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44 Cards in this Set
- Front
- Back
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atherosclerosis
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a disease in which plaque builds up inside your arteries
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nitroglycerin - actions
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decreases oxygen demand on heart
dialates arteries and veins reduces blood volume decreases preload on heart |
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nitroglycerin - uses
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angina pectoris
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nitroglycerin - common adverse effect
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excessive hypotension
prolonged headache tolerance |
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nitroglycerin - indication
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most common drug to treat angina pectoris (drug of choice)
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nitrate - medication administration forms
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sublingual tablets
substance release - capsules, tablets, ointment, transmucosal tablets, transdermal patches translingual spray amyl nitrite for inhalation (glass vials) |
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nitrates - sublingual tablets
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Disolves rapidly. Primary for acute attacks
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Nitrates - substance release - capsules, tablets, ointment, transmucosal tablets, transdermal patches
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used prophylactically to prevent angina attack
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Nitrates - translingual spray
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used prophylactically and acute to prevent angina attack
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Nitrates - amyl nitrite for inhalation
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glass vials
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Beta blockers - actions
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Block beta adrenergic receptors in heart (reverses sympathetic nervous responses)
Reduce myocardial oxygen demand Reduce blood pressure (reduces hypertension) slows heart rate down slows cardiac output inhibits renin release = prevents vasoconstriction |
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Beta Blockers - uses
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Reduce the number of anginal attacks
Reduce nitroglycerin use (patient will use less nitro if on beta blockers) Anti-hypertensive (reduces blood pressure) |
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chronic stable angina
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Precipitated (caused) by stress or exertion
Short duration Relieved by rest or nitroglycerin Probable cause: fixed atherosclerotic obstruction (fix the plaque = fix the pain) |
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Plaque
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made up of deposits in arteries - ex cholesterol
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Unstable Angina
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Unpredictable; changes in frequency, duration, and onset
Probable cause: atherosclerosis and thrombus formation |
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Variant Angina
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Occurs at rest, characteristic ECG changes
Probable cause: vasospasm of the coronary artery |
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Angina Pectoris
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Chest discomfort arising from the heart due to lack of oxygen to the heart muscle
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Angina pectoris - signs and symptoms
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Squeezing in the chest, pressure, tightness, choking, burning, heaviness, may radiate to neck, shoulder, jaw
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Angina Pectoris - Causes (precipitating factors)
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Physical activity, exposure to cold, drinking caffeine-containing beverages, smoking, emotional stress, sexual intercourse, eating large meals
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Angina Pectoris Treatment - Goals
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Prevent myocardial infarction and death
Pain relief |
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Angina Pectoris Treatment - treatment
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drug therapy - nitrates/beta blockers
step 1 - Coronary angioplasty - they place a stent (hollow metal tube) where the blockage occurred. Step 2 - Coronary artery bypass surgery - they take a good vessel from a leg and replace it with the bad coronary vessel |
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Angina Pectoris - Patient education
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Avoid precipitating factors (cause)
Reduce risk factors Exercise |
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Angina attack duration
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30 seconds to 30 minutes
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Drugs to treat Angina Pectoris
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Nitrates
Beta-adrenergic blocking agents ACE inhibitors Calcium channel blockers Fatty oxidase enzyme inhibitors Statins Platelet-active agents |
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Angina pectoris - treatment
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Morphine - pain and vasodialating effects
Oxygen - reduces workload of the heart Nitro - vasodialator Aspirin - antiplatelet/reduces/prevents blood clots |
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Angina Pectoris - Patient education
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Correct use of prescription medications
Common adverse effects from prescription medication Avoid fatigue and cold weather Lifestyle modifications Smoking cessation referral, if necessary Always stop activity or exercise when chest pain is present |
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4 coronary vessels
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RCA - Right coronary artery
LCA - Left coronary artery Circumflex artery Left Anterior decending Coronary veins |
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RCA - Right coronary artery
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Supplies blood to:
right atrium right ventricle bottom portion of both ventricles and back of the septum |
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Left Coronary Artery
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Supplies blood to:
Circumflex artery Left Anterior Descending artery (LAD) |
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Left Anterior Decending
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supplies blood to:
front and bottom of the left ventricle front of the septum |
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Circumflex Artery
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supplies blood to the left atrium, side and back of the left ventricle
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Calcium Channel Blockers - uses
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Reduce incidence of MI
Secondary prevention for patients with known coronary artery disease |
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Calcium Channel Blockers - actions
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Inhibit flow of calcium ions across cell membrane
Reduce peripheral vascular resistance Improve coronary blood flow (increases blood flow to the heart) Vasodialator |
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ACE (angiotensin-converting enzyme) inhibitors - Actions
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Promote vasodilation
minimize cellular aggregation prevent thrombus formation |
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ACE (angiotensin-converting enzyme) inhibitors - Uses
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Reduce incidence of MI (Myocardial Infarction)
myo= muscle cardial= heart infarction = tissue death secondary prevention for patients with known coronary artery disease (CAD) |
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Ranolazine - Actions
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Enzyme modulator that affects the metabolism within myocardial cells to reduce oxygen demand
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Ranolazine - uses
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Treat chronic stable angina
Reduces frequency and severity of anginal attacks Reduces use of nitroglycerin during acute attacks |
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Ranolazine - adverse effects
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Dizziness, headache, constipation, nausea
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Ranolazine - drug combinations
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calcium channel blockers
beta blockers nitrates |
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Nitro-BID
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topical ointment
onset 30 minutes duration 3 hours |
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Nitro-Dur
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Patch, Transmucosal
onset 30-60 minutes Duration - less than 24 hours |
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Nitrolingual
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Spray, translingual
onset 2 minutes Duration 30-60 min |
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Nitroglycerin IV
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IV Fluid
onset 1-2 minutes Duration 3-5 minutes |
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NitroStat
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Tablet sublingual
Onset 1-2 minutes duration less than 30 minutes |
