WEEK 3 ANGINA & ACS MEDS/LABS

Question 1

Explain the action of nitrates

Answer 1

Dilates coronary arteries

Question 2

Patients taking nitroglycerin should avoid which 2 substances?

Answer 2

1. Alcohol
2. ED drugs

Question 3

What are the instructions for using nitroglycerin during an acute anginal episode?

Answer 3

1. Take one tablet
2. If the chest pain not relieved in 5 minutes, call 911 immediately.
3. The patient may take one more tablet while awaiting emergency care and a third tablet 5 minutes later
4. Take no more than three tablets total.
5. Always sit or lie down before taking this medication.

Question 4

What dosage form of nitro has the longest duration?

Answer 4

Transdermal patch

Question 5

What are 3 side effects of nitroglycerin?

Answer 5

1. Headaches, dizziness, fatigue (lie down when taking)
2. Reflex tachycardia
3. Tolerance

Question 6

What is done to prevent developing tolerance to nitroglycerin?

Answer 6

Take off patch for 8 hrs at night

Question 7

What is the MOST APPROPRIATE use of sublingual nitroglycerin?

Answer 7

To prevent angina

Question 8

Calcium channel blockers are prescribed to treat which kind of angina?

Answer 8

Vasospastic

Question 9

Explain the action of antithrombotics

Answer 9

Prevents conversion of fibrinogen into fibrin by potentiating antithrombin

Question 10

What is the therapeutic effect of antithrombotics?

Answer 10

Prevents thrombus formation and extension of existing thrombi

Question 11

Name 2 examples of antithrombotics

Answer 11

1. Heparin
2. Enoxaparin

Question 12

How are heparin and enoxaparin different?

Answer 12

Heparin is faster acting, enoxaparin lasts longer

Question 13

What foods should be avoided in patients taking antithrombotics?

Answer 13

Foods high in vitamin K, as they will decrease the effectiveness

Question 14

What 2 points regarding personal care should be included in patient teaching for antithrombotics?

Answer 14

1. Brush teeth gently
2. Use electric razors

Question 15

Explain the action of stool softeners like docusate

Answer 15

Promotes incorporation of water into stool

Question 16

Why are stool softeners prescribed to patients post MI?

Answer 16

Prevention of constipation in patients who should avoid straining

Question 17

Explain the action of thrombolytics

Answer 17

Directly converts plasminogen to plasmin to degrade clot-bound fibrin

Question 18

What is the therapeutic effect of thrombolytics?

Answer 18

Lysis of thrombi/emboli

Question 19

Name 2 examples of thrombolytics

Answer 19

1. Streptokinase
2. tPA (thrombolytic plasminogen activator)

Question 20

How are thrombolytics administered?

Answer 20

Only through a compressible site, an existing peripheral IV

Question 21

What are 3 contraindications for thrombolytics?

Answer 21

1. Active bleed (e.g. peptic ulcer)
2. Hypertensive crisis
3. Recent surgery (within 2 weeks)