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PDE Inhib&Antiangina
inocor/primacor/nitroglycerin
| Question | Answer |
|---|---|
| what is a PDE inhibitor | positive inotrope drugs that increase contractility of the heart |
| What are PDE inhibitors used to treat | CHF, when other drugs fail (not 1st line drug) |
| What are some examples of PDE inhibitors | inamrinone lactate (inocor) & milrinone lactate (primacor) |
| The only route of administration for PDE inhibitors is | IV while in the hospital |
| PDE inhibitors can cause | severe dysrhythmias so ECG monitoring is necessary |
| what is the usual duration of treatment for patients taking inocor/primacor (PDE inhibitor) | short term no more that 48-72hrs |
| What other drugs are used to treat Heart failure | vasodilators, ACE inhibitors, diuretics, beta blockers, nesiriitide, BiDif-(specific to AA) |
| What is the action of vasodilators | increase preload, decrease afterload, & increase CO |
| What is the action of ACE inhibitors | increase renal blood flow, decrease release of aldestrone which decreases Na+ and fluid retention |
| What is the action of the beta blockers carvedilol & metroprolol | increase cardiac performance |
| what drug is specifically use to treat HF in african americans | BiDil |
| Nesiriticle (natrecor) is used to treat HF what is its action | promotes Na+ & fluid loss |
| What are Antianginals | organic nitrates that treat chest pain, & cause vasodilation |
| What are some common antianginal drugs | nitroglycerine (Nitrol, nirtostat), Isosorbide dinitrate (Imdur) |
| What is classic (stable) angina | chest pain that occurs with stress or exertion, but is not present at rest |
| What is preinfarction (unstable) angina | chest pain that occurs frequently over the day and gets worse with each event. |
| What does a unstable angina attack indicate | impending MI |
| What should you teach patients about how to prevent angina | quit smoking, eat proper nutrition,avoid heavy meals,exercise moderately, avoid strenuous exercise,rest&relax, avoid emotional stress, avoid temperature extremes. |
| What is considered proper nutrition for patients with angina | low fat, low cholesterol-<300mg/day |
| How does smoking cause angina | smoking causes vasospasm and decreases O2 supply to entire body |
| nitrates (antianginals) are used to treat | acute attacks of angina, as a prophylaxis for stable angina, for variant(unstable)angina |
| When are antianginals given IV form | when chest pain is not responding to other medications, preoperative to control BP, & with HF resulting from acute MI |
| What is the most common form of nitroglycerin | sub-lingual |
| IV nitroglycerin must be given through what type of tubing | glass b/c it will eat through the plastic |
| When giving nitroglycerin ointment always | wear gloves, medication can absorb into your skin and cause side effects |
| Sublingual nitroglycerin must be kept | away from moisture and light |
| Side effects of antianginals (nitro)are | headache, orthostatic hypotension, reflex tachycardia |
| How does nitroglycerin cause reflex tachycardia | dilated vessels cause less blood flow back to the heart & the heart speeds up in response |
| all long acting antianginals require a medication free period every day how long is the period | 8 hours and usually at night (to avoid developing tolerance) |
| When is antianginals(nitroglycerin) contraindicated (you would not give them) | pregnancy, nitrate sensitivity, traumatic head injury |
| Why cant a pt with head injury take nitroglycerin | it can increase intracranial pressure and cause bleeding. |
| When do you need to use caution and closely monitor a patient taking nitroglycerin | pt is on anti-hypertensives(increase hypotensive effect), or w/ liver (metabolized) and renal (eliminated) dysfunction |
| Can patients on nitroglycerin drink alcohol | NO, it increases hypotensive effects & organs are not perfused |
| What drug when taken with nitroglycerin can be life threatening | sildenafil (Viagra) causes extreme drop in BP when taken together and causes the organs not to be perfused |
| Always teach patients on antianginal (nitro) not to take | Viagra |
| What should you teach a patient to do during an anginal attack | stop current activity, take a rapid-acting nitroglycerine immediately, after 5min u still have pain call 911 & take another pill,q5m up to 3 total |
| What is the expected action of antianginals in stable angina | Vasodilation of the veins decreases venous return,and lowers the amount of oxygen demanded by the heart |
| What is the expected action of antianginals during variant (unstable)angina | the vessels are constricted during unstable angina, vasodilation relaxes the coronary arteries, and increased the O2 supply to the heart. |
Created by:
leseanne
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