Wk 13. Antianginal Flashcards
- What type of angina is caused by coronary spasm?
Variant
- What kind of angina does not respond to beta-blockers?
Variant
- Nitrates predominately vasodilate which vessels in low doses? Prevent spasm where?
Veins. Coronary arteries.
- Headaches due to nitrates can be expected to do what over time?
Diminish
- What adverse effect is triggered by baroreceptors in response to venous dilation?
Reflex tachycardia
- What drugs are contraindicated in men who are taking nitrates?
Phosphodiesterase type 5 inhibitors
- Which nitrate formulation is recommended for intermittent angina treatment at home?
SL nitroglycerin
- How are SL nitroglycerin tablets taken?
1 Tablet (0.3-0.6 mg) every 5 minutes x 3, Emergency department if angina persists 5 min
- What must the nurse check before administering nitroglycerin?
Blood pressure and pulse
- Why should nitroglycerin paste be removed at night?
Prevent tachyphylaxis (tolerance)
- How would a dry mouth affect the absorption of nitroglycerin?
Slows absorption
- Nitrates in low doses decrease afterload or preload? Arterioles or veins?
Preload. Veins.
- Selective beta-blockers block which receptors at low doses?
Beta-1
- Beta-blockers decrease three parameters. What are they?
Heart rate, blood pressure, contractility
- What may beta-blockers mask in diabetes and during allergy shots?
Signs of hypoglycemia and allergic reactions.
- Which drug given for allergic reactions may be inhibited by beta-blockers?
Epinephrine
- In asthmatics, beta-blockers may cause what symptom? Block what receptor?
Bronchoconstriction. Beta-2.
- Beta-blockers with verapamil or diltiazem can severely decrease which vital sign parameter?
Heart rate
- Abrupt cessation of beta-blockers can lead to excitation or depression of the beta-adrenergic receptors?
Excitation
- Do not give beta-blockers if the pulse is below ____ or the systolic BP is below____.
Pulse 50, SBP 90
- What is the family of calcium-channel blockers which does not include verapamil or diltiazem?
Dihydropyridines
- Calcium-channel blockers vasodilate which blood vessels?
Arterioles
- Calcium-channel blockers decrease afterload or preload?
Afterload
- Dihydropyridines may cause what side effect which can be treated with beta-blockers?
Reflex tachycardia
- Swelling of extremities may be caused by what 2 classes of antihypertensive agents?
Nitrates & calcium-channel blockers
- Calcium-channel blockers are used for what kinds of angina?
Stable and variant
- Vasodilation of arteries reduces afterload or preload?
Afterload
- Digoxin (Lanoxin) is used in heart failure primarily for what effect?
Positive inotropic effect
- What should the nurse do before giving digoxin?
Take the apical pulse for 1 minute.
- What electrolyte competes with digoxin for the receptor?
Potassium
- What are some signs of digitalis toxicity?
Anorexia, nausea, vomiting, arrhythmias, weakness, yellow vision, halos around lights, blurred vision
- What is the antidote for digoxin toxicity?
Digibind
- What common drug classes can precipitate digoxin toxicity?
Loop and thiazide diuretics
- What are the effects of alpha-1 activation by catecholamines?
Vasoconstriction of arterioles in skin, viscera, & mucous membranes and in veins.
- What are the effects of beta-1 activation by catecholamines?
Increased heart rate, contractility, and conduction rate. Renin release.
- What are the effects of beta-2 activation in the lungs and liver?
Bronchodilation & glycogenolysis.
- What are the effects of dopamine activation?
Renal blood vessel dilation.
- Which IV continuous drug is used to increase contractility without causing vasoconstriction?
Dobutamine (Dobutrex).
