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What are the three main classes of drugs used to treat angina?
- 1. Nitrates
- 2. Ca channel blockers
- 3. Beta blockers
Common nitrates used to treat and prevent angina =
- 1. Isordil
- 2. Nitroglycerin (NTG) - all forms
How do nitrates work?
- - promote peripheral vasodilation
- - reduce MVO2
What are the uses of nitrates?
- angina - tx and px
- prevent vasospasms - post procedures
- Prevent anginal attacks - by reducing afterload
What are the side effects associated with nitrates?
- Hypotension - monitor BP before and throughout!!
- Reflex tachycardia
You may develop _____ while taking nitrates. How can this be avoided?
Tolerance - avoid by having nitrate-free periods usually at night.
When taking nitrates- Hypotension is worsened when also taking....
- Ca channel blockers
When should you take nitrates?
- at first sign of chest pain
- - take 3 tablets five mins apart
What are the contraindications and precautions when taking nitrates?
- Contraindicated- Hypotension
- Caution- acute MI, hyperthyroidism, anemia, glaucoma, head injury, uncorrected hypovolemia
What different ways are Nitrates administered?
- 1. Tablet- PO, SL
- 2. Spray
- 3. Topical- patch/ointment; rotate, avoid ausculation sites, dont get on fingers, take off old papers
- 4. IV- drip admin by pump only!continuous BP, PAP, CO monitoring. Titrated to client's pain control.
Possible appropriate nursing diagnosis:
- 1. risk for injury
- 2. pain
- 3. impaired skin integrity
- 4. fluid volume alterations