antianginal drugs (chest pain)

Question 1

What is angina characterized by?

Answer 1

Chest pain or pressure, described as a dull, heavy pain

Question 2

When does angina occur?

Answer 2

when there is a lack of oxygen to the myocardium, or the demand for oxygen from the myocardium is not available

Question 3

What is the most common cause of angina?

Answer 3

atherosclerotic plaque formation in the coronary arteries

Question 4

What triggers chronic stable angina?

Answer 4

exertion or other stress.

Question 5

What substances exacerbate chronic stable angina?

Answer 5

Nicotine, alcohol, coffee, and other drugs exacerbate the pain.

Question 6

How long does the pain from chronic stable angina usually last?

Answer 6

usually within 15 minutes by rest or antianginal drug

Question 7

What causes chronic stable angina?

Answer 7

narrowing or partial occlusion of the coronary arteries

Question 8

What is another name for chronic stable angina?

Answer 8

‘classic angina’ or ‘effort angina’

Question 9

What characterizes unstable angina?

Answer 9

early stage of progressive coronary artery disease (CAD) and myocardial infarction (MI) in subsequent years.

Question 10

How does the pain in unstable angina change over time?

Answer 10

Pain increases in severity, frequency of attacks, and in later stages, it can occur while at rest.

Question 11

What does unstable angina often indicate?

Answer 11

impending myocardial infarction (MI) and needs immediate medical attention

Question 12

What are the other names for unstable angina?

Answer 12

‘pre-infarction angina’ or ‘crescendo angina’.

Question 13

What is vasospastic angina?

Answer 13

Vasospastic angina involves spasms in the smooth muscle that surrounds coronary arteries.

Question 14

When does vasospastic angina typically occur?

Answer 14

at the same time of the day

Question 15

What often accompanies attacks of vasospastic angina?

Answer 15

Dysrhythmias and electrocardiogram (ECG) changes

Question 16

What is another name for Prinzmetal angina?

Answer 16

variant angina

Question 17

What causes Prinzmetal angina?

Answer 17

vessel spasm or vasospasm.

Question 18

3 main class of treatment for angina pectoris?

Answer 18

Nitrates/Nitrites, Beta Blockers, and Calcium Channel Blockers

Question 19

What is the therapeutic objective related to blood flow?

Answer 19

Increase in blood flow to the myocardium

Question 20

What is the therapeutic objective regarding angina pain?

Answer 20

Decrease in frequency of attacks, duration and intensity of angina pain

Question 21

What is the therapeutic objective for patient functioning?

Answer 21

Improvement of patients functioning

Question 22

What is the therapeutic objective related to pre-load and filling pressures?

Answer 22

Decrease the pre-load and filling pressures

Question 23

What are nitrates/nitrites used for?

Answer 23

prophylaxis and treatment

Question 24

What is the mechanism of action of nitrates/nitrites?

Answer 24

dilate blood vessels

Question 25

What are the contraindications for using nitrates/nitrites?

Answer 25

allergy, severe anemia, closed angle glaucoma, hypotension, or severe head injury

Question 26

What are the side effects of nitrates/nitrites?

Answer 26

Side effects include headache (HA), dizziness, hypotension, tachycardia, and gastrointestinal issues.

Question 27

What is the mechanism of action (MOA) of nitrates/vasodilators?

Answer 27

They act by relaxing smooth muscle in the blood vessel walls and producing vasodilation, which increases blood flow to ischemic areas of the heart.

Question 28

What are common side effects of nitrates/vasodilators?

Answer 28

Weakness, dizziness, headache, and flushing.

Question 29

What are the adverse effects of nitrates/vasodilators?

Answer 29

Orthostatic hypotension, dizziness, lightheadedness, and bradycardia.

Question 30

What nursing considerations should be taken with nitrates/vasodilators?

Answer 30

avoid with erectile dysfunction phosphodiesterase inhibitors (e.g., Viagra, Cialis) due to lethal complications. Multiple doses may be required.

Question 31

What is an example of a nitrate/vasodilator?

Answer 31

Nitroglycerin (Nitrostat) ## Footnote Sublingual-3 doses in 5 minutes: 1st tab for angina attack, 2nd tab if not better after 5 minutes, head to ER for 3rd tab. Max dose is 3; do not take anymore.

Question 32

MOA of nitrates/vasodilators in chronic stable angina pectoris?

Answer 32

relax smooth muscle in the blood vessel walls and producing vasodilation, increasing blood flow to ischemic areas of the heart

Question 33

What are some examples of nitrates/vasodilators?

Answer 33

Isosorbide mononitrate (Imdure), isosorbide dinitrate (Isordil), and nitroglycerin (NitroDur) for transdermal prevention of angina pectoris due to coronary artery disease.