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3312 #3
Cardiovascular Drugs- Antianginals
| Question | Answer |
|---|---|
| episodes of chest pain; caused by deficit myocardial oxygen supply (myocardial ischemia) in regard to oxygen demand | angina |
| deficit in myocardial oxygen supply | myocardial ischemia |
| T or F Antianginals improve myocardial blood flow | True |
| T or F Nitrates are vasodilators (dilate peripheral and coronary blood vessels) | True |
| An action of antianginals is to | decrease myocardial oxygen demand |
| These two types of antianginals used to improve myocardial blood flow | 1. nitrates 2. calcium channel blockers |
| This type of antianginal decreases myocardial oxygen demand | beta adrenergic blockers |
| What happens in relation to oxygen in beta adrenergic blockers | increased oxygen in blood flow, decreased myocardial oxygen demand |
| What type of antianginals are used for chronic angina | patches (rotate site of patch), ointment, oral |
| Common cardiac side/adverse effects of antianginals are | 1. bradycardia 2. hypotension 3. HF or CHF |
| Common vascular side/adverse effects of antianginals are | headache due to dilation of cerebral vessels |
| Three classes of antianginals are: | 1. organic nitrates 2. beta adrenergic blockers 3. calcium channel blockers |
| mechanisms of organic nitrates are: | dilate peripheral and coronary blood vessels |
| nitroglycerin is an example of which class of antianginal drug | organic nitrates |
| what is the recommended dose of nitrogylcerin before seeking ER care | may take 1 tablet, wait 5 minutes, if no relief seek ER care |
| to prevent acute angina or prevent acute angina, which route of nitroglycerin should be given | Sublingual |
| A unique feature of nitroglycerin | keep pt away from heat or light; replace every 6mo |
| T or F Nitroglycerin constricts cerebral blood vessels causing headaches | False- nitroglycerin dilates cerebral blood vessels causing headaches |
| T or F Nitroglycerin opens blood vessels to increase oxygen to heart via increased blood flow | True |
| How long does it take nitroglycerin to work if given sublingually or by spray | less than or equal to 2 minutes |
| forms of organic nitrates used to treat chronic angina are | patches (rotate site of patch/ointment), ointment, oral |
| Where should patches be placed? | apply to upper arm or chest, avoid hairy areas; place in areas that the pt can visibly see (NOT on BACK) |
| What is the minimum about time a pt can develop tolerance to nitroglycerin | 24-48 hrs; take patches off at night before bed |
| side effects of nitrogylcerin (organic nitrate) include: | 1. reflex tachycardia, CHF, hypotension, flushing 2. flushing is due to vasodiltion |
| contraindications for nitroglycerin (organic nitrate) are: | 1. contraindicated with anti-impotence medications (do not use within same 24hr period) (ex viagra, cialis) |
| nitroglycerin can have very LIFE THREATENING ____ events | hypotensive |
| mechanisms of calcium channel blocking agents (CCBs) (nifedipine) are | 1. dilate coronary and peripheral arteries 2. some suppress impulse conduction |
| nifedipine is classified as what type of antianginla | Calcium Channel Blocking Agents (CCBs) |
| nifedipine is used to tx what type of angina | chronic angina |
| mechanisms of beta adrenergic blockers (propranolol) | 1. decrease sympathetic response 2. reduce heart rate and force of contraction |
| propranolol is classified as what type of antianginal | beta adrenergic blockers- it can also be used as an antidysrhythmic |
| unique features of propranolol (Beta Adrenergic Blockers) | used to prevent angina |
| Adverse/Side Effects of propranolol (Beta Adrenergic Blockers) | decreased B/P decreased HR Heart failure |
| Are Beta Adrenergic Blockers (propranolol) used for long or short term use in treatment as antianginal | long term ONLY, nitrates are used for acute use |
| Side/Adverse Effects of Calcium Channel Blocking Agents (CCBs) ( nifiedipine) | tachycardia bradycardia hypotension- from vasodilation coronary heart failure |
| Calcium Channel Blocking Agents (CCBs) (nifidipine) are used to | prevent angina |
| contraindications for antianginals | hypotension (all) Congestive Heart Failure beta blockers calcium channel blockers (contractility in beta blockers and calcium channel blocker but can still use with heart failure) |
| Nurses should assess pts for | pain apical heart rate B/P |