Dietary Intake

(carbs, protein, fat, fiber cholesterol)

·         Total fat: 25%-35% of total calories

·         Carbohydrates: 50%-60% of total calories

·         Protein: 15% of total calories

·         Cholesterol: less than 200mg/day

·        Intake of at least 25 g of fiber each day is 

unstable angina

intractable or refactory angina

variable angina

silent ischemia

objective evidence of ischemia but patient reports no pain 

nitroglycerine

·         Vasoactive agent, dilates primarily the veins and, in higher  doses, the arteries

·         Dilation of the veins causes venous pooling  of blood throughout the body resulting in less blood returning to the heart and filling pressure (preload) reduced

·         These effects decrease myocardial oxygen requirements and increase oxygen supply, bringing a balance bw supply and demand 

Beta-Adrenergic Blocking Agents

·        -  Reduction in heart rate, slowed conduction of impulses through the conduction system, decreased BP, and reduced myocardial contractility to balance the myocardial oxygen needs and the amount of oxygen available

·        -  Cardiac side effects and possible contraindications include hypotension, bradycardia, advanced AV block, and acute heart failure

·        -  Side effects include depression, fatigue, decreased libido, and masking of symptoms of hypoglycemia

Calcium channel blocking agents 

·       -  Decrease SA node automaticity and AV node conduction, resulting in a slower heart rate and a decrease in the strength of myocardial contraction

·        - Also relax the blood vessels, causing a decrease in BP and an increase in coronary artery perfusion

·       -   Most commonly used is amlodipine (Norvasc) and diltiazem (cardizem, Tiazac)

Heparin

o   Heparin therapy is usually considered therapeutic when the aPTT is 2 to 2.5 times the normal aPTT value

 o   prevents formation of new blood clots

o   Patient is monitored for signs and symptoms of external and internal bleeding, such as low BP, increased heart rate, and decreased serum hempglobin and hematocrit

o   A decrease in platelet count or evidence of thrombosis may indicate heparin-induced thrombocytopenia 

Glycoprotein IIb/IIa Agents

·         prevent platelet aggregation by blocking the the GP IIb/IIa receptors on  the platelets, preventing the adhesion of fibrinogen and other factors that crosslink platelets to each other 

creatine Kinase(CK) isoenzymes