Antianginal Drugs Flashcards
Number One Cause of Chest Pain
Atherosclerosis
Chronic Stable Angina
Angina without MI
Aggravated by stress or activity
Unstable Angina
Precursor to MI
Vasospastic Angina
Spasms in coronary arteries, no underlying coronary artery disease
Nitrates and Nitrites
Cause vasodilation because of relaxation of smooth muscles
Potent dilating effect on coronary arteries
Used for the prevention and treatment of angina
Nitroglycerin
Large first-pass effect with oral forms
Used for symptomatic treatment of ischemic heart conditions
Adverse Effects of Nitrates
HEADACHES
POSTURAL HYPOTENSION
Reflex tachycardia
Beta Blockers
Mainstay in the treatment of angina, MI, hypertension, and atrial dysrhythmias
Work to decrease heart rate to decrease myocardial oxygen demand and decrease contractility to conserve energy
BLOCK THE HARMFUL EFFECTS OF CATECHOLAMINES, THUS IMPROVING SURVIVAL AFTER AN MI
Adverse Effects of Beta Blockers
BRADYCARDIA, WHEEZING, masks low blood sugar, insomnia, depression
Diltiazem (Cardizem)
Calcium channel blocker
Very effective for the treatment of angina pectoris resulting from coronary insufficiency and hypertension
Used in the treatment of atrial fibrillation and flutter and paroxysmal supraventricular tachycardia
Indications for Calcium Channel Blockers
Angina Hypertension CORONARY ARTERY SPASMS (PRINZMETAL ANGINA) Migraine headaches Raynaud's disease
Adverse Effects of Calcium Channel Blockers
Primarily related to overexpression of their therapeutic effects
May cause hypotension, palpitations, tachycardia or bradycardia, constipation, nausea, dyspnea
Nursing Implications
Perform a COMPLETE HEALTH HISTORY to check for contraindications
Obtain BASELINE VITAL SIGNS including RESPIRATORY patterns and rate
Nitroglycerin should always be clear; potency is lost in 3 MONTHS
BURNING SENSATION is felt with sublingual nitroglycerin
Metaprolol
Antianginal beta blocker
Verapamil
Calcium channel blocker