80 Questions
What is the effect of dilation of the veins on blood flow?
Decreases filling pressure (preload)
How do nitrates affect the systemic arteriolar bed?
They relax the arteriolar bed, lowering blood pressure
What is the purpose of applying topical nitroglycerin patches in the morning and removing them at bedtime?
To prevent the development of tolerance
How do beta-blockers reduce myocardial oxygen consumption?
By blocking beta-adrenergic sympathetic stimulation to the heart
Why should beta-blocker therapy not be stopped abruptly?
Because it may worsen angina and lead to MI
What is the primary effect of calcium channel blockers on the ischemic myocardium?
Decrease the workload of the heart
Which drug is commonly prescribed in addition to aspirin in patients at high risk for MI?
Heparin
What is the main mechanism by which nitroglycerin relieves angina?
Venous dilation
What is the risk associated with both clopidogrel and newer oral agents such as prasugrel and ticagrelor?
Bleeding from the GI tract or other sites
What is the indication for IV administration of glycoprotein IIb/IIIa agents, such as abciximab or eptifibatide?
As adjunct therapy for PCI
How is heparin therapy considered therapeutic?
When the activated partial thromboplastin time (aPTT) is 2 to 2.5 times the normal value
How are organic nitrates like nitroglycerin converted in the body?
Converted to a vasodilator
Which of the following best describes the action of antianginal drugs?
Dilating blood vessels to increase oxygen supply
What influences the demand for oxygen by the heart muscle?
Heart rate and preload
Which drug is described as a potent vasodilator that improves blood flow to the heart muscle?
Nitrates
What type of vessels does nitroglycerin primarily dilate?
Veins
Which of the following is NOT an influence on the demand for oxygen by the heart muscle?
Body temperature
What is the primary purpose of nitrates in angina treatment?
Improving blood flow to the heart muscle
What is the purpose of observing a 10- to 12-hour nitrate-free interval?
To prevent the development of tolerance to nitroglycerin
When is the oral form of nitroglycerin useful?
For prophylactic use in chronic chest pain
In which situation is IV nitroglycerin useful according to the text?
Controlling blood pressure in perioperative or emergency situations
What is the most common adverse effect of nitroglycerin?
Severe headache
What are the contraindications to nitroglycerin according to the text?
Hypersensitivity reactions and hypotension
What should the nurse do if a patient has hypotension and tachycardia prior to administering nitroglycerin?
Withhold the medication
What is the recommended action if chest pain is not relieved within 5 minutes of taking sublingual nitroglycerin tablets?
Dissolve a second tablet under the tongue
What should be done if withdrawal of a beta-adrenergic blocker is planned?
Gradually decrease the dose under prescriber's guidance
How should transmucosal tablets of nitroglycerin be administered?
Place them under the upper lip or between the cheek and gum and allow them to dissolve slowly
What is important to remember about applying nitroglycerin patches and ointment?
Rotate application sites to promote effective and consistent drug absorption
What should be avoided when taking nitroglycerin and other nitrate preparations?
Taking medications for erectile dysfunction
How should oral nitrates be taken?
On an empty stomach with a glass of water
What should be done if heart rate falls below 55 beats/min while taking beta-adrenergic blockers?
Report to the health care provider
How should atenolol be taken?
At the same time each day
What should be done if withdrawal of a beta-adrenergic blocker is planned by the prescriber?
Gradually decrease the dose under prescriber's guidance
What should be done when taking drugs for heart disease on a regular schedule?
Take them at evenly spaced intervals to increase drug effectiveness in preventing acute attacks of angina
What should patients avoid while using nitrate drugs?
Alcohol consumption
How should nitroglycerin ointment be applied to the skin?
By spreading in a thin, even layer on a nonhairy area of the skin
What is the recommended administration route for IV nitroglycerin?
Infusion pump
When should extended-release oral nitrate preparations be used post-MI?
If angina persists after revascularization
What happens if sublingual nitroglycerin tablets are exposed to body heat for a prolonged period?
They become ineffective
What effect may occur with nitrate antianginal drugs, especially sublingual nitroglycerin?
Headache and dizziness
Which of the following is the primary effect of nitroglycerin?
Dilating veins and arteries
What is the primary influence on the demand for oxygen by the heart muscle?
Heart rate
What is the main mechanism by which beta-adrenergic blockers reduce myocardial oxygen consumption?
