drugs for angina, MI and CVA

Question 1

what is atherossclerosis

Answer 1

this is when the arterial blood supply is compromised due to narrowing and the cardiovascular and cerebrovascular supply becomes impaired

Question 2

what are deprived of nutrients with atherosclerosis since blood and cerebral vascular flow are impaired

Answer 2

heart brain and other organs

Question 3

angina pectoris, acute MI and cerebral vascular accident are all results of what

Answer 3

atherosclerosis and poor blood supply

Question 4

endothelial injury and inflammation result in what cells migrating

Answer 4

immune cells to the site of injury

Question 5

when are tight junctions between cells loosened

Answer 5

when there is endothelial injury

Question 6

what is going to go into the tight junstions of cells if they are loosned

Answer 6

LDL

Question 7

what are foam cells

Answer 7

this is when macrophages engulf oxdized LDL

Question 8

when t-lymphocytes secrete cytokines inducing smooth muscle migration, what happens to blood vessel elasticity and responsiveness

Answer 8

impiares bloof vessel elasticity and responsiveness to stimuli

Question 9

angina pectrois is what kind of issue

Answer 9

it is a demand issue

Question 10

what is angina pectoris

Answer 10

this is acute chest pain arising from inadequate oxygen supply to the myocardium

Question 11

what is characterized by a steady, intense pain that is sometimes accompanies by a crushing, constricting sensation

Answer 11

angina pectoris

Question 12

your patient comes in with pain radiating across the left shoulder, down the left arm, they are pallor, SOB, and sweating - what do you suspect is happening

Answer 12

the patient is experiencing angina pectoris

Question 13

what might a female patient with angina pectoris experience

Answer 13

nausea, abdominal pain

Question 14

stable angina

Answer 14

predicatble frquency, duration and intensity, not associated with myocardial damage

Question 15

unstable angina - intensity, variable period, frequency

Answer 15

variable intensity, occurs during period of rest, inceased frequncy

Question 16

what is associated with an increased risk of MI

Answer 16

unstable angina

Question 17

non-pharmacological interventions for stable angina

Answer 17

limit alcohol, foods high in cholestoroal, control hyperlipidemia, control hypertension, regular exercise, control blood glucose

Question 18

limit alcohol, foods high in cholestoroal, control hyperlipidemia, control hypertension, regular exercise, control blood glucose

Answer 18

non-pharmacological interventions for stable angina

Question 19

what is the goal of drug therapy

Answer 19

slow HR, reduce force of cardiac contraction, dilate veins, dilate arterioles

Question 20

what is the first line therapy for stable angina

Answer 20

nitrates

Question 21

what do nitrates do

Answer 21

they facilitate the formation of nitric acid, a potent dialator for smooth muscle

Question 22

nitrate; what does the dilation of smooth muscle allow for; blood flow

Answer 22

decreased the amount of blood returning to the heart, CO, workload, O2 demand

Question 23

decreases the amount of blood returning to the heart, CO, workload, O2 demand

Answer 23

nitrate

Question 24

nitrates; what does the dilation of arterial smooth muscle do to blood flow and oxygen supply

Answer 24

increases blood flow and improves oxygen supply to the myocardium

Question 25

what is the protocol for taking nitrate

Answer 25

rest, take drug and wait 5 min, if no imporvement take another dose wait 5 min

Question 26

what is the maximum dose for nitrates

Answer 26

3 doses in 15 minutes

Question 27

how should you withdrawl a patient off of nitrate

Answer 27

slowly to prevent risk of MI

Question 28

adverse effects for nitrates

Answer 28

all rt vasodilation and decrease in blood flow - headache, dizziness weakness, hypotension, relfex tachycardia

Question 29

your patient recently had angina, and is experiencing a headache and hypotension. they ask why this is happening - why

Answer 29

because there is vasodilation and decreased blood flow

Question 30

when should you be cautious when giving nitrates

Answer 30

wiht pt with hypotension, hypovolemia

Question 31

what drug interactions are there for nitrates

Answer 31

treatment for ED, alcohol

Question 32

why dont you want your patient to take nitrates when they are on ED medications and drinking alcohol

Answer 32

because they both cause vasodliation, so could lead to hypotension

Question 33

beta adrenergic antagonists are first line therapy for what- angina pectoris

Answer 33

first like therapy for chrinic stable angina

Question 34

hwo to beta adrenergic antagonists work

Answer 34

they work to reduce the cardiac workload, which slows the HR and reduces contractilitiy

Question 35

what works to reduce cardiac workload, slows HR and contractibility

Answer 35

beta adrenergic antagonists

Question 36

when should you be careful when usings beta adrenergeric antogonists (4)

Answer 36

asthma, COPD, depression and diabetes

Question 37

adverse effects of beta adrenergic antagonists - think weakness

Answer 37

fatigue, weakness, bradycardia, hypotension, sleep distubrances

Question 38

how should you take a patient off of beta adrenergic antagonist drugs

Answer 38

reduce the does over 1-2 weeks

Question 39

why arent calcium channel blockers firts line therapy for angina?

Answer 39

because they can cause low bp

Question 40

calcium channel blockers are used for the prevention of what angina, and in clients whom cannot tolerate what

Answer 40

the prevention of chronic stable angina in clients who cannot tolerate beta blockers

Question 41

what causes decreased myocardial demand, relax arteriolar smooth muscle lowering BP and decreasing afterload, and decreases heart rate

Answer 41

calcium channel blockers

Question 42

adverse effects of CCB

Answer 42

dizziness, lightheadedness, fatigue, bradycardia, flushing, nausea

Question 43

what should you monitor for with someone taking ccb

Answer 43

hypotension, and reflex tachycardia

Question 44

why should grapefruit juice be avoided when on ccb

Answer 44

because it will increase the ccb levels

Question 45

what is myocardial infarction a result of what disease

Answer 45

result of advanced coronary artery disease

Question 46

what happens when a coronary artery is occluded

Answer 46

MI and necrosis

Question 47

what are the goals of MI therapy

Answer 47

reduce myocardial oxygen demand | restore blood supplt to the damaged myocardium

Question 48

thrombolytics - MI

Answer 48

restore blood supply to the damamged myocardium

Question 49

nitrates, beta blockers, ACE inhibitors - are used to prevent what demand?????

Answer 49

to reduce myocardial oxyegn demand and to prevent further infarction

Question 50

what is used to control or prevent MI-associated dysrhythmias

Answer 50

beat blockers

Question 51

what is used to reduce post-MI mortality

Answer 51

aspirin, beta-blockers, ace inhibitors, statins

Question 52

how do we manage severe pain and anxiety of MI

Answer 52

opiates

Question 53

warning signs of stroke

Answer 53

paralysis on one side, vision issues, dizziness, speech problems, headache

Question 54

true or false | 80% of strokes are thrombotic and 20% are hemorrhagic

Answer 54

trie

Question 55

how can we pharmacologically treat thrombotic CVA

Answer 55

thrombolytics