Antianginals

Question 1

What is angina pectoris?

Answer 1

Chest pain
The bodies response to lack of oxygen
-heart muscle does not contain pain receptors
-Substance p is released from ischemic myocardial cells and substance p reacts with pain receptors

Question 2

What is stable angina ?

Answer 2

Exertion,pain relieved by rest or nitrates

Question 3

What is prinzmetal angina ?

Answer 3

Spasms, can occur rest and/ or night

Question 4

What is unstable angina ?

Answer 4

Advanced dz,often leads to MI

Question 5

What is unstable angina ?

Answer 5

Advanced dz, often lead to MI

Question 6

How do antianginal drugs work?

Answer 6

Dilating blood vessels and decreasing workload of heart

Question 7

What are additional meds to prevent angina ?

Answer 7

ASA,antilipids,HTN meds

Question 8

What is nitroglycerin

Answer 8

A nitrate which is for antianginal

Question 9

What is the therapeutic actions of nitroglycerin ?

Answer 9

nitrate
-Relax smooth muscles producing vasodilation
-dilation reduces venous pressure and return
-Decrease blood volume/pressure (preload)
-Vasodilation increase blood flow to ischemic areas
-Dilation reduces peripheral,vascular resistance (afterload)

Question 10

What are indications of Nitroglycerin (Nitro-bid)

Answer 10

Mainstay of antianginal drug to (both prophylaxis and treatment)

Question 11

What are routes of administration for nitroglycerin?

Answer 11

Nitrate
Sublingual, buffalo,chewable, tablets, capsules, ointments, patches & IVs

Question 12

Describe sublingual administration of Nitroglycerin?

Answer 12

-Immediate relief of angina
-Place under tongue–> allow to dissolve
Should “burn” under the tongue
-Check Bp before admin
-Could administer it 5 minx 3doses( should be spaced out by 5 mins)
-If there is no relief call 911

Question 13

Describe the bottle of a sublingual Nitroglycerine

Answer 13

Nitrate
-Potency deteriotes when bottle is opened
-Change every 6 month unopened and every 3 months opened
-Light sensitive dark bottle( Keep in a dark/ dry place and in a dark color container, no plastic.

Question 14

What are adverse effects of Nitroglycerine orally?

Answer 14

Nitrate
-Dizziness
-Headache
-Lowers bp-fall potential
Flushing, sweating

Question 15

Describe transdermal administration of Nitroglycerine?

Answer 15

Nitrate
-Prophylaxis(Used to prevent anginal attacks)
- Use prn SL preparations if CP occurs
-Apply to clean area (not breasts)
- Do not shave hair (OK to clip)
- Rotate sites
- Leave off at bedtime (to reduce tolerance)
- In hospital  date, record placement in EMAR
- Monitor for skin reactions

Question 16

What are contras of Nitroglycerine?

Answer 16

Nitrate
-Head trauma or cerebral hemorrhage as
relaxation of vessels could cause bleeding
-Pregnancy
-Erectile drugs – hypotension

Question 17

What are cautions of Nitroglycerine?

Answer 17

Nitrate
-Hypotension
- Hepatic or renal disease