Decreasing the work of the heart
What is the purpose of observing a 10- to 12-hour nitrate-free interval?
To avoid tolerance to nitrates
Which drug is commonly prescribed in addition to aspirin in patients at high risk for MI?
Calcium channel blockers
How do antianginal drugs primarily work to improve blood delivery to the heart muscle?
By dilating blood vessels or decreasing the work of the heart
Which effect do beta-blockers have on the heart?
Decrease heart rate and myocardial contractility
What is the primary purpose of calcium channel blockers in the treatment of angina?
Decrease workload of the heart and decrease myocardial oxygen demand
What is the recommended dose of aspirin for a patient with a new diagnosis of angina?
162 mg daily
What is a common adverse effect of nitroglycerin?
Headache
What should patients taking beta-blockers do if the prescriber plans to discontinue the medication?
Gradually decrease the dose over several days
Which patient condition is a contraindication for IV administration of nitroglycerin?
Systolic blood pressure less than 90 mm Hg
What is the primary purpose of administering IV administration of glycoprotein IIb/IIIa agents, such as abciximab or eptifibatide?
To block the GP IIb/IIIa receptors on platelets and prevent adhesion of fibrinogen
What is the main risk associated with both clopidogrel and newer oral agents such as prasugrel and ticagrelor?
Bleeding from the gastrointestinal tract or other sites
What is the primary effect of calcium channel blockers on the ischemic myocardium?
Vasodilation and reduction in peripheral vascular resistance
How is heparin therapy considered therapeutic?
When the activated partial thromboplastin time (aPTT) is 2 to 2.5 times the normal value
What is the main mechanism by which nitroglycerin relieves angina?
By reducing venous pressure and decreasing venous return to the heart
What should be done if a patient has received heparin within the past 3 months or has been receiving unfractionated heparin for 4 to 14 days?
Switch to low-molecular-weight heparin (LMWH)
What is the purpose of observing a 10- to 12-hour nitrate-free interval?
To prevent the development of tolerance to nitroglycerin
In which situation is IV nitroglycerin useful according to the text?
To manage pain associated with an MI when unresponsive to other forms of nitrates
What is the most common adverse effect of nitroglycerin?
Severe headache
What should be done if a patient has hypotension and tachycardia prior to administering nitroglycerin?
Withhold the medication and monitor the patient closely
What is important to remember about administering SL nitroglycerin or translingual spray?
It should be used as soon as chest pain develops
What drugs interact with nitroglycerin, increasing or decreasing its effects?
Calcium channel blockers and alcohol
Why should nitroglycerin ointment not be massaged into the patient's skin?
It increases the absorption of the ointment
Why do patients take PO nitrates in the morning after a nitrate-free interval?
To prevent tolerance development
Why should extended-release oral nitrate preparations be used post-MI if angina persists after revascularization?
To maintain long-term control of angina
Why is it important to avoid PVC tubing when administering IV nitroglycerin?
PVC tubing absorbs a significant amount of the drug
What should patients do if rest and three sublingual tablets or oral sprays do not relieve chest pain?
Seek emergency care immediately
What is a potential side effect that may occur with nitrate antianginal drugs, especially sublingual nitroglycerin?
Temporary headache
What should be done if chest pain is not relieved within 5 minutes of taking sublingual nitroglycerin tablets?
Dissolve a second tablet under the tongue
What should patients avoid while using nitrate drugs?
Erectile dysfunction medications
How should transmucosal tablets of nitroglycerin be administered?
Place them under the tongue until they dissolve
Why should beta-blocker therapy not be stopped abruptly?
To avoid rebound tachycardia
What is the primary influence on the demand for oxygen by the heart muscle?
Myocardial oxygen consumption
How are organic nitrates like nitroglycerin converted in the body?
They are converted to nitric oxide
What is the main mechanism by which nitroglycerin relieves angina?
Dilating blood vessels
What is the primary purpose of nitrates in angina treatment?
To reduce myocardial oxygen demand
Which drug is commonly prescribed in addition to aspirin in patients at high risk for MI?
Clopidogrel
What are the contraindications to nitroglycerin according to the text?
Use of erectile dysfunction medications
Test your knowledge on the safety measures to avoid the development of tolerance to nitroglycerin, including the importance of a nitrate-free interval and the pharmacokinetics of its oral form. Understand the prophylactic use of nitroglycerin in preventing acute chest pain.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
