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1390-59 Intro to Pharmacology > Chapter 24 > Flashcards

Chapter 24 Flashcards

1
Q

angina pectoris

A

chest pain due to decreased blood flow (ischemia) to the heart

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2
Q

atherosclerosis

A

fatty degeneration of arteries due to the accumulation of cholesterol plaques

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3
Q

coronary artery

A

artery that supplies blood flow to the heart

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4
Q

coronary artery disease (CAD)

A

condition due to atherosclerosis and insufficient blood flow to the heart

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5
Q

exertional angina

A

angina pectoris caused by increased physical exertion

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6
Q

ischemia

A

insufficient blood flow to a tissue

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7
Q

variant or prinzmetal angina

A

angina pectoris caused by vasospasm of the coronary arteries

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8
Q

Exertional

Classification of Angina Pectoris

A

caused by exercise, overexertion, stress

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9
Q

Variant or Prinzmetal

Classification of Angina Pectoris

A

caused by vasospasm of coronary arteries

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10
Q

Unstable

Classification of Angina Pectoris

A

occurs when coronary arteries are almost completely blocked

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11
Q

Treatment of CAD

A

Aimed at:

  • Reducing the number and severity of anginal attacks
  • Limiting progression of atherosclerosis
  • Preventing occurrence of myocardial infarction (MI) and possible death

Non-drug components

  • Diets low in fat and cholesterol
  • Exercise
  • Smoking cessation
  • Weight control

Drug components

  • Nitrates
  • Beta-blockers
  • Calcium channel blockers
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12
Q

Nitrates

A

Produce a general vasodilation of systemic veins and arteries

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13
Q

How are Nitrates administered

A

During angina attacks to relieve pain

On a daily basis to prevent angina attacks

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14
Q

Mechanism of action for Nitrates

A

Nitrate oxide relaxes vascular smooth muscle.

Vasodilation decreases preload and afterload.

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15
Q

Clinical Use of Nitrates

A

Sublingual nitroglycerin
-Relieves acute angina attacks

Nitroglycerin ointment 2%
-Helps prevent the occurrence of angina

Nitroglycerin extended-release capsules
-Used daily as a form of prophylaxis

Transdermal nitroglycerin (Transderm-nitro)
-Used in the prevention of angina

Nitroglycerin for intravenous infusion
-Used during emergency and surgical situations

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16
Q

Adverse effects of Nitrates

A

Cutaneous flushing, dizziness, headache, weakness, and fainting

Sudden drops in blood pressure can cause reflex tachycardia

17
Q

Patient education of Nitrates

A

Patients must carry the prescribed medication at all times.

-Tablets must be stored in light-resistant, airtight containers.

Individuals experiencing angina must sit down and place a nitroglycerin tablet under the tongue.

Awareness of side effects is important.

18
Q

Drug Integrations with Nitrates

A

Nitrate drugs should not be taken in combination with drugs that treat erectile dysfunction.

Causes excessive vasodilation, hypotension, reflex tachycardia, and potentially myocardial infarction

19
Q

Beta Adrenergic Blocking Drugs

A

Reverse the effects of sympathetic activation

Decrease cardiac work and oxygen consumption

20
Q

Indication of Beta Adrenergic Blocking Drugs

A

Long-term (chronic) management of angina pectoris

21
Q

Adverse effects of Beta Adrenergic Blocking Drugs

A

Drowsiness, tiredness, and GI disturbances

Effects of excessive dosage
-Bradycardia, hypotension, and possible development of heart failure

Nonselective beta-blockers should not be given to asthma or COPD patients.
-Can cause bronchoconstriction

22
Q

Calcium Channel Blockers Mechanism of action

A

Inhibit the influx of calcium ions into vascular smooth muscle
-Enable arteriolar vasodilation and reduce blood pressure

Administered on a daily basis to prevent angina
-Preferred drugs for treatment of variant or Prinzmetal angina and to relieve vasospasm

23
Q

Calcium Channel Blockers

Drugs with direct cardiac effects

A

Verapamil
-Used to treat supraventricular arrhythmias and angina

Diltiazem
-Possesses greater vasodilating effects in comparison to verapamil

24
Q

Calcium Channel Blockers

Drugs without direct cardiac effects

A

Nifedipine
-Potent arterial vasodilator

Nicardipine
-Causes vasodilation and relaxation of coronary artery spasm

Other calcium antagonists
-Amlodipine, felodipine, and isradipine

25
Q

Adverse effects of Calcium Channel Blockers

A

Headache, facial flushing, dizziness, hypotension, and minor GI disturbances

Verapamil and diltiazem

  • Overdosage can cause bradycardia, AV block, decreased myocardial contraction, and possible heart failure.
  • Contraindicated with beta-blockers
    • Causes excessive cardiac depression and heart failure
26
Q

External, fixed, or stable

Preferred Therapy for Angina Pectoris

A
  • nitrates
  • beta-blockers
  • calcium channel blockers
27
Q

Variant or Prinzmetal

Preferred Therapy for Angina Pectoris

A
  • calcium channel blockers

- nitrates

28
Q

Unstable

Preferred Therapy for Angina Pectoris

A
  • anitplatelet
  • anticoagulant therapy
  • life style changes

1390-59 Intro to Pharmacology (17 decks)

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