Mod 6- Antianginal Agents

Question 1

What type of angina subsides w/ rest and causes no damage to the heart?

Answer 1

Stable angina

Question 2

What type of angina occurs with episodes of ischemia even at rest?

Answer 2

Unstable Angina

Question 3

What type of angina is caused by the SPASMING not just narrowing of the vessels?

Answer 3

Prinzmeta’ls angina

Question 4

What is the action of Antianginal Drugs

Answer 4

improve blood delivery to the heart by dilating the blood vessels- thus increasing supply of o2
improve blood delivery to heart muscle by decreasing work of the heart- decreases demand for o2

Question 5

T/F Antianginal Drugs do not cross the placenta and enter breastmilk

Answer 5

FALSE- they do cross placenta and enter breast milk

Question 6

How would you identify a Nitrate medication?

Answer 6

Has nitrate or Nitro in the name
isosorbide dinitrate
isosorbide mononitrate
Nitroglycerin- taken when chest pain

Question 7

Action of Nitrates

Answer 7

Acts on smooth muscle to cause relaxation and depress muscle tone of blood vessels

Question 8

When are nitrates indicated?

Answer 8

prevention & tx of attacks of angina pectoris

Question 9

Contraindications of Nitrates

Answer 9

allergy, severe anemia- reduced o2 carrying capacity, vasodilation can cause hypotension, can complicate o2 delivery
head trauma/ cerebral hemorrhage- can cause more bleeding

Question 10

Cautions for Nitrates

Answer 10

hepatic/ renal disease

hypotension, hypovolemia, conditions that limit cardiac output

Question 11

Nitrate ADE

Answer 11

R/t vasodilation and decrease in blood flow
CNS- HA, dizziness, weakness
GI- N/V
*Hypotension- especially when changing positions
flushing, pallor, increase perspiration

Question 12

Drug/ Drug interactions for Nitrates

Answer 12

Ergot derivatives- can cause vasoconstriction, causes decreased effects
Heparin
Sildenail, tadalafil, vardenafil- erectile dysfunction drugs

Question 13

What is an important question to ask male patients if planning to administer a nitrate? Can impact life/ death

Answer 13

Have you taken any erectile dysfunction drugs in the last 24 hours? If given together, can cause CV collapse

Question 14

Should a pt lay down or stand up prior to administering Nitrates?

Answer 14

Lay down bc hypotension

Question 15

How often can you give a sublingual nitrate and how many times before reporting to the emergency room?

Answer 15

Give 3 doses 5 min apart

Question 16

What is the suffix for Beta Blockers?

Answer 16

"-olol"
atenolol 
metoprolol 
propanolol 
nadolol

Question 17

Actions of beta blockers

Answer 17

Lowers blood volume and causes vasodilation; decreases release of renin

Question 18

When are beta blockers indicated?

Answer 18

Tx of stable angina pectoris and hypertension; prevents reinfarction in MI pts, treats stable CHF

Question 19

When would you not give a beta blocker?

Answer 19

Bradycardia, heart block, cardiogenic shock- b/c heart is already less functional, asthma COPD, pregnancy/ lactation

Question 20

Why should you be careful giving beta blockers to a diabetic?

Answer 20

It can mask symptoms of hypoglycemia

Question 21

ADE of Beta blockers

Answer 21

r/t blockage of SNS
CNS- dizziness, fatigue, emotional depression
GI- N/V, colitis
Respiratory- bronchospasm, dyspnea, cough

Question 22

Drug/ Drug interactions w/ Beta Blockers

Answer 22

Clonidine

NSAIDs

Question 23

T/F Beta Blockers can be stopped immediately

Answer 23

FALSE- must be tapered over 2 weeks to avoid rebound hypertension

Question 24

Beta Blocker Prototype

Answer 24

Metoprolol

Question 25

Calcium Channel Blocker Medications

Answer 25

``` most end in "-odpine" amlodipine diltiazem nicardipine nifedipine verapamil ```

Question 26

Action of Calcium Channel Blockers

Answer 26

inhibits the movement of calcium, altering the action potential and blocking the muscle cell contraction

Question 27

Indications for Calcium Channel blockers

Answer 27

Prinzemetal's angina

Question 28

When are calcium channel blockers contraindicated?

Answer 28

allergy, heart block or sick sinus syndrome, renal/ hepatic dysfunction, pregnancy/ lactation

Question 29

ADE of Calcium Channel Blockers *

Answer 29

*hypotension *cardiac arrhythmia GI upset skin reactions H/A

Question 30

Drug/ Drug interactions of Calcium Channel Blockers

Answer 30

Cyclosporine | Dogoxin- can cause complete heart block and digoxin toxicity