Angina and MI Drugs Ch. 28 (N241)

angina

chest pain due to heart's lack of oxygen, possibly as a result of a possible obstruction and activity that increases the demand of the heart

fats

non-pharm managements of angina:

- limit alcohol

- limit foods that are high in bad ______, such as trans fat, saturated fat, LDL

- no smoking

- BP management

- weight management (treat obesity)

- exercise

- euglycemia

- low sodium diet

oxygen

the overall goal of pharmacological management of angina is to reduce myocardial ___________ demand

- slow HR

- reduce preload

- reduced contractility

- reduced afterload

betablockers

what drug class slows heart rate?

nitrate

what drug reduces preload and is a potent vasodilator?

statins

drugs used to lower cholesterol in the bloodstream

contraindications: pregnancy

- check AST/ALT liver levels

- call provider if muscle or joint pain / cramps

- check if cholesterol decreases to see drug effectiveness

nitrates

potent vasodilator

use: angina

MOA: reduces preload and afterload and dilates coronary arteries

nitroglycerin

class: nitrate

use: angina

MOA: dilates veins and decreases preload --> decreases cardiac oxygen demand

A/E: H/A, orthostatic hypotension

contraindication: do NOT take with Sildenafil (Viagra) or Tadalafil (Cialis) since they are both potent vasodilators; pregnancy

sublingual route is short acting (2-4 minutes) and if the patient is at home, they may go up to 3 doses

- patient should call provider if chest pain does not subside after 1 dose

- drug should be kept in a dark place and at room temp

betablockers

which class of drugs?

stable angina prophylaxis

TU: reduce cardiac workload and treats angina

ex. metoprolol, propranolol

- monitor especially patients with asthma or COPD (bronchoconstriction) and diabetic patients (masks hypoglycemia)

calcium

what ion is necessary for muscle contraction?

the blockage of this ion results in the limiting of muscular contraction and the relaxation of smooth muscles of arteries / decrease in vascular resistance

therefore:

- reduces afterload

- decreases cardiac workload

- dilates coronary arteries

blood pressure

if we use calcium channel blockers for angina, we should assess the patient's heart rate and _________ ____________ since it may contribute to peripheral edema

diltiazem (verapamil)

class: calcium channel blocker

use: angina

S/E: dizziness, edema