Quiz 6 #1 Antianginals

Question 1

Role of coronary arteries

Answer 1

Arteries that deliver oxygen to the heart muscle

Question 2

Types of Angina

Answer 2

1) chronic stable angina (also known as classic or exertional angina)
2) variant angina (also known as Prinzmetal’s or vasospastic angina)
3) unstable angina.

Question 3

Nitro Instructions

Answer 3

1 pill every 5 minutes, if first pill did not resolve chest pain, call 911 as taking the second pill
*Max of 3 pills always 5 mins apart

Question 4

Angina definition and cause

Answer 4

Sudden pain beneath the sternum, often radiating to the left shoulder, left arm, and jaw.

Anginal pain is precipitated when the oxygen supply to the heart is insufficient to meet oxygen demand. Occurs secondary to atherosclerosis of coronary arteries.

Question 5

Contrast “rescue” and “controller” drugs

Answer 5

Controller drugs:
Beta-blockers, calcium channel blockers, and long-acting nitrates provide baseline prophylaxis or protection against acute angina attacks

Rescue drugs:
Sublingual (SL), translingual spray, and intravenous (IV) nitroglycerin is used to treat acute anginal pain

Question 6

Nitroglycerin Tolerance

Answer 6

Occurs in patients taking nitrates around the clock or with long-acting forms.
Prevented by allowing a regular nitrate-free period to allow enzyme pathways to replenish.

Question 7

Nitrates MOA/Drug Effects

Answer 7

MOA: NTG dilates veins which reduces venous return (↓ preload).

Effects: Decreased cardiac oxygen demand (atherosclerosis heart disease) and increased cardiac oxygen supply (variant angina)

Question 8

Nitrates Indications

Answer 8

Stable, unstable, and variant angina

Question 9

Nitrates Contraindications

Answer 9

Hypotension, erectile dysfunction drugs (e.g. Viagra, Levitra, or Cialis)

Question 10

Nitrates Adverse Effects

Answer 10

Headache
Orthostatic hypotension
Reflex tachycardia
Tolerance

Question 11

Nitrates Patient Education

Answer 11

• Instruct proper technique for administering SL, transdermal patch ointment, or oral routes
• Manage headache with acetaminophen
• Instruct men not to take with ED drugs (lethal combo!)

Question 12

Beta Blockers MOA/Drug Effects

Answer 12

MOA: Prevent stimulation of beta receptors in the heart which decreases heart rate and contractility. Also prevents release of renin.

Effect: Decreased myocardial oxygen demand

Question 13

Beta Blockers Indications

Answer 13

Prevention/prophylaxis of stable angina

Question 14

Beta Blockers Nursing Implications

Answer 14

Assess vital signs – hold and notify MD for HR less than 60

Question 15

Review Calcium Channel Blockers and Beta Blockers

Answer 15

I left some of the stuff we’ve done, out of the cards