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NCLEX > Antianginal Drugs > Flashcards

Antianginal Drugs Flashcards

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0
Q

Atenolol

Chemical Classification

A

Beta-Blocker, Beta1-, Beta2-blocker (high doses)

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1
Q

Atenolol

Functional Classification

A

Antihypertensive, antianginal

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2
Q

Atenolol

Mechanism of Action

A

Completely blocks stimulation of beta-adrenergic receptor within vascular smooth muscle; produces negative chronotropic activity (decreases rate of SA node discharge, increases recovery time), slows conduction of AV node, decreases heart rate, negative inotropic activity decreases O2 consumption in myocardium; decreases action of renin-aldosterone-angiotensin system at high doses, inhibits Beta2-receptors in bronchial system at higher doses

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3
Q

Atenolol

Uses

A

Mild to moderate hypertension, prophylaxis of angina pectoris; suspected or known MI (IV use); MI prophylaxis

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4
Q

Atenolol

Contraindications

A

Pregnancy (D), hypersensitivity to Beta-blockers, cardiogenic shock, 2nd- or 3rd-degree heart block, sinus bradycardia, cardiac failure, Raynaud’s disease, pulmonary edema

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5
Q

Atenolol

Side Effects

A

CNS: Insomnia, Fatigue, Dizziness, Mental Changes, memory loss, hallucinations, depression, lethargy, drowsiness, strange dreams, catatonia
CV: PROFOUND HYPOTENSION, BRADYCARDIA, CHF, Cold Extremities, Postural Hypotension, 2nd- or 3rd-degree Heart Block
EENT: sore throat; dry, burning eyes; blurred vision; stuffy nose
ENDO: increase hypoglycemic response to insulin
GI: Nausea, Diarrhea, vomiting, MESENTERIC ARTERIAL THROMBOSIS, ISCHEMIC COLITIS
GU: impotence, decreased libido
HEMA: AGRANULOCYTOSIS, THROMBOCYTOPENIA PURPURA
INTEG: rash, fever, alopecia
RESP: BRONCHOSPASM, dyspnea, wheezing, pulmonary edema

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6
Q

Atenolol

Nursing Considerations

A

ASSESS:

  • I&O, weight daily; watch for CHF (rales/crackles, jugular vein distention, weight gain, edema)
  • Hypertension: BP, pulse q4hr; note rate, rhythm, quality; apical/radial pulse before administration; notify prescriber of any significant changes (<50 bpm); ECG
  • Baselines in renal/hepatic studies before therapy begins
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7
Q

Atenolol

Overdose Treatment

A

Lavage, IV atropine for bradycardia, IV theophylline for bronchospasm, dextrose for hypoglycemia, digoxin, O2, diuretic for cardiac failure, hemodialysis

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8
Q

Diltiazem (Cardizem)

Functional Classification

A

Calcium Channel Blocker, antiarrhythmic class IV, antihypertensive

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9
Q

Diltiazem (Cardizem)

Chemical Classification

A

Benzothiazepine

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10
Q

Diltiazem (Cardizem)

Mechanism of Action

A

Inhibits calcium ion influx across cell membrane during cardiac depolarization; produces relaxation of coronary vascular smooth muscle, dilates coronary arteries, slows SA/AV node conduction times, dilates peripheral arteries

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11
Q

Diltiazem (Cardizem)

Uses

A

PO: Angina pectoris due to coronary artery spasm, hypertension
IV: atrial fibrillation, flutter, paroxysmal supraventricular tachycardia

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12
Q

Diltiazem (Cardizem)

Contraindications

A

Sick sinus syndrome, AV heart block, hypotension <90mmHg systolic, acute MI, pulmonary congestion, cardiogenic shock

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13
Q

Diltiazem (Cardizem)

Side Effects

A

CNS: Headache, Fatigue, Drowsiness, dizziness, depression, weakness, insomnia, tremor, paresthesia
CV: DYSRHYTHMIA, Edema, CHF, bradycardia, hypotension, palpitations, HEART BLOCK
GI: Nausea, vomiting, diarrhea, gastric upset, Constipation, increased LFTs
GU: nocturia, polyuria, ACUTE RENAL FAILURE
INTEG: Rash, flushing, photosensitivity, burning pruritus at inj site
RESP: rhinitis, dyspnea, pharyngitis

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14
Q

Diltiazem (Cardizem)

Nursing Considerations

A

ASSESS:

  • CHF: dyspnea, weight gain, edema, jugular venous distention, rales; monitor I&O ratios daily, weight
  • ANGINA: location, duration, alleviating factors, activity when pain starts
  • DYSRHYTHMIAS: cardiac status: BP, pulse, respiration, ECG and intervals PR, QRS, QT; if systolic BP <50 bpm, hold dose, notify prescriber
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15
Q

Diltiazem (Cardizem)

Overdose Treatment

A

Atropine for AV block, vasopressor for hypotension

16
Q

Isosorbide dinitrate and Isosorbide mononitrate

Functional Classification

A

Antianginal, Vasodilator

17
Q

Isosorbide dinitrate and Isosorbide mononitrate

Chemical Classification

A

Nitrate

18
Q

Isosorbide dinitrate and Isosorbide mononitrate

Mechanism of Action

A

Relaxation of vascular smooth muscle, which leads to decreased preload, afterload, which is responsible for decreasing left ventricular end-diastolic pressure, systemic vascular resistance, and reducing cardiac oxygen demand

