Antianginal Drugs (Flashcards)
Stable Angina?
regular pattern, once you stop exercising or take medications (nitroglycerin) the pain goes away.
Unstable angina?
Unstable angina is different. The pain or discomfort:
often happens when you are sleeping or resting takes you by surprise
might last as long as 30 minutes and might become progressively worse
cannot be relieved with rest or medication
might be a sign of a heart attack that will happen soon
*Unstable angina tends to happen more often in older adults.
What is the drug under nitrates/nitrites?
Nitroglycerin
what forms can you take nitroglycerin?
Routes: oral, sublingual, metered-dose aerosol that is sprayed under the tongue, intravenous, and topical
whats the IV form of nitroglycerin used for?
Intravenous form used for control of blood pressure in perioperative hypertension, treatment of heart failure, ischemic pain, pulmonary edema associated with acute myocardial infarction, and hypertensive emergencies
Nitroglycerin adverse effects
Headaches
Usually diminish in intensity and frequency with continued use
Reflex tachycardia
Postural hypotension
Tolerance may develop.
Nitroglycerin transdermal forms what should you do?
may be instructed to remove patch at bedtime for 8 hours, then apply a new patch in the morning
Nitroglycerin contraindications?
Severe anemia
Closed-angle glaucoma
Hypotension
Severe head injury
Use of the erectile dysfunction drugs sildenafil citrate (Viagra®), tadalafil (Cialis®), and vardenafil hydrochloride (Levitra®)
Atenolol and metoprolol indications
Angina
Hypertension
Cardiac dysrhythmias
myocardial infarction
Some used for migraine headaches, essential tremors, and stage fright
- just a note on what it does (Block β1-receptors on the heart
Decrease heart rate, resulting in decreased myocardial oxygen demand and increased oxygen delivery to the heart
Decrease myocardial contractility, helping to conserve energy or decrease demand)
Atenolol and metoprolol contraindications?
Systolic heart failure
Serious conduction disturbances
Caution: bronchial asthma, because any level of blockade of β2-receptors can promote bronchoconstriction
Diabetes mellitus: can mask hypoglycemia-induced tachycardia
Peripheral vascular disease: may further compromise cerebral or peripheral blood flow
Atenolol and metoprolol adverse effects?
Cardiovascular: Bradycardia, hypotension, atrioventricular block
Metabolic: Hyperglycemia, hypoglycemia, hyperlipidemia
Central nervous system: Dizziness, fatigue, depression, lethargy
Other: Erectile dysfunction, wheezing, dyspnea
Almodipine and diltiazem (calcium channel blockers) indications?
Angina
Hypertension
Supraventricular tachycardia
Coronary artery spasms (Prinzmetal angina)
Short-term management of atrial fibrillation and flutter
Migraine headaches
Raynaud’s disease
dihydropyridine nimodipine: cerebral artery spasms associated with aneurysm rupture
- just a note on what it does (Cause coronary artery vasodilation
Cause peripheral arterial vasodilation, thus decreasing systemic vascular resistance
Reduce the workload of the heart
Result: decreased myocardial oxygen demand).
Almodipine and diltiazem contraindications?
Known drug allergy
Acute myocardial infarction
Second- or third-degree atrioventricular block (unless the patient has a pacemaker)
Hypotension
Almodipine and diltiazem adverse effects?
Limited
Primarily relate to overexpression of their therapeutic effects
May cause hypotension, palpitations, tachycardia or bradycardia, constipation, nausea, dyspnea, other adverse effects
what is diltiazem used for?
Very effective for the treatment of angina pectoris resulting from coronary insufficiency and hypertension
Used in the treatment of atrial fibrillation and flutter along with paroxysmal supraventricular tachycardia
whats amlodipine used for?
Most popular calcium channel blocker of the dihydropyridine subclass
Indicated for both angina and hypertension
Available only for oral use.
what should patients report?
Blurred vision
Persistent headache
Dry mouth
Edema
Fainting episodes
Weight gain of 1 kg in 24 hours or 2.3 kg in 1 week
Pulse rate less than 60 beats/min
Dyspnea
why should you not take alcohol and spend time in hot baths?
Alcohol consumption and spending time in hot baths or whirlpools, hot tubs, or saunas will result in vasodilation, hypotension, and the possibility of fainting.
what does a burning sensation felt with sublingual forms mean?
means the drug is still potent.
Nitroglycerin how long is potency good for?
Instruct patients to keep a fresh supply of sublingual medication on hand; potency is good for about 3 to 6 months.
To preserve potency, medications should be stored in an airtight, dark glass bottle with a metal cap and no cotton filler.
what should you do if dizziness occurs while taking nitroglycerin?
If experiencing chest pain, the patient taking sublingual nitroglycerin should lie down to prevent or decrease dizziness and fainting that may occur because of hypotension.
Nitroglycerin
If anginal pain occurs tell patient to?
stop activity and sit or lie down and take a sublingual tablet.
Call 911 or emergency services immediately and take a second sublingual tablet if there is no relief in 5 minutes.
Take a third sublingual tablet If there is no relief in 5 minutes.
Do not try to drive to the hospital.
