Drugs for Angina Pectoris 1 Flashcards
both major right and left coronary arteries branch off of what
aorta
coronary arteries surround
the heart
coronary arteries provide what to the heart
nutrients and oxygen
if heart doesn’t get oxygen and nutrients then
muscle can become necrotic and lead to MI
angina pectoris indicator for
coronary artery disease
angina pectoris
sudden pain beneath the sternum, often radiating to left shoulder and arm
oxygen supply to the heart is insufficient to meet
oxygen demand
older women and angina pectoris
will not have classic symptoms, usually very fatigue, some complain of jaw pain; so people can have atypical symptoms
Chronic stable angina (exertional):
predictable and usually relieved with rest; pt can predict what will cause chest pain
Chronic stable angina (exertional) causes
emotional excitement; large meals; cold exposure; coronary artery disease (CAD)
Unstable Angina:
Unpredictable, occurs with rest or excretion; May or may not respond to therapy; usually having a MI
KNOW HOW BLOOD FLOWS THROUGH THE HEART
know
Variant or Prinzmetal’s Angina cause
coronary spasm
treatment goals and strategy of angina pectoris
Prevention of myocardial infarction and death; Prevention of myocardial ischemia and anginal pain; Decrease Oxygen demand; Increase Oxygen supply
myocardial infarction
death of tissue
myocardial ischemia
lack of oxygen and when want to do intervention
number one treatment for angina pectoris is
calcium channel blockers
what drugs can be used for MI
beta blockers
calcium does what
depolarizes and leads to contraction of smooth muscle
drugs used for angina pectoris:
Three families of antianginal agents - Organic nitrates, Beta blockers, Calcium channel blockers; Also used is - Aspirin (salicylates)
an example of anti platelet drug
aspirin (salicylates)
sublingual tablets
under the tongue, have great hepatic 1st pass effect
sustained- release oral capsules
for maintenance issues, to keep vessels open
transdermal delivery systems
patches
intravenous infusion
(tradil - nitroglycerine drip )
paste
most common; tape chest on paper, do not get on your fingers because will vasodilate you
Organic Nitrates - Preparations and routes of administration
Sublingual tablets; Sustained-release oral capsules; Transdermal delivery systems; Translingual spray; Transmucosal (buccal) tablets; Topical ointment; Intravenous infusion
NTG acts directly on what
vascular smooth muscle to promote vasodilation
when vasodilate blood pressure
decreases; so monitor bp and might have to give blood interact
nitroglycerin
heart and vessel dilator
nitroglycerin is a
A Vasodilator that: decreases workload of heart muscle, and Decreases “preload” – amount of volume returning to heart
preload
work of the heart; volume coming back to the heart
nitroglycerin also decreases
afterload
afterload
resistance left ventricle meets as trying to push out of the body, so vessels dilate so it doesn’t have to work as heard
adverse effects of nitroglycerin
headache, orthostatic hypotension, reflex tachycardia
reflex tachycardia
heart responds to vasodilation, sometimes by pumping harder
Viagra, Levitra, or Cialis
pretty strong vasodilators; combined w/ NTG will cause big problems
can’t use what w/in 24 hours of receiving NTG
Viagra or Levitra - Will cause significant: Hypotension, headaches, muscle aches and pains, GERD
can’t us what w/in 36 hours of receiving NTG
Cialis - will cause significant Hypotension, headaches, muscle aches and pains, GERD
Interactions with NTG
Hypotensive drugs; Phosphodiesterase type 5 inhibitors (sildenafil –Viagra); Beta blockers, verapamil, and diltiazem
viagra will do what with NTG
will further lower BP
verapamil and diltiazem
calcium channel blockers
When and how to take NTG:
: One tablet sublingually every 5 minutes x 3; If pain persists, call 911
how to store NTG
in dry cool place; tablets are heat, light, and moisture sensitive; not in bathroom cabinet moisture and heat not good for med
Nitrate Free Interval-
remove nitrate paste at night to prevent “tolerance” effect
Tablets should _____ under tongue
“sizzle”
NTG dates of bottles
date bottle when first opened; only good for 1-3 months
with NTG have “golden hour”
sooner than later to open up vessel
if use NTG paste
if use paste 24 hr a day then a tolerance effect will happen and vessels will become intolerant if paste is used continuos
