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antianginal drugs

Pharm exam 3: vasodilators

define angina pectoris chest pain caused by lack of oxygenated blood to heart muscles
etiology of angina pectoris narrowing of arteries, hypotension, vasoconstriction, SNS or drugs
precipitating factors of angina pectoris exercise, anxiety, cold, heavy meals, smoking
symptoms of angina pectoris chest pain persisting for 3-5 minutes; dissipates upon rest
ECG changes seen in angina pectoris S-T changes
management of angina pectoris education; vasodilating drugs
effect of vasodilating drugs cause dilation of blood vessels and tend to lower blood pressure
Vasodilators are used to treat... hypertension, coronary disease (angina) or peripheral vascular disease
where do nitrates act? directly on smooth muscles of peripheral and coronary vascular bed
effect of nitrates peripheral vasodilatation
how do nitrates decrease preload venous dilation
how do nitrates decrease afterload arterial dilation
what do nitrates reduce? work of heart and oxygen requirement
What do nitrates dilate large normal coronary artery, not lined with plaque
Drug of choice of angina nitrates
side effects of angina tachycardia, flushing, severe headache, nausea/vomiting, hypotension, vertigo
tolerance occurs to what nitrates long acting; not usually to nitroglycerin (NTG)
What interacts with nitrates? alcohol, antihypertensive drugs, aspirin
Nitrate kinetics sublingual (Nitrostat) NTG tabletss
normal dosage for NTG tablets 0.15-0.6 mg; usually 0.4mg
How often can nitrates be given repeated several times a day
how often do you take nitrates for chest pain 5 minute intervals x 3
Dynamics of nitrates effect in 2 minutes; peak in 4 minutes; disappears in 10-30 minutes
can nitrates be taken before exertion? yes; as prophylaxis
NTG is inactivated by what? light, heat, air, moisture, and time
How often should patients get a fresh supply of nitrates? every 3-6 months
Education of storage of NTG airtight, dark container; avoid keeping close to body; don't store in bathroom
What should patient do before taking NTG? sit or lie down
What does NTG cause besides desired effect? flushing or headaches - if not; medication is not good
What to take for headaches with NTG? Tylenol
describe NTG spray metered dose; oral spray; take seated or lying down; do not inhale
describe NTG sustained release (Nitro-bid) take on empty stomach with full glass of water, do not cut or chew
Effect and duration of NTG sustained release effect 24-45 minutes; duration 4-8 hours
Onset and duration of NTG patches onset 30-60 minutes; duration 18-24 hours
Education for NTG patches wear gloves to apply; rotate site and wash skin; remove old patch when replacing new
When to remove NTG patch from 8-12 hr/day; before defibrillation; when replacing old patch
When to use NTG IV acute situation with unrelieved angina
NTG IV onset immediate
Use what monitoring devices with NTG IV pump and cardiac, blood pressure monitor
Beta-adrenergic Blocker prototype propranolol (Inderal)
Where does propranolol (inderal) act? heart receptors
effect of propranolol (inderal) decreased HR; decreased force of contraction, decreased myocardial oxygen demand
adverse effects of propranolol (inderal) slowed heart rate; lowers BP; contributes to impotence
calcium channel blocker prototype verapamil (Calan)
action of verapamil (Calan) inhibit release of intracellular calcium
effect of verapamil (Calan) decrease force of myocardial contraction = decrease heart oxygen demand; dilate coronary artery to increase oxygen supply
use of verapamil (Calan) long term prevention of angina
side effects of verapamil (Calan) hypotension, arrhythmias, heart failure
Created by: 1818554924