CHD Drugs Flashcards
Nonpharmaceutical Treatment
- decrease risk factors (changing lifestyle/diet or increase activity)
- pt education (knowing the risks)
- cardiovascular (stenting)
Nitrate Examples
Nitroglycerin (Nitro-Bid)
Isosorbide Dinitrate (Isordil)
Isosorbide Mononitrate (Imdur)
Nitrate Routes
Oral (50-60% absorbed)
IV (no absorption needed)
Sublingual (100% absorbed Onset: 1-3 minutes) (best)
Ointment
Transdermal Disk (absorption varies with site)
Nitrate Action
relaxes smooth muscle, promotes vasodilation
Nitrate Uses
relief of sudden chest pain
Nitrates SE
headaches
hypotension
reflex tachycardia
Nitrates Complications
Severe Anemia
Hypotension
Hypovolemia
ICH (HTN, bradycardia, irregular breathing)
Nitrates Considerations
skin irritation
tolerance build up
availability
interaction with vitamin c
Nitrates Pt Education
Vitamin C interaction
do not carry in pocket!
Calcium Channel Blockers Example
Diltiazem (cardizem)
Calcium Channel Blockers Action
promote vasodilation by inhibiting calcium
(decreases refractory period of AV node —> decreases ventricular response —> decreases HR)
Calcium Channel Blockers Uses
HTN Management
Calcium Channel Blockers SE
bradycardia
hypotension
headache
dizziness
Calcium Channel Blockers Considerations
monitor BP & HR
Calcium Channel Blockers Pt Education
Change positions slowly (bp may drop d/t orthostatic hypotension)
Avoid grapefruit juice
Beta-Adrenergic Blockers Example
Sotalol (betapace)
Beta-Adrenergic Blockers Action
prolongs cardiac action potential (does not interfere with vasodilation or bronchoconstriction) (lengthen QT interval)
Beta-Adrenergic Blockers Uses
HTN (pt less than 50)
Beta-Adrenergic Blockers SE
arrhythmias
chest pain
palpitations
fatigue
dizziness
hypotension
bradycardia
HF
cardiac ischemia
bronchospasm
thyroid abnormalities
hypoglycemia
Beta-Adrenergic Blockers Considerations
dosing is determined by evaluating renal function
monitor BP & HR
Beta-Adrenergic Blockers Pt Education
orthostatic hypotension
masking the signs of hypoglycemia (diabetes pts take extra caution)
Ranolazine (Ranexa) Action
unknown, reduces Na and Ca within myocardial cells
Ranolazine (Ranexa) Uses
first line tx for CHD
Ranolazine (Ranexa) Adverse Effects
HTN
QT interval prolonging (Mg can be given for reversal)
multiple drug interactions
Ranolazine (Ranexa) Considerations
not as effective in women
MONA Therapy
M: morphine (chest pain)
O: oxygen (improve supply for demand)
N: nitrate (vasodilation)
A: aspirin (improve blood flow)
