Antianginals And MI Medications Flashcards
Atherosclerosis
- Most common etiology of CAD
* Caused by presence of plaque
Coronary artery disease
- One of the leading causes of death in United States
- Narrowing or occlusion of a coronary artery
- Narrowing causes myocardial ischemia
Angina pectoris
- Acute chest pain due to insufficient O2 to myocardium
- Accompanies physical exertion or emotional excitement
- Causes increased myocardial oxygen demand
Angina signs and symptoms
- Steady, intense pain in anterior chest
- Pain radiating to left shoulder, left arm, spine, jaw
- Fear of impending death
- Pallor, dyspnea, diaphoresis
- Tachycardia, elevated blood pressure
Therapeutic management of angina
•Therapeutic outcomes
◦Reduce intensity and frequency of episodes
◦ Improve exercise tolerance
2 main ways angina pharmacology works
◦Those that terminate acute angina episode
◦Those that decrease frequency of episodes
Reduce O2 demand by:
- Slowing heart rate
- Reducing preload
- Reducing contractility
- Lowering blood pressure (reduced afterload)
Nitrates prototype
•Prototype drug: nitroglycerin (Nitrostat)
Nitrate action
Mechanism of action: relax both arterial and venous smooth muscle; dilate coronary arteries
◦Short acting-terminate acute angina episode
◦Long-acting-decrease severity and frequency of episodes
Nitrate primary use
•Primary use: for lowering myocardial oxygen demand
Nitrate adverse effects
Adverse effects: hypotension, dizziness, headache, flushing of face, rash
Nitrate implications
- Obtain blood pressure and monitor
- IV nitrates have greatest risk for severe hypotension
- Educate client that alcohol is contraindicated with nitrates
- If hypotension occurs, withhold nitrates
Beta-adrenergic blocker prototype
•Prototype drug: atenolol (Tenormin)
Beta-adrenergic action
Mechanism of action: to reduce the cardiac workload by slowing heart rate and reducing contractility
Beta-adrenergic blocker primary use
•Primary use: for prophylaxis of stable angina
