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Pharm 2 exam 1 cardiac

Terms in this set (63)

Drugs for Angina
Nitrates/nitrites
Beta blockers
Calcium channel blockers
Nitrates/Nitrites Available forms
Sublingual*
Chewable tablets
Oral capsules/tablets
Intravenous solutions*
Transdermal patches*
Ointments*
Translingual sprays*

*Bypass the liver and the first-pass effect
nitrates drug effect
Cause vasodilation because of relaxation of smooth muscles
Potent dilating effect on coronary arteries
Result: oxygen to ischemic myocardial tissue
Used for prevention and treatment of angina
Nitrates/Nitrites Indications
Rapid-acting forms
Used to treat acute anginal attacks
Sublingual tablets; intravenous infusion
Long-acting forms
Used to PREVENT anginal episodes
nitrates Adverse effects
Headaches
Reflex tachycardia
Postural hypotension
Contact dermatitis
Tolerance
Sustained release capsule teaching
Take on empty stomach
Drink at least 8 oz. water
Do not crush
Transdermal teaching
Do not cut patch
Remove patch at night/decrease risk for tolerance
Remove old patch/wash site with soap & H20, dry
Place on hairless area
Rotate sites
Topical Ointment teaching
Remove prior dose
Measure new dose with applicator paper
Spread over 2.5-3.5 inches of the paper
Apply to hairless part of body
Cover with clear plastic wrap
Avoid touching ointment
Intravenous teaching
Glass bottle/special non PVC tubing
Start slowly/5 mcg/min
Titrate for response
Discard if solution blue, green, or dark red
Sublingual tab/translingual spray teaching
Stop activity
Sit/lie down
Use 1 tablet/let dissolve Rest 5 minutes
No relief after 1 tab: call 911 take second tablet
No relief after 2 tablets, take 3rd tablet
3 tablets/sprays max
1 SL tablet= 1 spray
Store in airtight dark glass bottle
Change every 3 months
Ranolazine
Lowers cardiac oxygen demand
Improves exercise tolerance
Decreases pain
Used for chronic stable angina
Used in combination with amlodipine
Obtain baseline ECG/ monitor QT
Contraindications
Patients with prolonged QT
Liver dysfunction
Caution in older adults
Beta Blockers: Cardioselective
metoprolol (Lopressor)
Metoprolol succinate (Toprol XL)
Atenolol
Esmolol HCL
Non selective Beta Blockers
Affect heart/lungs
Propranolol
Nadolol
Contraindicated with asthma/bronchospasm/heart failure

Alpha and Beta Blockers
Carvedilol
Labetalol
Beta Blockers: Mechanism of Action
Block beta1 receptors on the heart
Decrease HR, resulting in decreased myocardial oxygen demand and increased oxygen delivery to the heart
Decrease myocardial contractility, helping to conserve energy or decrease demand

After an MI, a high level of circulating catecholamines irritate the heart, causing an imbalance in supply and demand ratio and even leading to life-threatening dysrhythmias
Beta blockers block the harmful effects of catecholamines, thus improving survival after an MI
Beta Blockers: Indications
Angina
Antihypertensive
Cardiac dysrhythmias
Cardioprotective effects, especially after MI
Some used for migraine headaches, essential tremors, and stage fright
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