CV Meds: Antianginal Meds

Question 1

Antianginal meds use organic nitrates, beta blockers, and Ca+ channel blockers to…

Answer 1

Treat pain related to imbalances in myocardial O2 supply and demand

Question 2

How do Antianginal meds reduce O2 demands of the heart?

Answer 2

1. They release peripheral vascular smoothie muscles
2. Resulting in dilation of arteries/veins 3. Thus reducing venous blood return (decreased preload) to the heart
3. Leads to decreased O2 demands of the heart

Question 3

Antianginal meds can also increase myocardial O2 demand by..

Answer 3

Dilating large coronary arteries and redistributing blood flow

Question 4

Example of Antianginal med:

Answer 4

Nitroglycerin

Question 5

Types of nitroglycerin (4):

Answer 5

1. SL tabs
2. Sustained release tabs
3. Transdermal ointment
4. Transdermal unit (patch)

Question 6

What is nitroglycerin used for?

Answer 6

• acute anginal attack
• phroohylaxis of chronic stable or variant angina

Question 7

What are the side effects of nitroglycerin?

Answer 7

• headache
• orthostatic hypotension
• reflex tachycardia
• tolerance

Question 8

What are some contraindications of Antianginal meds?

Answer 8

• pts with head injury
• caution with pts taking antihypertensives meds (hypotensive risk)
• pts taking erectile dysfunction meds (life threatening hypotension)

Question 9

Nitrostat/Nitrolingual is given how?

Answer 9

Sublingually

Question 10

Instructions for administering Nitrostat/Nitrolingual:

Answer 10

1. Administer SL
2. Rest for 5 minutes
3. If pain unrelieved with 1st tab, call 911
4. Then take 2nd tab
5. May use up 3 tabs taken 5 minutes apart (max of 15 min)

Question 11

How do you store Nitrostat/Nitrolingual?

Answer 11

• Keep in original dark container
• Do not shake container (forms bubbles)
• Replace NTG tabs every 6 months

Question 12

If taking prophylactically, how long before exercise should you take Nitrostat/Nitrolingual?

Answer 12

5-10 min before

Question 13

If taking Nitrostat/Nitrolingual, you should wear a:

Answer 13

Medical alert bracelet

Question 14

Nitro-Bid is what kind of med?

Answer 14

A topical ointment

Question 15

Applications instructions for Nitro-Bid:

Answer 15

• wear gloves for application
• do not massage or rub area
• apply to area without hair (chest, flank, or upper arm preferable)
• cover area where cream is with clear plastic wrap and tape in place
• gradually reduce dose and frequency over 4-6 weeks

Question 16

How long do you gradually reduce dose and frequency of Nitro-Bid application over?

Answer 16

4-6 weeks

Question 17

Nitrodur is what kind of medication?

Answer 17

A transderm patch

Question 18

Instructions for Nitrodur (transderm patch) application:

Answer 18

• optimal locations: upper chest/side, pelvis, and inner, upper arm
• put on in morning
• wear for 12-14 hrs then remove
• rotate skin sites