Cardio 10 Deck 5 Flashcards
Long-Acting Nitrates route
oral or transdermal
Long-Acting Nitrates used for
patients intolerant to BBs
Isosorbide dinitrate (Isordil) given
2 or 3 times/day
With a 10 to 12 hour nitrate-free interval to prevent nitrate tolerance
Timing of the nitrate-free interval should coincide with the time of fewest episodes of angina
Combinations of BBs and CCBs have been shown to
be more effective than individual drugs used alone; can add ranolizine, too.
Combinations of a long-acting nitrate and a
BB are safe, effective, and low in cost.
Older adults
Combination of long-acting nitrates and CCBs
is rarely used because of the high risk for hypotension and additive adverse reaction profiles.
Older Adults ACE and BB
if the patient has congestive heart failure (CHF)
Older Adults CCbs will
make CHF worse
Women tend to go
undertreated in stable angina
no differences in treatment
Cost nitrates
cheapest
Angina assessment
Electrocardiography (ECG) Fasting lipid levels Chest x-ray Complete blood count (CBC) Tests for diabetes, thyroid function, and renal function
Angina evaluation
4 to 6 months during the first year of therapy
Angina questions to ask
Has the patient’s level of physical activity decreased since the last visit?
How well is the patient tolerating therapy?
Angina monitoring
Has the patient’s level of physical activity decreased since the last visit?
How well is the patient tolerating therapy?
Has the patient developed any new comorbid illnesses, or has the severity or treatment of known comorbid illnesses worsened the patient’s angina?
NTG pt education
Taking the drug exactly as prescribed
Eccentric dosing of some long-acting nitrates
Use of sublingual NTG
