Cardiovascular medication's part 2

Question 1

Anti-anginal drugs are:

Answer 1

• used to treat coronary artery disease
  -minimise frequency and intensity of angina episodes

Question 2

Ischemic Heart Disease is:

Answer 2

• when cholesterol, calcium and other substances build up in the inner lining of the arteries forming a plaque
• the artery becomes narrowed and blood flow is reduced
• a reduction of blood flow caused damage when blockage of the artery occurs

Question 3

Angina Pectoris is:

Answer 3

• chest pain associated with myocardial ischaemia
• myocardial demand exceeds available oxygen and nutrients which causes chest pain

Question 4

When does angina pectoris occur?

Answer 4

• on exertion and is usually relieved with rest

Question 5

When can variant (unstable) angina occur?

Answer 5

• at anytime
• occurs when plaque ruptures and causes clot formation

Question 6

Anti-anginal drugs:

Answer 6

-intention of drug therapy is to restore balance between myocardial demand and oxygen supply

Question 7

what do peripheral vasodilators do?

Answer 7

• dilate veins and arteries by effecting vascular smooth muscle
• reduce peripheral resistance

Question 8

Examples of peripheral vasodilators:

Answer 8

• Glyceryl trinitrate (Nitroglycerin)
• Isosorbide dinitrate / mononitrate
  These are used to treat and prevent heart-related chest pain (angina).
  They work by relaxing and widening blood vessels so blood can flow more easily to the heart

Question 9

Available forms of nitrates:

Answer 9

• tablets
• paste
• patch (nitro 25 or 50)
• spray
• intradermal implant

Question 10

Side effects of vasodilation:

Answer 10

• tachycardia
• hypotension
• facial flushing
• syncope
• headache
  -skin rashes

Question 11

Hyperlipidemia is?

Answer 11

• raised serum levels - fats in blood
• VLDL (very low-density lipoproteins)
• LDL (low density lipoproteins)
• HDL (high density lipoproteins)

Question 12

Cholesterol:

Answer 12

• Normal level should be: 5.5mmol/l
• it is desirable to have HDL:LDL ratio

Question 13

Non-drug measures for hyperlipidemia can be:

Answer 13

• diet - restrict intake of fatty foods
• increase intake of vegetables, fruit and fish
• exercise, weight and smoke reduction - this raises HDL and lower LDL cholesterol -

Question 14

What is some lipid lowering drugs?

Answer 14

• Fibrates
• Statins
• Bile acid-binding resins
• Other agents: nicotinic acid, fish oil etc.

Question 15

Fibrate drug examples:

Answer 15

• Gemfibrozil
• fenofibrate
  These are used to treat high cholesterol. By lowering triglyceride levels and reducing LDL levels and increasing HDL levels

Question 16

Side effects of Fibrate drugs include:

Answer 16

• abdominal pain
• diarrhoea
• nausea
• liver irritation
• may cause gallstones following long term use

Question 17

HMG-CoA reductase inhibitors (Statins) is:

Answer 17

• first line treatment for hypocholesterolemia
• reduces the levels of LDL-C
• have anti-inflammatory and antithrombotic effect
• statins reduce the risk of acute myocardial infarction, stroke and mortality

Question 18

Examples of Statins include:

Answer 18

• Atorvastatin (Lipitor)
• Pravastatin (Pravachol)
• Rosuvastatin (Crestil)
• Simvastatin (Zocor)

Question 19

Side effects of Statins:

Answer 19

• headaches
• GIT upset
• myocytosis - inflammation of the voluntary muscles
• can affect liver funtion

Question 20

Nursing considerations of Statins:

Answer 20

• give at night with food to reduce GI problems
• Assess for liver disease and monitor liver function regularly
• advocate a change in lifestyle
• educate patient to stay on tablets for instructed period of time
• monitor for muscle weakness or pain

Question 21

Bile acid-binding receptors is:

Answer 21

• used infrequently due to high incidence of adverse effects and drug interactions
• prevents enterohepatic cycle of bile
• poor adherence tolerance

Question 22

Side effects of Bile acid-binding resins:

Answer 22

• constipation
  -indigestion
• abdominal pain
• nausea and vomiting
• dizziness and headaches
• bloated
• impairs absorption of acidic vitamins and drugs
• impairs absorption of fat-soluble vitamins `

Question 23

Nursing considerations for Bile acid-binding receptors:

Answer 23

• encourage low fat diet
• not to be given to pregnant women
• review patients medication regime and administer with meals
• ensure adequate time lapse between antihyperlipidemic agents and other medications
• avoid biliary obstruction or constipation

Question 24

Nicotinic acid (Vitamin B3) is:

Answer 24

• water soluble vitamin that reduces transport of free fatty acids to the liver
• reduces triglyceride synthesis
• requires large doses
• often given in conjunction with other lipid lowering agents

Question 25

Side effects of Nicotinic acids:

Answer 25

- hypotension - flushing - nasal stuffiness - diarrhoea - vomiting and dyspepsia - skin rash, dry skin and eyes

Question 26

Fish oil (Omega 3 fatty acids):

Answer 26

- reduces ischaemic heart disease and risk of myocardial infarction - present in oily fish: tuna, salmon and mackerel

Question 27

Side effects of Fish oil:

Answer 27

- fish oil is relatively safe - high doses may cause bleeding - may cause recurrence of atrial fibrillation/flutter - belching, fishy breath