Chapter 23: Antianginal Drugs

Question 1

ischemia

Answer 1

damaged cells/tissue as the result of inadequate oxygen supply

Question 2

Angina Pectoris

Answer 2

chest pain that occurs when the heart’s supply of blood carrying oxygen is insufficient to meet the demands of the heart.

Question 3

atherosclerosis

Answer 3

common form of arteriosclerosis involving deposits of fatty, cholesterol-containing material (plaques) within the arterial walls that can slow or block blood flow to the tissues.

Question 4

myocardial infarction

Answer 4

• commonly called a heart attack
• occurs when blood flow through coronary arteries to myocardium is blocked so that part of the heart muscle cannot receive any of the blood-borne nutrients. if it’s not reversed immediately, the area of the heart dies and becomes necrotic.

Question 5

myocardial infarction is almost always caused by

Answer 5

atherosclerosis of the coronary arteries

Question 6

coronary artery disease (CAD)

Answer 6

any one of the abnormal conditions that can affect the arteries of the heart and produce various pathologic effects, especially a reduced supply of oxygen and nutrients to the myocardium

Question 7

damage to a large enough area of the myocardium can be

Answer 7

disabling or fatal

Question 8

Atherosclerosis: Process of Injury

Answer 8

• endothelial damage
• fatty streak
• fibrous plaque
• complicated lesion

Question 9

There are three classic types of angina pectoris:

Answer 9

1. stable angina
2. unstable angina
3. prinzmetal angina

Question 10

Acute Coronary Syndrome

Answer 10

sudden obstruction of coronary blood flow.

O2 demand/needs > O2 supply

Question 11

What happens after a myocardial infarction?

Answer 11

• scar tissue replaces necrotic area
• contractility is lost
• abnormal wall motion
• electrical malfunction
• changes in cardiac pressures
• changes in volumes in cardiac chambers

Question 12

What can result from the changes to the heart due to myocardial infarction?

Answer 12

dysrhythmias and congestive heart failure

Question 13

Two classifications of MI

Answer 13

• transmural MI (highest risk for complications)

- subendocardial MI

Question 14

Women and Coronary Artery Disease

Answer 14

• women have different signs and symptoms of myocardial infarction (MI) (c/o flu like symptoms)
• in-hospital mortality post-MI is higher in women than in men

Question 15

chronic stable angina

Answer 15

• atherosclerosis is the primary cause.
• can be triggered by exertion or other stress.
• pain is commonly intense but subsides within 15 minutes of either rest or appropriate antianginal drug therapy

Question 16

unstable angina

Answer 16

• usually the early stage of progressive coronary artery disease.
• often ends in MI
• pain increases in severity as does the frequency of attacks

Question 17

prinzmetal angina

Answer 17

r-esults from spasms in the layer of smooth muscle that surrounds coronary arteries.
-pain occurs at rest without any precipitating cause. no regular pattern.

Question 18

Three main classes of drugs used to treat angina pectoris:

Answer 18

1. nitrates/nitrites
2. beta blockers
3. calcium channel blockers

Question 19

Three main therapeutic objectives of antianginal drug therapy

Answer 19

1. minimize the frequency of attacks and decrease the duration and intensity of anginal pain
2. improve the patients functional capacity with as few adverse effects as possible
3. prevent or delay the worst possible outcome, MI

Question 20

Available forms of nitrates

Answer 20

• sublingual
• chewable tablets
• oral capsules/tablets
• intravenous solutions
• transdermal patches
• ointments
• translingual sprays

Question 21

Mechanism of Action: Nitrates

Answer 21

Relaxation of smooth muscles → dilate all blood vessels → O2 to heart muscle

Question 22

Nitrates are used to treat

Answer 22

stable, unstable and prinzmetal angina

Question 23

What are the two types of forms of nitrates?

Answer 23

• rapid-acting forms

- long-acting forms

Question 24

rapid-acting forms

Answer 24

• acute angina

- include sublingual tables; intravenous infusion

Question 25

long-acting forms

Answer 25

PREVENT anginal episodes

Question 26

The following are the rapid- and long-acting nitrates available for clinical use:

Answer 26

1. isosobide mononitrate (Imdur) (primarily long acting)
2. isosobide dinitrate (Isordil) (both rapid and long acting)
3. nitroglycerin (both rapid and long acting)

Question 27

Adverse effects of Nitrates

Answer 27

• Headaches (Usually diminish in intensity and frequency with continued use.)
• Reflex tachycardia
• Postural hypotension
• Tolerance may develop

Question 28

Discuss the Nursing Process focus on Patient-Centered Care (pp. 370-374)

Answer 28

Assessment
Nursing Diagnoses
Planning
Implementation
Evaluation