Chapter 24 Antianginal Drugs

Question 1

Ischemia

Answer 1

Poor blood supply to an organ

Question 2

Therapeutic objectives

Answer 2

• Increase blood flow to ischemic heart muscle and/or decrease myocardial oxygen demand
• Minimize the frequency of attacks and decrease the duration and intensity of anginal pain
• Improve the clients functional ability with minimal adverse effects
• Prevent or delay an MI

Question 3

Main actions

Answer 3

• Increase blood flow to the heart
• Increase duration of diastole
• Decrease preload and afterload
• Reduce contractility
• Most decrease HR

Question 4

Nitrates

Answer 4

• Cause vasodilation due to the relaxation of smooth muscles which reduces myocardial oxygen demand
• Many different routes: rapid acting (IV or spray) and long acting (patch)
• Adverse effects: can cause reflex tachycardia with rapid vasodilation, headaches, hypotension
• Make sure the patient is not standing when you administer
• Nitrates are only stable for 3-6 months
• Nitroglycerin has a large first pass effect so it not typically administered PO

Question 5

Beta Blockers

Answer 5

• suffix is olol
• B1 adrenergic receptors on the heart are blocked
• Decreases HR resulting in decreased myocardial oxygen demand and increased oxygen delivery to the heart
• Decreases myocardial contractility which helps to conserve energy
• Can also improve kidney function by suppressing renin activity
• Used for exertional angina, and has cardioprotective effects (especially after an MI)
• Adverse effects: hypotension, dizziness, impotence,

Question 6

Calcium Channel Blockers

Answer 6

• Used for vasospastic angina
• Cause coronary and peripheral vasodilation which decreases the workload of the heart (decreased oxygen demand)
• Adverse effects: constipation, hypotension, peripheral edema

Question 7

Nursing Considerations

Answer 7

• Always check BP (systolic less then 90 or HR less then 60 HOLD)
• Watch for othostatic hypotension and decreased peripheral circulation