pharm antianginal agents ch. 23
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| nitrates/nitrites | -cause vasodilation d/t relaxation of smooth muscles
-potent dilating effect on coronary arteries
-used for prevention and treatment of angina
-vasodilation results in reduced myocardial oxygen demand
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| nitrates/nitrites | -nitrates cause dilation of both large and small coronary vessels
-result: oxygen to ischemic myocardial tissue
-nitrates alleviate coronary artery spasms
**when someone takes nitroglycerin they should be laying down b/c they will get a drop in BP
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| nitroglycerin | -rapid acting
-large first pass effect with oral forms
**used for acute relief of angina
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| nitrates: Long-acting | -isosorbide dinitrate
-isosorbide mononitrate
**used for prophylaxis in situations that may provoke angina; longterm prophylaxis of angina
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| nitrates side effects | -headache
-tachy, postural hypotension, dizziness
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| Beta blockers | -atenolol
-metoprolol
-propanolol
-nadolol
**YOU DO NOT ABRUPTLY STOP BETA BLOCKERS**
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| calcium channel blockers | -verapamil (calan)
-diltiazem (cardizem)
-nifedipine (procardia)
**they reduce myocardial contractility (negative inotropic action)**
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| calcium channel blockers | first line agents for treatment of angina, HTN, supraventricular tachycardia
-prevent future attacks
-popular for lowering BP in A.A
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| calcium channel blockers side effects | hypotension, constipation, edema
**constipation is a common problem; instruct pt. to take in adequate fluids and eat high-fiber foods
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| beta-blockers | inform pts that these meds are for long-term prevention of angina, not for immediate relief
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| a pt. has a new perscription for transdermal nitroglycerin patches. the nurse teaches the pt that these patches are most appropriately used | to prevent the occurrence of angina
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| a nurse with adequate knowledge about the administration of IV nitroglycerin will recognize that which statement is correct? | IV nitroglycerin must be protected from exposure to light through the use of special tubing
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| which statement by the pt. reflects the need for additional pt. education about the calcium channel blocker diltiazem (cardizem)? | "i can take this drug to stop acute anginal attacks"
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| while assessing pt. with angina who is starting beta blocker therapy, the nurse is aware that the presence of which condition may be a problem if these drugs were used? | asthma
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| a 68 y/o man has been taking the nitrate isosorbide dinitrate for 2 years for angina. he recently has been experiencing erectile dysfunction and wants a perscription for sildenafil (viagra). which response would the nurse most likely hear from the doc | "taking sildenafil with nitrate may result in severe hypotension, so a contraindication exists"
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| the nurse is reviewing drug interactions with a male pt. who has a prescription for isosorbide dinitrate (isordil) as treatment for angina symptoms. which substances listed could potentially result in drug interaction? | -a glass of wine
-sildenafil(viagra), an erectile dysfunction drug
-carvedilol (coreg), a beta blocker
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