Exam 3 Study Guide - Antiangina and Antilipids

What is the major class of drugs used to treat high cholesterol (also what the drugs end in)?

Statins

What is rhabdomyolysis and how is it related to cholesterol medications?

Potential muscle wasting and deterioration due to taking statin medications

What patient populations should not take Statins?

Liver disease or increased liver enzymes, pregnancy

What body systems should be monitored closely when taking antilipemic drugs and how do you monitor?

Liver - liver function test

What is the long name for Statins?

Hydrooxymethylglutaryl-coenzyme A reductase inhibitors

What are the three Statins?

Atorvastatin

Pravastatin

Simvastatin

When should a pt take Statins?

At bedtime since that is when the affected enzymes function

What drug is a Bile Acid Sequestrant?

Cholestyramine (Questran)

What are contraindications to Cholestyramine?

PKU, bilary or bowel obstruction

What are key nursing points for Cholestyramine?

-Take with meals to reduce GI upset

-Increase fiber to help with constipation

-Take 1 hr before or 4-6 hours after other medications

-Effects absorption of Vitamin A, D, E, K

What vitamin is Niacin?

B3

What are contraindications of Niacin?

Liver disease, peptic ulcer, active bleeding

What does Niacin do?

Lowers all lipoproteins

What are 3 classes of drugs used to treat angina?

-Nitrates

-Beta Blockers

-Calcium Channel Blockers

How do Nitrate drugs treat angina?

Cause venous dilation decreasing the volume of blood returning to the heart overall decreasing LV pressure and O2 demand

What other drug class would be contraindicated with Nitrates?

Erecticle Dysfunction Drugs

What hemodynamic changes would oyou expect to see when giving Nitroglycerin?

Hypotension, Headache, and reflex tachycardia

What instructions would you give to a patient with a new prescription for Nitroglycerin?

-Sit down and take one tablet

-If chest pain is not relieved 5 minutes after 1st tablet, call 911 then take the 2nd tablet

-If no relieft avail, take a 3rd tablet 5 minutes later

-Don’t consume more than 3 doeses and do not swallow

-Potency is lost in 3 months after the bottle is opened

What is an appropriate way to give a patient taking nitroglycerin a “drug holiday”?

Tell them to not wear their topical form of Nitroglycerin at night

What are the special nursing considerations when giving Nitroglycerin IV?

Must be given with special non-pvc tubing

How do beta blockers help pts with angina?

Decrease the rate and strength of contraction

What type of angina is helped with beta blockers?

Exertional angina (during activity)

How do you determine if the anit-angina drugs are having adverse effects on hemodymanics?

-Weight gain - 2lbs in 1 day of 5lbs in 1 week

-Pulse rate less than 60

What are the Beta Blockers for Agina?

-Metoprolol

-Atenolol

-Propranolol

What are the Calcium-Channel Blockers for Angina?

-Diltiazem

-Verapamil

-Amlodipine

-Nifedipine

-Nicardipine

What forms can Nitroglycerin be found in?

Patches, spray, SR Oral Tablets, IV, RA Sublingual

What is the goal of anti-angina drugs?

To increase blow flow and decrease O2 demand