Mod 6- Antianginal Agents Flashcards
What type of angina subsides w/ rest and causes no damage to the heart?
Stable angina
What type of angina occurs with episodes of ischemia even at rest?
Unstable Angina
What type of angina is caused by the SPASMING not just narrowing of the vessels?
Prinzmeta’ls angina
What is the action of Antianginal Drugs
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
T/F Antianginal Drugs do not cross the placenta and enter breastmilk
FALSE- they do cross placenta and enter breast milk
How would you identify a Nitrate medication?
Has nitrate or Nitro in the name
isosorbide dinitrate
isosorbide mononitrate
Nitroglycerin- taken when chest pain
Action of Nitrates
Acts on smooth muscle to cause relaxation and depress muscle tone of blood vessels
When are nitrates indicated?
prevention & tx of attacks of angina pectoris
Contraindications of Nitrates
allergy, severe anemia- reduced o2 carrying capacity, vasodilation can cause hypotension, can complicate o2 delivery
head trauma/ cerebral hemorrhage- can cause more bleeding
Cautions for Nitrates
hepatic/ renal disease
hypotension, hypovolemia, conditions that limit cardiac output
Nitrate ADE
R/t vasodilation and decrease in blood flow
CNS- HA, dizziness, weakness
GI- N/V
*Hypotension- especially when changing positions
flushing, pallor, increase perspiration
Drug/ Drug interactions for Nitrates
Ergot derivatives- can cause vasoconstriction, causes decreased effects
Heparin
Sildenail, tadalafil, vardenafil- erectile dysfunction drugs
What is an important question to ask male patients if planning to administer a nitrate? Can impact life/ death
Have you taken any erectile dysfunction drugs in the last 24 hours? If given together, can cause CV collapse
Should a pt lay down or stand up prior to administering Nitrates?
Lay down bc hypotension
How often can you give a sublingual nitrate and how many times before reporting to the emergency room?
Give 3 doses 5 min apart
What is the suffix for Beta Blockers?
"-olol" atenolol metoprolol propanolol nadolol
Actions of beta blockers
Lowers blood volume and causes vasodilation; decreases release of renin
When are beta blockers indicated?
Tx of stable angina pectoris and hypertension; prevents reinfarction in MI pts, treats stable CHF
When would you not give a beta blocker?
Bradycardia, heart block, cardiogenic shock- b/c heart is already less functional, asthma COPD, pregnancy/ lactation
Why should you be careful giving beta blockers to a diabetic?
It can mask symptoms of hypoglycemia
ADE of Beta blockers
r/t blockage of SNS
CNS- dizziness, fatigue, emotional depression
GI- N/V, colitis
Respiratory- bronchospasm, dyspnea, cough
Drug/ Drug interactions w/ Beta Blockers
Clonidine
NSAIDs
T/F Beta Blockers can be stopped immediately
FALSE- must be tapered over 2 weeks to avoid rebound hypertension
Beta Blocker Prototype
Metoprolol
Calcium Channel Blocker Medications
most end in "-odpine" amlodipine diltiazem nicardipine nifedipine verapamil
Action of Calcium Channel Blockers
inhibits the movement of calcium, altering the action potential and blocking the muscle cell contraction
Indications for Calcium Channel blockers
Prinzemetal’s angina
When are calcium channel blockers contraindicated?
allergy, heart block or sick sinus syndrome, renal/ hepatic dysfunction, pregnancy/ lactation
ADE of Calcium Channel Blockers *
*hypotension
*cardiac arrhythmia
GI upset
skin reactions
H/A
Drug/ Drug interactions of Calcium Channel Blockers
Cyclosporine
Dogoxin- can cause complete heart block and digoxin toxicity
