Flashcards in Ch 22 Angina Deck (13)
What is angina
Anginal pain is a result of an imbalance between myocardial oxygen supply and demand
How is anginal pain managed
Managed with organic nitrates, beta adrenergic blocking agents, calcium channel blockers, and ranolaxine.
Clients who have chronic stable angina should concurrently take an anti platelet agents such as aspirin or clopidogrel ( plavix), a cholesterol lowering agent or an ACE inhibitor to prevent myocardial infarction and death.
Wha meds are of the class organic nitrate
Oral extended release capsule: Nitro- time
Sublingual tab: nitro stat
Translingual spray: nitro lingual
Topical ointment: nitro bid
Transdermal patch: nitro- dur
IV: nitro bid IV
Sublingual: isosorbide dinitrate ( Isordil)
Oral: isosorbide mono nitrate ( Imdur)
What are organic nitrates used for
Treatment of acute angina attack
Prophylaxis of chronic stable angina or variant angina
What are adverse effects of organic nitrates
Reflex tachycardia: administer a beta blocker if symptoms appear
Organic nitrates should be used cautiously in who
Nitroglycerin is contraindicated in ppl who have traumatic head injury because the med may increase intracranial pressure
Use cautiously in ppl taking antihypertensive meds and ppl who have renal or lover dysfunction.
What effect can alcohol have with nitroglycerins
It can contribute to the hypotensive effect
What meds interact with organic nitrates
Antihypertensive meds such as beta blockers, calcium channel blockers, and diuretics can contribute to hypotensive effects
Concurrently taking what meds can cause severe life threatening hypotension
The use of PDE5 inhibitors, sildenafil ( Viagra), talalafil ( Cialis),vardenafil( Levitra) and nitroglycerin.
Anti angina agent
Prototype drug: ranolaxine ( Ranexa)
What does the anti anginal agent ranolazine ( Ranexa) do?
It lowers cardiac oxygen demand and thereby improves exercise tolerance and decreases pain
Used for chronic stable angina in combination with amlodipine ( Norvasc), a beta adrenergic blocker or a organic nitrate.
What are adverse effects of anti anginal agent ranolazine ( Ranexa)