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Pharm II > Angina - CP > Flashcards

Angina - CP Flashcards

1
Q

Means: Squeezing Pain

A

Angina

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2
Q

Angina ______ with age

A

Increases

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3
Q 
Stable angina: 
Lasts less than \_\_\_ minutes.
Is triggered by exertion or emotional \_\_\_\_\_\_\_.
Requires greater than \_\_\_% stenosis
Involves reversible \_\_\_\_\_\_\_\_\_ injury
A

20
stress
70
myocyte

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4
Q

What is it if angina lasts longer than 20 min?

A

Myocardial infarction

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5
Q

In which type of angina does everything work under normal circumstances but when something abnormal happens (Like running up stairs) patient feels the pain.

A

Stable Angina

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6
Q

Signs and Symptoms of Stable angina: (4)

A
  • Chest pain less than 20 minutes
  • Pain that radiates
  • Diaphoresis
  • SOB
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7
Q

Type of angina that occurs at rest

A

unstable

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8
Q 
Unstable Angina:
Involves a ruptured \_\_\_\_\_\_\_\_\_\_ and thrombosis.
Only \_\_\_\_\_\_\_\_ occlusion results.
Reversible \_\_\_\_\_\_\_\_\_ injury
Is blood flow still present?
A

plaque
partial
myocyte
Yes, but decreased.

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9
Q

Type of angina that:

  • Is caused by vasospasm
  • Is unrelated to exertion
  • Has reversible myocyte injury (If less than 20 minutes)
A

Prinzmetal

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10
Q

Angina = ___ demand is greater than supply

A

O2

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11
Q

Best option for a person suffering angina: Decrease what?

A

The work of the heart

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12
Q

When you decrease the HR you decrease the work of the heart but you also increase _________ and the coronary artery perfusion (fill) during.

A

Diastole

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13
Q

When does the heart “eat” (fill).

A

Diastole

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14
Q

Most anginas come with an EKG that reflects what?

A

ST depression

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15
Q

What type of angina comes with ST elevation?

A

Prinzmetal

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16
Q
  1. Prinzmetal angina comes with ST elevation because?

2. ST elevation is what also shows up when a patient is having a ____ ?

A

blood flow is totally cut off

MI

17
Q

What does STEMI stand for?

A

ST elevated MI

18
Q

How should a nurse teach a patient taking nitroglycerine to position themselves and why?

A

Sit or lie down before taking because it will work really quickly and drop blood pressure.

19
Q

Why is nitroglycerine dissolved under the tongue?

A

To avoid first pass metabolism.

20
Q

What happens if nitroglycerine doesn’t relieve the pain in 5 minutes?

A

Take another one

21
Q

Nitroglycerine is indicated for Q5M. How many doses can be taken?

A

3

22
Q

Ways that nitro can be administered? (5)

A 
Sublingual tabs
Translingual spray
oral capsules SR
transdermal patch
topical ointment
23
Q

Can you crush isosorbide mononitrate?

A

No

24
Q

How long does isosorbide mononitrate last?

A

12 hours

25
Q

What kind of drug is isosorbide mononitrate?

A

Nitrate

26
Q

MOA of nitrates:

A

reduces cardiac oxygen demand by decreasing left ventricular pressure and preload

27
Q

Discuss why a client might take nitroglycerin prior to a stressful event.

A

Rapid-acting preparations also can be used for acute prophylaxis of angina. For this purpose, they are taken just before anticipated exertion

28
Q

Identify which clients might benefit from a long acting or transdermal nitrate:

A

These would be for someone looking to prevent an angina episode. These are not for an acute attack.

29
Q

Because sublingual administration of nitroglycerine works fast, this route is ideal for (2):

A
  1. Terminating an ongoing attack and

2. Short-term prophylaxis when exertion is anticipated.

30
Q

Effects of sublingual nitroglycerin begin rapidly—in ___ to ___ minutes—and persist up to __ hour.

A

1-3

1 hour

31
Q

By lowering the blood pressure, nitroglycerin can activate what reflex?

A

baroreceptor reflex,

32
Q

By lowering the blood pressure, nitroglycerin can activate baroreceptor reflex causing:

A

(reflex tachycardia) sympathetic stimulation of the heart

33
Q

What can prevent the reflex tachycardia response that comes with nitroglycerine:

A

Pretreatment with a beta-blocker or verapamil can prevent

34
Q

How does increasing time spent in diastole help the client with angina?

A

It increases the time blood flows through myocardial vessels.

35
Q

What is the goal heart rate when administering a beta blocker?

A

50-60 beats per minute

36
Q

Why cant you use beta blockers to treat prinzmetal angina?

A

Because it involves coronary vasospasm and beta blockers can make that worse.

37
Q

Adverse effects of isosorbide mononitrate?

A

Headache (50%),
Orthostasis,
Flushing (esp the face),
Dizziness

38
Q

Nitroglycerine can be taken every ___ minutes

A

5

39
Q

Nitrates have interactions with drugs containing:

A

PDE 5 (The enzyme that breaks down cGmp)

Pharm II (37 decks)

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