angina drugs

Question 1

angina

Answer 1

chest pain that results from ischemia

O2 reqs of heart are greater than supply

Question 2

4 risk factors for coronary heart disease and angina

Answer 2

smoking
diabetes
hyperlipidemia
hypertension

Question 3

4 types of angina

Answer 3

stable angina
unstable angina
prinzmetal/variant angina
microvascular angina

Question 4

stable angina

Answer 4

precipitated by stress

relieved by rest, ntg

Question 5

unstable angina

Answer 5

severe symptoms
less responsive to tx
intermediate of stable angina and MI

Question 6

variant (prinzmetal’s) angina

Answer 6

results from coronary artery spasm

does not necessarily occur with exertion

Question 7

refractory (intractable) angina

Answer 7

incapacitating pain

does not respond to standard tx

Question 8

beta blockers & angina

Answer 8

prevent beta-adrenergic receptions from being stimulated

decreases O2 demand of heart and therefore decreases angina

Question 9

calcium channel blockers & angina

Answer 9

inhibit calcium from moving across cell membranes
decreases contraction, depresses impulse formation (automaticity), slows conduction velocity
arteriolar dilation, decreasing afterload
these effects decrease O2 demands of heart

Question 10

nitrates & angina

Answer 10

dilate vascular smooth muscle and both venous/arterial vessels
venous dilation decreases preload
arterial dilation decreases systematic vascular resistance and arterial pressure (afterload)

Question 11

when to use ACE inhibitor for CAD

Answer 11

when pt also has diabetes, systolic dysfuction, or both

Question 12

nitroglycerin (Nitrostat)

Answer 12

nitrate prototype

improves circulation to the heart by redistributing blood flow to collateral vessels

Question 13

nitroglycerin (Nitrostat) pharmacokinetics

Answer 13

can be IV, oral, topical, sublingual, nasal

Question 14

nitroglycerin (Nitrostat) pharmacodynamics

Answer 14

relaxes vascular smooth muscle and dilates arterial and venous vessels, but more effective on venous side

Question 15

nitroglycerin (Nitrostat) contraindications

Answer 15

hypersensitivity, severe anemia, closed-angle glaucoma

Question 16

nitroglycerin (Nitrostat) adverse effects

Answer 16

headache
hypotension
tachycardia
vertigo
weakness/syncope
anxiety

Question 17

nitroglycerin (Nitrostat) nursing dx

Answer 17

acute pain: r/t cardiac disease
decreased cardiac output: r/t drug therapy
risk for injury: r/t hypotension and dizziness 2/2 drug therapy

Question 18

nitroglycerin (Nitrostat) planning/intervention

Answer 18

max therapeutic effect: varies with ROA

min adverse effect: check vitals before admin, monitor BP and assist pt when standing, treat headaches w aspirin/acetominophen

Question 19

nitroglycerin (Nitrostat) pt education

Answer 19

instruct pt to sit or lie down when experiencing angina
do not apply patch to distal parts of extremities
make pt aware of orthostatic hypotension

Question 20

if a patient is taking phosphodiesterase inhibitors (erectile dysfunction drugs), such as sildenafil, what type of antianginal drug should be avoided?

Answer 20

nitrates

Question 21

nicardipine

Answer 21

calcium channel blocker; decreases afterload and automaticity

Question 22

time of onset for sublingual nitroglycerin

Answer 22

1-3 min

Question 23

oral nitroglycerin storage

Answer 23

keep tablets and capsules in their original container

never mix oral nitroglycerin w other drugs in a container
never store oral nitroglycerin in a plastic container
replace lid tightly as soon as the drug is removed.

Question 24

angina pectoris

Answer 24

substernal chest pain that can radiate to the jaw

Question 25

s/s to monitor in clients taking calcium channel blockers

Answer 25

should be monitored for signs of heart failure (dyspnea, weight gain, peripheral edema, crackles, rales, and jugular vein distention).

Question 26

beta blockers & diabetes cautions

Answer 26

Beta blockers should be used with caution in patients with diabetes mellitus because they conceal signs of hypoglycemia

Question 27

The 47-year-old client is experiencing chest pain and has taken three sublingual nitrogylcerin tablets, but the pain remains. What should the client do next?

Answer 27

Call 911 do not transport by private vehicle w chest pain

Question 28

amplodipine

Answer 28

calcium channel blocker

Question 29

verapimil

Answer 29

calcium channel blocker

Question 30

nadolol

Answer 30

beta blocker