Wk 13. Antianginal Flashcards
(38 cards)
1
Q
- What type of angina is caused by coronary spasm?
A
Variant
2
Q
- What kind of angina does not respond to beta-blockers?
A
Variant
3
Q
- Nitrates predominately vasodilate which vessels in low doses? Prevent spasm where?
A
Veins. Coronary arteries.
4
Q
- Headaches due to nitrates can be expected to do what over time?
A
Diminish
5
Q
- What adverse effect is triggered by baroreceptors in response to venous dilation?
A
Reflex tachycardia
6
Q
- What drugs are contraindicated in men who are taking nitrates?
A
Phosphodiesterase type 5 inhibitors
7
Q
- Which nitrate formulation is recommended for intermittent angina treatment at home?
A
SL nitroglycerin
8
Q
- How are SL nitroglycerin tablets taken?
A
1 Tablet (0.3-0.6 mg) every 5 minutes x 3, Emergency department if angina persists 5 min
9
Q
- What must the nurse check before administering nitroglycerin?
A
Blood pressure and pulse
10
Q
- Why should nitroglycerin paste be removed at night?
A
Prevent tachyphylaxis (tolerance)
11
Q
- How would a dry mouth affect the absorption of nitroglycerin?
A
Slows absorption
12
Q
- Nitrates in low doses decrease afterload or preload? Arterioles or veins?
A
Preload. Veins.
13
Q
- Selective beta-blockers block which receptors at low doses?
A
Beta-1
14
Q
- Beta-blockers decrease three parameters. What are they?
A
Heart rate, blood pressure, contractility
15
Q
- What may beta-blockers mask in diabetes and during allergy shots?
A
Signs of hypoglycemia and allergic reactions.
16
Q
- Which drug given for allergic reactions may be inhibited by beta-blockers?
A
Epinephrine
17
Q
- In asthmatics, beta-blockers may cause what symptom? Block what receptor?
A
Bronchoconstriction. Beta-2.
18
Q
- Beta-blockers with verapamil or diltiazem can severely decrease which vital sign parameter?
A
Heart rate
19
Q
- Abrupt cessation of beta-blockers can lead to excitation or depression of the beta-adrenergic receptors?
A
Excitation
20
Q
- Do not give beta-blockers if the pulse is below ____ or the systolic BP is below____.
A
Pulse 50, SBP 90
21
Q
- What is the family of calcium-channel blockers which does not include verapamil or diltiazem?
A
Dihydropyridines
22
Q
- Calcium-channel blockers vasodilate which blood vessels?
A
Arterioles
23
Q
- Calcium-channel blockers decrease afterload or preload?
A
Afterload
24
Q
- Dihydropyridines may cause what side effect which can be treated with beta-blockers?
A
Reflex tachycardia
25
25. Swelling of extremities may be caused by what 2 classes of antihypertensive agents?
Nitrates & calcium-channel blockers
26
26. Calcium-channel blockers are used for what kinds of angina?
Stable and variant
27
27. Vasodilation of arteries reduces afterload or preload?
Afterload
28
28. Digoxin (Lanoxin) is used in heart failure primarily for what effect?
Positive inotropic effect
29
29. What should the nurse do before giving digoxin?
Take the apical pulse for 1 minute.
30
30. What electrolyte competes with digoxin for the receptor?
Potassium
31
31. What are some signs of digitalis toxicity?
Anorexia, nausea, vomiting, arrhythmias, weakness, yellow vision, halos around lights, blurred vision
32
32. What is the antidote for digoxin toxicity?
Digibind
33
33. What common drug classes can precipitate digoxin toxicity?
Loop and thiazide diuretics
34
34. What are the effects of alpha-1 activation by catecholamines?
Vasoconstriction of arterioles in skin, viscera, & mucous membranes and in veins.
35
35. What are the effects of beta-1 activation by catecholamines?
Increased heart rate, contractility, and conduction rate. Renin release.
36
36. What are the effects of beta-2 activation in the lungs and liver?
Bronchodilation & glycogenolysis.
37
37. What are the effects of dopamine activation?
Renal blood vessel dilation.
38
38. Which IV continuous drug is used to increase contractility without causing vasoconstriction?
Dobutamine (Dobutrex).
