antianginal drugs (broadhead)

Question 1

prototype of nitrate

Answer 1

nitroglycerine (Nitrostat, NitroDur, NitroBid)

Question 2

actions of nitroglycerine

Answer 2

dilates vascullar smooth muscle of coronary veins, decreased venous return, decreased preload, relaxes spasm in coronary arteries

Question 3

indications of nitroglycerine

Answer 3

treatment and prophylaxis of angina pectoris, IV NTG used for unstable angine, BP control postop, treatment of heart failure following MI

Question 4

side effects of nitroglycerine

Answer 4

hypotension (if BP is

Question 5

contraindications of nitroglycerine

Answer 5

head injury, severe anemia, hypovalemia

Question 6

special considerations of nitroglycerine

Answer 6

do not touch ointment, monitor BP and HR, give beta blockers of Ca channel blockers to suppress tachycardia, know application requirements

Question 7

beta adrenergic blocker prototype

Answer 7

atenolol (Tenormin) and metoprolol (Lopressor)

Question 8

action of atenolol and metoprolol

Answer 8

block cardiac beta1 receptors resulting in decressed HR and contractibility (caused decreased cardiac output and suppresses reflec tachycardia), block renal beta1 receptors decreasing release of renin, decreases peripheral resistane of blood vessels

Question 9

indications of atenolol and metaprolol

Answer 9

hypertension, angina pectoris, decreased mortality following MI, cardiac dysrhythmias, heart failure (only 2 including metoprolol)

Question 10

side effects of metaprolol and atenolol

Answer 10

bradycardia, heart failure (shortness of breath, edema, cough at night), rebound excitation cauing angina or MI with sudden withdrawl

Question 11

adverse effects of metaprolol and atenolol

Answer 11

cardiac arrect, agranulocytosis, bronchospasm

Question 12

contraindications of metaprolol and atenolol

Answer 12

bradycardia, severe heart failure, cardiogenic shock

Question 13

special considerations of metaprolol and atenolol

Answer 13

monitor HR is

Question 14

calcium channel blockers prototype name

Answer 14

nifedipine (Aldat, Procardia) and verapamil (Calan)

Question 15

action of nifedipine and verapamil

Answer 15

blocks calcium channels in muscle cells of peripheral and cardiac arterioles and cardiac arteries resulting in arteriolar vasodilation, decreased BP, increased coronary perfusion, indirectly increases HR

Question 16

indications of nifedipine and verapamil

Answer 16

hypertension, stable angina, and variant angina

Question 17

side effects of nifedipine and verapamil

Answer 17

reflec tachycardia causing increased angina in client with angina, gingival hyperplasia, lightheadednness, facial flushing, peripheral edema of feet and legs, hypotension

Question 18

adverse effects of nifedipine and verapamil

Answer 18

Stevens Johnsons syndrome, dysrhythmias, heart failure

Question 19

contraindications of nidefipine and verapamil

Answer 19

acute MI, unstable angina, GI obstruction, cardiogenic shock, severe heart failure

Question 20

special considerations of nidefipine and verapamil

Answer 20

give beta blocker to prevent tachycardia, monitor HR, BP, regular dental care, report CNS effects