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nurs 252 > antianginal drugs > Flashcards

antianginal drugs Flashcards

1
Q

angina pectoris

A

insufficient o2 and nutrient supply to the heart causing pain

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2
Q

ischemia

A

poor blood supply to an organ

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3
Q

ischemic heart disease

A

poor blood supply to heart muscle, atherosclerosis, coronary artery disease

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4
Q

preload and afterload

A

preload: filling and stretching (end of diastole)
afterload: pressure to pump against (systole)

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5
Q

myocardial infarction

A

necrosis or death of cardiac tissue
disabling or fatal

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6
Q

5 types of angina

A
  • stable angina (classic/effort angina)
  • unstable angina ( pre-infarction angina)
  • variant (vasosparatic/ Prinzmetal)
  • atypical
  • microvascular
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7
Q

symptoms of angina

A
  • usually after heavy exercise or emotional stress
  • pain in middle of chest, spreads to L arm, back, neck or jaw (dull)
  • pressure or squeezing in chest or arms
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8
Q

stable angina

A

when the heart works harder than normal
- regular pattern
- stops after rest or medication (nitroglycerin) within a few mins
- feels the same each time it happens
- less than 5 mins
- might feel like indigestion

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9
Q

unstable angina

A
  • sign of possible heart attack
  • no predicted pattern
  • should be treated as an emergency
  • increased risk of cardiac arrest or arrhythmias
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10
Q

unstable angina characteristics

A
  • pain happens when resting or sleeping
  • last as long as 30 mins and may become worse
  • not relieved by rest or meds
  • might be a sign of a possible heart attach
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11
Q

women and angina

A
  • stabbing, pulsating or sharp pain
  • more likely to have nausea, SOB, abd pain
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12
Q

therapeutic objectives of antiangina meds

A
  • minimize frequency of attacks
  • increase blood flow to ischemic myocardium and decrease myocardiac 02 demand .
  • improve functioning
  • prevent or delay MI
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13
Q

nitrates and nitrite forms

A
  • IV sol
  • transdermal patches
  • translingual sprays
    bypasses the liver and first pass effect
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14
Q

MOA of nitrates

A

vasodilation from relaxation
dilating effect on coronary arteries
results in o2 to ischemic myocardial tissue
decreases preload and afterload

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15
Q

rapid acting nitates and nitrites

A

treat acute anginal attacks
sublingual tablets or spray; IV infusion

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16
Q

long acting nitrates

A

used to prevent anginal episodes

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17
Q

nitroglycerin

A

rapid and long acting
most important for symptomatic treatment of ischemic heart conditions
PO, SL, metered-dose aerosol, IV, topical

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18
Q

nitroglycerin IV indications and storage

A

treatment of HF, ischemic pain, hypertensive emergencies.
- given with non polyvinyl chloride tubing and bags

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19
Q

nitrates adverse effects

A
  • headaches (most common)
  • reflex tachycardia
  • postural hypotension
  • tolerance may develop
20
Q

how to prevent tolerance with nitrates

A

-allow a regular nitrate free period to allow enzyme pathways to replenish.
- remove transdermal patch at bedtime for 8 hrs and then apply new patch

21
Q

nitrate contraindications

A

anemia, glaucoma, hypotension, severe head energy, erectile dysfunction drugs

22
Q

beta blockers

A

mainstay in the treatment in cardiovascular disease
(angina, MI, hypertension, dysrhythmias)

23
Q

antianginal beta blockers

A

atenolol and metoprolol

24
Q

beta blocker MOAs

A

-decreases HR= decreased oxygen demands= increased delivery of oxygen to the heart
- decrease myocardial contractility, helping to conserve energy or decrease demand
-blocks effects of catecholamines improving survival of MI

25
Q

beta blocker indications

A

angina, hypertension, cardiac dysrhythmias, MI, migraine, essential tremors, stage fright

26
Q

beta blocker contraindications

A

systolic HF, serious conduction disturbances, asthma, diabetes, PVD

27
Q

caution with beta blockers in

A

-bronchial asthma (can cause bronchoconstriction)
- diabetes mellitus (can mask hypoglycemia-induced tachycardia)
- PVD (can compromise blood flow)

28
Q

beta blocker adverse effects

A

CV: bradycardia, hyoptension, atrioventricular shock
Metabolic: hyperglycemia, hypoglycemia, hyperlipidemia
CNS: dizziness, fatigue, depression, lethargy
Other: erectile dysfunction, wheezing, dyspnea

29
Q

atenolol

A
  • B1 receptor blocker
  • prophylactic treatment of angina
  • use of atenolol after myocardial infarction can decrease mortality
    -PO
30
Q

metroprolol tartrate

A
  • B1 beta blocker
  • prophylactic treatment of angina
  • reduces mortality rate after MI
  • PO and injectable
31
Q

IV metropolol

A

after MI and is used for treatment of hypertension in pts unable to take oral meds

32
Q

Ca channel blockers for chronic unstable angina

A
  • amlodipine and diltiazem
33
Q

Ca channel blocker MOA

A
  • vasodilation
  • reduces workload of heart
  • decreased myocardial o2 demand
  • depression of conduction through SA and AV node for dysrhythmias
34
Q

Ca channel blocker indications

A
  • angina
  • hypertension
  • tachycardia
  • coronary artery spasms
  • short term a-fib management
  • migraine
  • raynaud’s
35
Q

Ca channel blocker contraindications

A
  • acute MI. allergy, 2-3rd degree AV block, hypotension
36
Q

Ca channel blocker adverse effects

A
  • overexpression of therapeutic effects
  • hypotension, palpitations, tachycardia, bradycardia, constipation, nausea, dyspnea
37
Q

diltiazem hcl

A
  • treats angina and hypertension
  • treatment of a fib and along tachycardia
38
Q

amlodipine besylate

A

most popular ca channel blocker of dihydropyridine subclass
angina and hypertension
PO only

39
Q

pts should limit ____ intake

A

caffeine

40
Q

pts should report

A

blurred vision, persistent headache, dry mouth, edema, fainting, weight gain, pulse rate < 60 BPM, dyspnea

41
Q

t or f you can swallow sublingual nitroglycerin forms

A

false. never chew or swallow the sublingual form

42
Q

what indicates sublingual nitroglycerin is potent

A

burning sensation
potency is good for 3-6 months

43
Q

how to store nitroglyc

A

airtight, dark glass bottle with metal cap, no cotton filter

44
Q

how to take nitro with chest pain

A

lay down to prevent dizziness or fainting

45
Q

what to do with anginal pain

A
  • stop activity
  • take sublingual tab
  • call 911 and take 2nd tab if theres no relief in 5 mins
  • 3rd tab if no relief after 5 mins
  • dont drive to hospital
46
Q

common problem with calcium channel blockers

A

constipation

47
Q
A

nurs 252 (23 decks)

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