Antianginals

Question 1

Nitrates/ Nitrite Meds (list them)

Answer 1

Nitrostat (vasodilator), Isosorbide dinitrate (Isordil), Isosorbide mononitrate (Imdur)
MOA: vasodilator; dilation decr venous return -> dcr preload -> decr oxygen demand
A/E: h/a, reflex tachycardia, postural hpn, may dev TOLERANCE
Contraindications: anemic, closed-angle glaucoma, hpn, recurrent h/a, on ED meds
*mononitrate used LONG ACTING
*Nitroglycerin used for BOTH rapid + long-acting relief
*nitro must be stored in original container and only opened when needed. expires in 3 months
**SL nitro can be taken 3 times, 5 mins apart
-> if after first dose no improvement, call 911 & take another
**has HIGH first-pass effect so topical/ SL is best

Question 2

Beta Blocker med

Answer 2

Metoprolol, Atenolol

refer to previous quiz

Question 3

Three types of angina

Answer 3

Stable- due to exertion
Unstable- during rest. NOT alleviated w/ nitroglycerin
Variant- anytime

Question 4

Angina

Answer 4

decr blood flow-> decr O2 in heart -> anaerobic metabolism -> lactic acid byproduct = PAIN

Question 5

Ischemia

Answer 5

decrease blood flow

Question 6

Infarct

Answer 6

death of tissue

Question 7

Calcium Channel Blocker (CCB) Meds

Answer 7

Amlodipine, Verapamil, Diltiazem, Nifedipine
MOA: prevents SM contraction. decr workload of heart by decr oxygen demand
Indications: stable AND variant angina, HTN, dysrhythmias (diltiazem), prevent artery spasm after cerebral hemorrhage (nimodipine)
A/E: hpn, flushing, dizzy, fatigue, edema, palpitations

Question 8

Education for antianginals:

Answer 8

• Avoid alcohol, hot baths, hot tubs, saunas
• change positions slowly
• keep a good log of attacks