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Antianginal Agents

Quiz 6

Group of drugs used to treat angina. Act directly on vascular smooth muscle to produce vasodilation. Act primarily on venous, but also on arterial smooth muscle. Nitrates
Specific drug used to relieve acute angina and prevent expected angina. Isosorbide dinatrate
What type of drug is Isosorbide dinatrate? Nitrate
Specific drug is a metabolite and active component of isosorbide dinatrate. Not subject to first pass effect. Onset of action occurs within 1 hour. Used only for prevention of chest pain, not for acute attacks. Isosorbide mononitrate
What type of drug is Isosorbide mononitrate? Nitrate
Specific drug used for relief of acute and persistent angina, or for long-term prevention. May be given during acute MI in continuous IV infusion until pain is relieved. Max dose not established. Also available PO, SRT, UNG, SL, and Transdermal Patch Nitroglycerin
What type of drug is Nitroglycerin? Nitrate
Absorbed most completely from richly vascularized oral muscosa. Onset of action 1-3 min after IV or SL administration. Nitroglycerin
Drug Group: Decrease preload and myocardial O2 demand by producing vasodilation. May also increase myocardial O2 supply by dilating arteries. Nitrates
Drug Group: Indicated for immediate relief of angina, prevention of angina when attack might be expected, and long-term prevention of chronic angina. Nitrates
Drug interactions of this group includes severe hypotension with alcohol. Delayed SL absorption in patients with dry mouth from anticholinergic agents. Nitrates
Adverse reactions include hypotension compounded by reduced cardiac output. Syncope, dizziness, weakness, clammy skin, N/V, tachycardia associated with hypotension. Nitrates
Complete collapse of cardiovascular system may occur with even normal doses. HA is most common side effect and usually is relieved after several days of drug admin. Nitrates
Localized skin irritation may occur with transderm patch. Tolerance may develop over time with long-term, high-dose therapy. Nitrates
If nitrates do not work, what may be given? Morphine sulfate
What are the three parameters when titrating IV nitrates? BP (q 5-15 min), chest pain, headache
Why should nitrate patch be applied am and removed hs? Decrease risk of developing tolerance
What is the time frame for d/c nitrates? several weeks
Group of drugs used for long-term prevention of angina. Act to decrease BP and block beta receptor sites in the myocardium and electrical conduction system of the heart. Results in decreased HR and decreased myocardial contractility (reducing O2 needs) Beta-Adrenergic Blockers
Group of drugs not used in treatment of Prinzmetal's (variant) angina because they intensify the frequency and severity of vasospasm. When d/c should be tapered gradually to prevent rebound angina and possible MI. Beta-Adrenergic Blockers
What type of drug is Atenolol? Beta-Adrenergic Blockers
What type of drug is Metaprolol Tartrate? Beta-Adrenergic Blockers
What type of drug is Nadolol? Beta-Adrenergic Blockers
What type of drug is Propranolol Hcl? Beta-Adrenergic Blockers
Adverse drug reactions include hypotension and bradycardia. Fluid retention and peripheral edema may occur. Bronchoconstriction may also occur. Beta-Adrenergic Blockers
Drug Interaction: Alter requirements of insulin and oral hypoglycemic agents. Additive effect of slowing heart rate when given with digoxin. Beta-Adrenergic Blockers
What type of angina occurs with predictable stress or exertion? Stable (classic) angina
What type of angina occurs frequently with progressive severity unrelated to activity; Unpredictable regarding stress/exertion and intensity? Unstable (preinfarction) angina
What type of angina occurs during rest? Vasospastic (Variant, Prinzmetal’s) angina
Created by: mreedy