Term
| What is Angina and what is it caused by? |
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Definition
| Acute temporary chest pain caused by lack of sufficient oxygen |
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Term
| What types of Angina are there (3)? |
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Definition
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Term
| What is Stable Angina characterized by (2)? |
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Definition
-Associated with exercise
-Often occurs with coronary artery disease (CAD). |
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Term
| What is Unstable Angina characterized by (3)? |
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Definition
-Changes in intensity
-Associated with the rupture of atherosclerotic plaques
-Not predictable. Plaques spontaneously break off and clog artery, forming thrombai. This is called a preinfraction. |
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Term
| What is Variant Angina characterized by? |
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Definition
| Spasms of the large coronary vessels |
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Term
| What lifestyle changes are necessary for patients suffering from angina (4)? |
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Definition
-Weight reduction
-Stop smoking
-No alcohol
-Stop stress |
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Term
| Name 3 groups of antianginal drugs. |
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Definition
-Organic nitrovasodilators
-Beta-blockers
-Calcium channel blockers |
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Term
| What adjunct therapy is used with antianginal drugs (2)? |
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Definition
-Antiplatelet therapy
-Lipid-lowering drugs |
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Term
| Name 2 Nitrates used to treat angina. |
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Definition
-Isosorbide dinitrate (longer acting)
-Nitroglycerin |
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Term
| What is the mechanism of action of nitrate antianginal drugs (2)? |
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Definition
-Cause vasodilation and venodilation which results in a decreased pre-load.
-Higher doses result in arterial dilation which also reduces the after-load. The myocardial oxygen demand is then decreased. |
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Term
| What are antianginal nitrates used for (4)? |
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Definition
-First-line therapy for prevention and treatment of angina
-Mainstay of antianginal medication
-CHF (Congestive Heart Failure)
-Increase exercise capacity with CAD |
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Term
| Pharmacokinetics of Nitrates (6) |
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Definition
-onset is 1-3 minutes
-Rapidly degraded by the liver
-Extensive first-pass effect
-large doses required for prophylactic use
-tolerance may develop
-risk of toxicity |
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Term
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Definition
-Dizziness
-Hypotension
-Syncope (fainting)
-Flushing |
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Term
| Nursing Implications of Nitrates (11) |
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Definition
-Assess vital signs
-Assess type of pain
-One tablet every 5 min x3 and if pain is not relieved go to ED
-Recommend lifestyle changes
-Notify health care provider of chest pain
-Headache may indicate too high of dose
-If dizzy lie down before taking medication
-Instruct family members
-Review storage directions with patient
-Take before activity
-Avoid alcohol |
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Term
| What routes are available for nitrates (7)? |
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Definition
-Sublingual
-Buccal (patch you put on gums)
-Chewable tablets
-Lingual
-Oral extended release
-Transdermal patch
-Ointments |
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