Antianginal Agents

Question 1

atheromas

Answer 1

fatty tumors in the intima of the heart vessels

Question 2

atherosclerosis

Answer 2

narrowing of the heart vessels

Question 3

angina pectoris

Answer 3

suffocation of the chest

Question 4

stable angina

Answer 4

no damage to heart muscle; basic reflexes surrounding the pain restore blood flow

Question 5

unstable angina

Answer 5

episodes of ischemia occur even at rest

Question 6

prinzmetal’s angina

Answer 6

caused by spasm of the blood vessels, not just by vessel narrowing

Question 7

acute myocardial infarction

Answer 7

if a coronary vessel becomes completely occluded and is unable to deliver blood to the cardiac muscle the area of muscle that depends on that vessel for oxygen becomes ischemic and then necrotic

Question 8

acute myocardial infarction symptoms

Answer 8

excruciating pain, nausea, and severe sympathetic stress reaction

Question 9

what are the actions of antianginal drugs

Answer 9

improve blood delivery to the heart muscle by dilating blood vessels and decreasing the work of the heart; increase oxygen supply, decrease oxygen demand

Question 10

types of antianginal drugs

Answer 10

nitrates, beta-adrenergic blockers, calcium channel blockers

Question 11

nitrates

Answer 11

nitroglycerin; help restore the appropriate supply-and-demand ration in oxygen delivery to the myocardium when rest is not enough

Question 12

action of nitroglycerin

Answer 12

act directly on smooth muscle to cause relaxation and depress muscle tone

Question 13

indication of nitroglycerin

Answer 13

very rapidly absorbed; metabolized in the liver; excreted in the urine

Question 14

contraindications of nitroglycerin

Answer 14

allergy, severe anemia, head trauma or cerebral hemorrhage, pregnancy and lactation

Question 15

cautions with nitroglycerin

Answer 15

hepatic or renal disease; hypotension, hypovolemia, and conditions that limit cardiac output

Question 16

adverse effects of nitroglycerin

Answer 16

r/t the vasodilation and decrease in blood flow; headache, nausea, weakness, dizziness, vomiting, hypotension, flushing, pallor increased perspiration

Question 17

drug-drug interactions of nitroglycerin

Answer 17

ergot derivatives and heparin

Question 18

routes for nitroglycerin

Answer 18

IV, sublingual, translingual spray, transmucosal tablet, oral SR tablet, topical ointment, transdermal

Question 19

nursing considerations for nitroglycerin

Answer 19

early MI, head trauma, cerebral hemorrhage, hypotension, hypovolemia, anemia, or low CO states; pregnancy or lactation

Question 20

protocol for sublingual nitroglycerin tablets

Answer 20

take 1 when experiencing chest pain; if not resolved in 5 minutes, take another tablet and call 911; if not resolved in another 5 minutes, take another tab (3)

Question 21

why can’t a patient take more than 3 tabs of nitroglycerin

Answer 21

BP may be low, they shouldn’t move

Question 22

background on sublingual nitroglycerin

Answer 22

let tablet dissolve under tongue, tingling or burning under the tongue means it is not expired; tablets need to be replaced every 3 months

Question 23

background on topical nitroglycerin

Answer 23

pt can develop a tolerance; should be taken off at night adn replaced in the morning

Question 24

nitroglycerin main side effects

Answer 24

facial flushing and headache (take tylenol)

Question 25

beta blockers

Answer 25

used to decrease heart rate

Question 26

major side effect of beta blockers

Answer 26

bradycardia

Question 27

what assessment should you do after giving beta blockers

Answer 27

auscultation of lungs

Question 28

calcium channel blockers

Answer 28

diltiazem; inhibit the movement of calcium ions across the membranes of myocardial and arterial muscle cells

Question 29

actions of diltiazem

Answer 29

inhibit the movement of calcium ions across the membranes of myocardial and arterial muscle cells, altering the action potential and blocking the muscle cell contraction

Question 30

indications of diltiazem

Answer 30

prinzmental’s angina

Question 31

pharmacokinetics of diltiazem

Answer 31

well absorbed, metabolized in the liver, excreted in the urine

Question 32

contraindications of dilatiazem

Answer 32

allergy, heart block or sinus syndrome, renal/hepatic dysfunction, pregnancy or lactation

Question 33

adverse effects of diltiazem

Answer 33

hypotension, cardiac arrhythmias, GI upset, skin reactions, headache

Question 34

drug-drug interactions of diltiazem

Answer 34

cyclosporine, digoxin, vary with each drug

Question 35

nursing considerations for diltiazem

Answer 35

impaired liver or kidney function

Question 36

ranolazine

Answer 36

treats angina that keeps coming back (chronic angina); may be used with other medicines that are used for heart problems and blood pressure control; can decrease blood glucose levels

Question 37

what route is used for ranolazine

Answer 37

oral ER tablet

Question 38

mechanism of ranolazine

Answer 38

unknown

Question 39

cautions of ranolazine

Answer 39

pregnancy and renal impairment

Question 40

adverse effects of ranolazine

Answer 40

dizziness, headache, nausea, constipation

Question 41

drug-drug interactions of ranolazine

Answer 41

diltiazem, verapamil, macrolide antibiotics, HIV protease inhibitors, digoxin, TCAs and antipsychotics

Question 42

what’s affected on an ECG while on ranolazine

Answer 42

prolonged QT waves

Question 43

when is ranolazine prescribed

Answer 43

when other BP meds fail; can be used with other antihypertensives