19
Q

Isosorbide dinitrate and Isosorbide mononitrate

Uses

A

Treatment, prevention of chronic stable angina pectoris

20
Q

Isosorbide dinitrate and Isosorbide mononitrate

Contraindications

A

Hypersensitivity to this product or nitrates; severe anemia, increased intracranial pressure, cerebral hemorrhage, acute MI

21
Q

Isosorbide dinitrate and Isosorbide mononitrate

Side Effects

A

CNS: Vascular Headache, Flushing, Dizziness, weakness, faintness
CV: Postural Hypotension, tachycardia, COLLAPSE, syncope, palpitations
GI: nausea, vomiting, diarrhea
INTEG: pallor, sweating, rash
MISC: twitching, hemolytic anemia, METHEMOGLOBINEMIA, tolerance

22
Q

Isosorbide dinitrate and Isosorbide mononitrate

Nursing Considerations

A

ASSESS:

  • ANGINAL PAIN: duration, time started, activity being performed, character
  • BP, pulse, respirations during beginning therapy
  • Tolerance if taken over long period
  • Headache, lightheadedness, decreased BP; may indicate need for decreased dosage
23
Q

Metoprolol (Lopressor)

Functional Classification

A

Antihypertensive, antianginal

24
Q

Metoprolol (Lopressor)

Chemical Classification

A

Beta1-Blocker

25
Q

Metoprolol (Lopressor)

Mechanism of Action

A

Lowers BP by Beta-blocking effects; reduces elevated renin plasma levels; blocks Beta2-adrenergic receptors in bronchial, vascular smooth muscle only at high doses; negative chronotropic effect

26
Q

Metoprolol (Lopressor)

Uses

A

Mild to moderate hypertension, acute MI to reduce cardiovascular mortality, angina pectoris, NYHA class II, III heart failure

27
Q

Metoprolol (Lopressor)

Contraindications

A

Hypersensitivity to Beta-blockers, cardiogenic shock, heart block (2nd, 3rd degree), sinus bradycardia, pheochromocytoma, sick sinus syndrome

28
Q

Metoprolol (Lopressor)

Side Effects

A

CNS: Insomnia, Dizziness, mental changes, hallucinations, depression, anxiety, headaches, nightmares, confusion, fatigue
CV: Hypotension, BRADYCARDIA, CHF, Palpitations, dysrhythmias, CARDIAC ARREST, AV BLOCK, PULMONARY/PERIPHERAL EDEMA, CHEST PAIN
EENT: sore throat; dry, burning eyes
GI: Nausea, Vomiting, colitis, cramps, Diarrhea, constipation, flatulence, dry mouth, Hiccups
GU: impotence
HEMA: AGRANULOCYTOSIS, EOSINOPHILIA, THROMBOCYTOPENIA, PURPURA
INTEG: rash, purpura, alopecia, dry skin, urticaria, pruritus
RESP: BRONCHOSPASM, dyspnea, wheezing

29
Q

Metoprolol (Lopressor)

Nursing Considerations

A

ASSESS:

  • ECG directly when giving IV during initial treatment
  • I&O, weight daily; check for CHF (weight gain, jugular venous distention, crackles, edema, dyspnea)
  • BP during initial treatment, periodically thereafter; pulse q4hr; not rate, rhythm, quality
  • Apical/radial pulse before administration; notify prescriber of any significant changes or pulse <50 bpm
  • Baselines of renal, hepatic studies before therapy begins
  • Skin turgor, dryness of mucous membranes for hydration status
30
Q

Metoprolol (Lopressor)

Overdose Treatment

A

Lavage, IV atropine for bradycardia, IV theophylline for bronchospasm, digoxin, O2, diuretic for cardiac failure, hemodialysis, administer vasopressor

31
Q

Nitroglycerin

Functional Classification

A

Coronary Vasodilator, antianginal

32
Q

Nitroglycerin

Chemical Classification)

A

Nitrate

33
Q

Nitroglycerin

Mechanism of Action

A

Decreases preload and afterload, which are responsible for decreasing left ventricular end-diastolic pressure, systemic vascular resistance; dilates coronary arteries, improves blood flow through coronary vasculature, dilates arterial and venous beds systemically

34
Q

Nitroglycerin

Uses

A

Chronic stable angina pectoris, prophylaxis of angina pain, CHF, acute MI, controlled hypotension for surgical procedures, anal fissures

35
Q

Nitroglycerin

Contraindications

A

Hypersensitivity to this product or nitrites; severe anemia, increased intracranial pressure, cerebral hemorrhage, closed-angle glaucoma, cardiac tamponade, cardiomyopathy, constrictive pericarditis

36
Q

Nitroglycerin

Side Effects

A

CNS: Headache, Flushing, Dizziness
CV: Postural Hypotension, tachycardia, COLLAPSE, syncope, palpitations
GI: nausea, vomiting
INTEG: pallor, sweating, rash

37
Q

Nitroglycerin

Nursing Considerations

A

ASSESS:

  • PAIN: duration, time started, activity being performed, character
  • Orthostatic BP, pulse prior to and after administration
  • Tolerance if taken over long period
  • Headache, lightheadedness, decreased BP; may indicate a need for decreased dosage

NCLEX (40 decks)

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