a result of ischemia

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4
Q

What is MI?

A

Necrosis of the myocardium. also known as a heart attack

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5
Q

What are the different types of angina?

A
  • Chronic stable angina
  • Unstable angina
  • Varient or vasospastic or Prinzmetal’s angina
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6
Q

Chronic stable angina
Classic angina
Effort angina

A

triggered by exertion or other stress (e.g. cold, emotions)

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7
Q

Unstable angina

A

Usually the early stage of progressive coronary artery disease. Often ends in MI

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8
Q

Varient angina
Vasospastic angina
Prinzmetal angina

A

Spasms in the layer of smooth muscle that surrounds coronary arteries

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9
Q

Describe the development of atherosclerosis

A

the build up of fatty plaque deposits in artery walls

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10
Q

Controller drugs

A

Beta- blockers, CCB, and long-acting nitrates provide baseline prophylaxis or protection against acute angina attacks

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11
Q

Rescue Drugs

A

SL, translingual spray, and IV nitroglycerin is used to treat acute anginal pain

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12
Q

Nitroglycerin tolerance

A
  • Occurs in pts taking nitrates around the clock or with long-acting forms
  • Prevented by allowing regular nitrate-free period to allow enzyme pathways to replenish allow at least 8 hrs.
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13
Q

Nitroglycerin MOA

A

In angina due to atherosclerosis, NTG dilates veins which reduces venous return (decrease preload). This decreases the workload of the heart. In variant angina, NTG dilates coronary arteries which improves blood flow through coronary vasculature.

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14
Q

Drug Effect of Nitroglycerin

A

Decreased cardiac oxygen demand and increased cardiac oxygen supply

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15
Q

Indications for Nitroglycerin

A

Stable, unstable and variant angina

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16
Q

Contraindications for Nitroglycerin

A

Hypotension, erectile dysfunction drugs (Viagra, Levitra, or Cialis)

17
Q

Adverse effects of Nitroglycerin

A

Headache, orthostatic hypotension, reflex tachycardia, tolerance

18
Q

Nursing Implications

A
  • Identify risk factors for CAD
  • Obtain baseline data regarding frequency, intensity, duration,location, and precipitating factors of attacks
  • Assess V/S and EKG
19
Q

Pt Ed

A
  • Instruct pt proper technique for administering SL, transdermal, ointment, or oral routes
  • Manage headache with acetaminophen
  • Instruct men not to take erectile dysfunction drugs (lethal combo)
20
Q

Beta Blockers MOA

A

Prevent stimulation of beta receptors in the heart which decreases HR and contractility. Also prevents release of renin

21
Q

Drug effects of Beta Blockers

A

Decreased myocardial oxygen demand

22
Q

Examples of beta blockers

A

propranolol (Inderal)

metroprolol (Lopressor)

23
Q

Indications for beta blockers

A

Prevention/ prophylaxis of stable angina

24
Q

Contraindications of Beta blockers

A

Bradycardia, AV block, asthma

25
Q

Adverse effects of beta blockers

A

Dizziness, bradycardia, heart block, mask S/S of hypoglycemia, bronchoconstriction, constipation

26
Q

Nursing Implications of beta blockers

A
  • Assess for contraindications

- Assess V/S- hold and notify MD if HR less than 60

27
Q

Pt ED

A
  • Inform pt they are for long-term prevention, not immediate relief
  • change positions slowly, avoid hot tubs, saunas which result in vasodilation
  • Monitor glucose closely if diabetic
  • do not abruptly stop
28
Q

CCB MOA

A

Prevents influx of calcium ions across cell membrane of vascular smooth muscle
Dilation of peripheral and coronary arteries

29
Q

Drug effects of CCB

A

Decreased after load decreases workload of the heart and therefore myocardial oxygen demand

30
Q

Examples of CCB

A

diltiazem (Cardizem)

verapamil (Calan)

31
Q

Indication for CCB

A

Prevention/ prophylaxis of stable, variant angina

32
Q

Adverse effect of CCB

A

dizziness, hypotension, constipation, peripheral edema

33
Q

Nursing implications for CCB

A

monitor VS

34
Q

Pt ED for CCB

A
  • Avoid hazardous activities while dizzy
  • change positions slowly
  • increase fluid and fiber intake to prevent constipation unless otherwise instructed by MD

Pharmacology (5 decks)

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