Card Set Information
Drugs for Angina
What is Angina?
Sudden pain beneath the sternum often radiating to left shoulder and arm
Oxygen demand greater than oxygen supply (eschemia)
Prodromal sign (warning)
Goals of Drug therapy for angina pectoris
Prevention of myocardial ischemia and anginal painPrevention of myocardial infarction and death
Types of Angina
Chronic stable angina (exertional)
: Increase O2 or decrease demand
Variant angina (Prinzmetal’s)
: Increase O2 with vasodilators
Unstable angina (no known cause or trigger)
: Decrease O2 demands, Reduce pain and progression with medications
Severe Coronary Artery Disease
Transient coronary thrombi/emboli
Calcium channel blockers
Find the flow chart for antianginal drug selection and know it.
Relaxes vascular smooth muscle beds
Decreases O2 consumption
Allows heart to work with a lower O2 demand
Reduces preload and afterload –results in decreased cardiac workload
Adverse Effects of Nitrates
Teaching is importatnt because you don't want pts with orthstatic hypotension driving around or trying to do ADLs that require them to be standing/alert.
Tolerence develops rapidly…should have at least 8 hours of drug free time a day
Should have at least 8hrs drug free time/day.
Nitrate routs of admin
so don't crush it!
Transdermal delivery systems.
Need to wear gloves to avoid self-administering nitroglycerin
and discard in appropriate way.
At first sign of angina, what should your pt do?
Take appropriate dose of nitrate
In 5 minutes if pain is not relieved…take another dose
In acute setting the nurse should take VS.
If SBP is < 100 or 25 mg lower than previous BP should notify MD prior to dose
A total of 3 doses may be administered in 15 minutes
If pain does not subside after 2nd dose, pt should call the am-buh-lance. Don't have sigother drive.
Proper storage of Nitrates
Nitrates should be replaced q 6 months
Drug is heat, air and light sensitive = Need to be in amber colored container
Administer and dispose of patches carefully. 1 patch = 1 dose. Should be tossed in a very inconspicuous way.
Emphasize importance of safety in drug administration
Beta Blockers for Angina
Used to prevent Angina from occuring. Not usually seen PRN.
Initial low dose
Heart rate monitoring
Calcium Channel Blockers for Angina.
Examples are verapamil, diltiazem, nifedipine.
Can be given PRN in same way as nitroglycerin
Stable and variant angina
Coronary Artery Bypass Graft Surgery (CABG)
Percutaneous Transluminal Coronary Angioplasty (PTCA)