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NURS 252 (Pharmacology 2) > Antianginal Drugs > Flashcards

Antianginal Drugs Flashcards

1
Q

What causes angina pectoris?

A

Decreased supply of oxygen to the heart resulting in the “aching” of the heart

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2
Q

What is ischemia, ischemic heart disease and MI?

A

I: Poor blood supply to an organ
IHD: Poor blood supply to the heart
MI: Necrosis of cardiac tissue

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3
Q

What are the 5 different kinds of angina and what are the two most common ?

A

Most common:
Stable, unstable
Others:
Variant, atypical, microvascular

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4
Q

What are the signs and symptoms of angina?

A

Pain in middle chest that radiates to L arm, back neck and jaw
Pressure, tightness or squeezing in arms and chest
Persistent indigestion
Numbness in arms, shoulders or wrists

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5
Q

What is a stable angina?

A

It occurs when the heart as to work harder than normal. (i.e exercise)
It has a regular pattern and usually subsides once activity is stopeed or medication is taken

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6
Q

What are the characteristics of a stable angina?

A

Feels the same each time it happens
Usually lasts <5 mins and stops after rest or medication
Might feel like indigestion

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7
Q

What is an unstable angina?

A

Often an indicator of an incoming heart attack
There is no predictable pattern, it can occur at any time
It should always be treated as an emergency
Increased risk for heart attacks, cardiac arrest or arrhythmias

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8
Q

What are the characteristics of an unstable angina?

A

Often happens during sleep or rest
May last >30 mins
Cannot be relieved with rest or meds

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9
Q

What is the relation between angina and women?

A

The type of pain is different: Usually stabbing, pulsating or sharp pain.
They’re also more likely to experience SOB, nausea, and abdominal pain

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10
Q

What are the 3 classes of angina drugs?

A

Nitrates and nitrites
Beta blockers
Calcium channel blockers

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11
Q

What is the overall goal of drug therapy?

A

Increase blood flow to ischemic myocardium and decrease myocardial o2 demand

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12
Q

What are the forms of nitrates and nitrites (N/N) that we need to know?

A

IV solutions, trandermal patches and translingual sprays

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13
Q

What is the MOA of N/N?

A

Vasodilation via relaxation of smooth muscles resulting in increased oxygen to ischemic myocardial tissue

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14
Q

What are the uses of rapid and long acting forms of N/N?

A

R: treatment of acute anginal attacks
L: Prevention of anginal episodes

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15
Q

Name a N/N

A

Nitroglycerin

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16
Q

What is the IV form of nitroglycerin used for?

A

Control of BP in periop HTN, HF, Ischemic pain, pulmonary edema and hypertensive emergencies

17
Q

What are the adverse effects of nitroglycerin?

A

Headaches
Reflex tachycardia
Postural hypotension
Tolerance may develop

18
Q

How can nitroglycerin tolerance be prevented and give an example

A

Allowing a regular nitrate-free period to allow enzyme pathways to replenish
Ex: Transdermal forms may be removed at bedtime and re-applied in the morning

19
Q

Name 2 antianginal beta blockers

A

Atenolol
Metoprolol

19
Q

What are the contraindications of nitrates?

A

Severe anemia
Closed-angle glaucoma
Hypotension
Severe head injury
Use of ED drugs

20
Q

What is the MOA of beta blockers?

A

Block beta receptors in the heart
Decrease HR, resulting in decreased O2 demand
Decrease contractility resulting in decreased demand and conserved energy

21
Q

How do beta blockers prevent further complications after a MI?

A

After a MI, a high level of catecholamines irritate the heart causing imbalances in supply and demand and leading to dysrhythmias
Beta blockers block the effects of catecholamines, improving survival after a MI

22
Q

What are the indications of beta blockers?

A

Angina
HTN
Dysrhythmias
MI

23
Q

What are the contraindications of beta blockers?

A

Systolic HF
Diabetes mellitus
Peripheral vascular disease
Use caution in bronchial asthma

24
Q

What are the adverse effects of beta blockers?

A

Bradycardia, hypotension, AV block, hyper and hypoglycemia, hyperlipidemia, dizziness, fatigue, depression, lethargy, ED, wheezing, dyspnea

25
Q

What is atenolol? (ID, forms)

A

ID: Prophylactic treatment of angina pectoris
Oral form

26
Q

What is metoprolol (ID, Forms)

A

ID: Prophylactic treatment of angina
Forms: Oral and parenteral forms

27
Q

Name 2 CCBs

A

Amlodipine
Diltiazem

28
Q

What is the MOA of CCBs

A

Cause coronary and peripheral artery dilation resulting in a reduction of the workload of the heart which decreases the o2 demand

29
Q

What are the indications of CCBs?

A

Angina
HTN
Supraventricular tachycardia
Coronary artery spasms
Short-term management of a-fib
Migraines
Raynauds

30
Q

What are the contraindications of CCBs?

A

Acute MI
Second or third degree AV block (Pacemaker exception)
Hypotension

31
Q

What are the adverse effects of CCBs

A

Hypotension, palpitations, tachy or bradycardia, constipation, nausea, dyspnea

32
Q

What complications should patients report?

A

Blurred vision
Persistent headache
Dry mouth
Edema
Fainting episodes
Weight gain >1kg/24h or >2.3kg/1w
HR less than 60 bpm
Dyspnea

33
Q

Encourage pts to keep a record of their anginal attacks including _______, ___________, _________

A

of pills taken

Precipitating factors
# of drugs taken
therapeutic effects

34
Q

How long is SL nitroglycerin potent for?

A

3 to 6 months

35
Q

How can potency be preserved for nitroglycerin?

A

Store in an airtight, dark glass bottle with a metal cap and no cotton filter

36
Q

What should you tell a pt to do if anginal pain occurs?

A

Stop activity and take a SL nitro tablet
Call 911 and take a 2nd tablet if no relief in 5 mins
Take a 3rd tablet if no relief in 5 mins
Do not drive to the hospital

37
Q

How should IV forms of nitro be administered?

A

with Special non-polyvinyl chloride tubing and bags

NURS 252 (Pharmacology 2) (23 decks)

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