Final Exam Flashcards - Angina

Question 1

Angina

Answer 1

• A symptom of ischemic heart disease

- In angina there is an imbalance between blood supplied to the heart and the need for blood and oxygen

Question 2

Symptoms of Angina

Answer 2

-Chest sensation expressed as pressure, squeezing, burning, fullness, etc.
symptoms are due to coronary arteries being damaged, blocked or narrowed

Question 3

Types of Angina

Answer 3

• Stable
• Unstable
• Variant

Question 4

Stable Angina

Answer 4

• Blood and O2 supply are sufficient if there are no demands placed on the heart
• Symptoms only occur with physical exertion
• Symptoms are relieved by rest and/or medication

Question 5

Unstable Angina

Answer 5

• Symptoms may occur at rest, without physical exertion

- Symptoms are NOT relieved by rest or medication

Question 6

Variant Angina

Answer 6

• Symptoms are caused by vasospasm of coronary arteries
• symptoms occur at rest, at night, or early morning
• Symptoms are relieved by medications

Question 7

Nitrates

Answer 7

• All have “nitro” or “nitra” in their names
• Dilate blood vessels
• Most are prodrugs

Question 8

Nitrate Dosage Forms

Answer 8

Some dosage systems are designed to deliver nitroglycerin quickly and are used to treat acute symptoms (ex. sublingual tablets, lingual spray, parenteral, oral tabs)
-Some are meant do deliver nitroglycerin over an extended period of time and are intended to prevent angina symptoms (ex. Transdermal patches, extended release tablets, ointment)

Question 9

Nitroglycerin For Acute Treatment

Answer 9

• Designed for Quick Delivery
• Schedule II
• May use 1 dose SL every 5 minutes for acute angina
• patient should be seated
• Maximum 3 doses in 15 minutes

Question 10

Isosorbide (-Nitrate)

Answer 10

• Isosorbide dinitrate is formulated for acute use (SL 5 mg tabs), and prevention (10 and 30 mg tabs)
• Isosorbide mononitrate is the long acting metabolite of ISDN. Used for prevention only

Question 11

Nitroglycerin Patches

Answer 11

• Transdermal delivery avoids first pass metabolism

- Patch is applied for 12-14 hours, then removed for 10-12 hours to avoid tolerance

Question 12

Nitrate ADR’s

Answer 12

• Hypotension
• Facial flushing
• Dizziness
• Headache
• N/V
• Weakness
• Fatigue

Question 13

Nitrate Tech Note!

Answer 13

• Patients who use nitrates can develop tolerance

- Patient must be nitrate free for at least 10-12 hours per day to minimize risk of tolerance

Question 14

B-Adrenergic Blockers For Angina

Answer 14

• Administered to reduce hearts demand for oxygen
• Decrease heart rate
• Decrease frequency and severity of stable angina (Used for prevention)

Question 15

CCB’s for Angina

Answer 15

-Used to treat variant and stable angina