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What are the 3 main groups to treat angina
Beta Blockers, Calcium Channel Blockers, Nitrates
What is the drug of choice for Prinzmetal Angina?
Calcium Channel Blockers
How do Nitrates help with angina?
- dilate coronary arteries, arterioles, veins (vasodilation)
- decrease the preload
- reduces resisitance and afterload
- no help in CO
Treatment of choice for pt having acute angina attack?
SL nitroglycerin or nitrates
Drug choice of nitrates for chronic recurrent angina?
topical route, or oral (oral is not nitroglycerin)
How to reduce tolerance build up to Nitrates?
- use smallest dose possible
- remove patch 8-10hrs during the night
Most common adverse effect of nitroglycerin?
Headache, BP/HR drop, *syncope, palpitations
Special accommodations for nitroglycerin storage?
- glass bottle/ special IV tubing
- toss after 3mo
- avoid light, heat or humidity exposure
What should the nurse teach the pt about nitroglycerin?
- repeat SL nitroglycerin 3x with 5 min break in between for relief
- pt should call EMS if they are taking their 3rd tablet
- *should feel tingling under tongue
What should the nurse watch for after administering NTG?
- Headache, reflex tachycardia *
- do not let NTG get on your skin, wear gloves, will cause HA, wash hands
What is the oral Antianginal agent?
- Isosorbide (Isordil)
- treats and prevents angina orally
long acting prototype, only NTG that does NOT treat HTN, SL or orally
Adjunct therapy for angina
- Morphine, Oxygen, NTG, Aspirin