Ch 22 Angina Flashcards Preview

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Flashcards in Ch 22 Angina Deck (13)
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What is angina

Anginal pain is a result of an imbalance between myocardial oxygen supply and demand


How is anginal pain managed

Managed with organic nitrates, beta adrenergic blocking agents, calcium channel blockers, and ranolaxine.
Clients who have chronic stable angina should concurrently take an anti platelet agents such as aspirin or clopidogrel ( plavix), a cholesterol lowering agent or an ACE inhibitor to prevent myocardial infarction and death.


Wha meds are of the class organic nitrate

Oral extended release capsule: Nitro- time
Sublingual tab: nitro stat
Translingual spray: nitro lingual
Topical ointment: nitro bid
Transdermal patch: nitro- dur
IV: nitro bid IV
Other meds;
Sublingual: isosorbide dinitrate ( Isordil)
Oral: isosorbide mono nitrate ( Imdur)


What are organic nitrates used for

Treatment of acute angina attack
Prophylaxis of chronic stable angina or variant angina


What are adverse effects of organic nitrates

Orthostatic hypotension
Reflex tachycardia: administer a beta blocker if symptoms appear


Organic nitrates should be used cautiously in who

Nitroglycerin is contraindicated in ppl who have traumatic head injury because the med may increase intracranial pressure
Use cautiously in ppl taking antihypertensive meds and ppl who have renal or lover dysfunction.


What effect can alcohol have with nitroglycerins

It can contribute to the hypotensive effect


What meds interact with organic nitrates

Antihypertensive meds such as beta blockers, calcium channel blockers, and diuretics can contribute to hypotensive effects


Concurrently taking what meds can cause severe life threatening hypotension

The use of PDE5 inhibitors, sildenafil ( Viagra), talalafil ( Cialis),vardenafil( Levitra) and nitroglycerin.


Anti angina agent

Prototype drug: ranolaxine ( Ranexa)


What does the anti anginal agent ranolazine ( Ranexa) do?

It lowers cardiac oxygen demand and thereby improves exercise tolerance and decreases pain
Used for chronic stable angina in combination with amlodipine ( Norvasc), a beta adrenergic blocker or a organic nitrate.


What are adverse effects of anti anginal agent ranolazine ( Ranexa)

QT prolongation
Elevated BP


What is a nursing consideration of ranolazine( Ranexa)

Administer as a extended release tab twice daily wi or without food do not crush or chew
Obtain baseline and monitor digoxin level with concurrent use