Pharmacology - Angina PDF

Pharm exam 2 Bullet Point Nursing Pharmacology – Angina Disclaimer: These notes are designed to provide the key points of each topic and may not contain all necessary information. Every effort is made to ensure this content is up to date and ac...

Pharm exam 2 Bullet Point Nursing Pharmacology – Angina Disclaimer: These notes are designed to provide the key points of each topic and may not contain all necessary information. Every effort is made to ensure this content is up to date and accurate at the time of writing. No liability is assumed for the content or its relation to current standards and practices. This should not replace comprehensive nursing educational resources. Pathophysiology review  Angina is when oxygen demand exceeds supply in the heart  Classic symptom is chest pain/discomfort  Stable angina is when the chest pain comes in a predictable pattern (with exertion) o Pain is relieved with rest and/or nitroglycerin Drug class: Nitrate  Drug: o Nitroglycerin  MOA: Dilates veins o At high doses can dilate arteries improveblood Laffite  Indications: Acute angina and heart failure FLY supply  SE/AE: Headache, orthostatic hypotension, reflex tachycardia  Routes: Sublingual, transdermal, IV o Be sure to wear gloves when handling transdermal medications  Dosed for acute stable angina SL at 0.4mg (400mcg) q5 minutes PRN up to three doses o Reassess BP prior to each dose when administered by a healthcare provider o Patients must be educated to seek emergency medial care if no relief after three doses  Used PRN as first line agent for stable angina  Used as alternative agent for angina prevention via the transdermal route o Requires dose vacation due to tolerance build up  Contraindicated for patient that took sildenafil, vardenafil, or tadalafil within 48-72 hours  Contraindicated in patients with suspected acute right ventricular myocardial infarction  Hypotension related to nitroglycerin is treated with fluids  BP must be assessed prior to administration due to hypotensive effects Drug class: Beta adrenergic antagonists (Beta blockers)  Drugs: o Propranolol o Metoprolol o Labetalol  MOA: Blocks beta receptors, decreases the workload of the heart to help angina  Indications: Angina, HTN, heart failure, AMI, dysrhythmias, migraines prevention, anxiety, and more  SE/AE: Fatigue and bradycardia  Black Box warning: Abrupt discontinuation can cause adverse cardiac effects Bullet Point Nursing © 2023  Bullet Point Nursing  Caution in those with underlying pulmonary conditions, can cause bronchoconstriction o Highest risk with propranolol  Alternative option for the treatment of hypertension o One of the safest options for HTN in pregnancy  Carvedilol (Coreg) is another drug in this class primarily used for heart failure  First line agent for angina prevention  RNs must assess HR and BP prior to administration Drug name: Ranolazine  MOA: Unknown – decreases oxygen demand  Indication: Angina prevention  SE/AE: QT prolongation Alternative to beta blocker for angina is a calcium channel blocker Angina cliniced diagny when when pt oxygen demand exceed supplyof heart Bullet Point Nursing © 2023  Bullet Point Nursing References Adams, M., Holland, N., & Urban, C. (2020). Pharmacology for nurses; A pathophysiologic approach. Pearson Burchum, J., & Rosenthal, L. (2022). Lehne's pharmacology for nursing care. Elsevier Kannam, J., Aroesty, J., & Gersh, B. (2021) Chronic coronary syndrome: overview of care. www.uptodate.com Mccuistion, L., Vuljoin-DiMaggio, K., Winton, M., & Yeager, J. (2023) Pharmacology: A patient centered nursing process approach. Elsevier 1 cardiac Disease 7 risk factors manage the cardiac Disease nonpharm BMI sleep is important educate patient MI heart attack cholesterol f hf Bullet Point Nursing © 2023  piece of Flame 51sHeart attack 1 Chestpain Ischemia a trouble breathis 3 Sweating Injury 4 nausea 1 heart attack 77 Infraction A treatment option takes place into CAT Lab Angioplasty procedure percutaneous intervention gon to vein PCI should be done in 90 mins Alterative Thrombolytic breakexisting clot c int is.itn t IV available have checklist needs to be done before administer Thrombocytics option B CABG Open surgery Intracranial hemonage bleeding in brain  99 willcan aests.isYan'causetuistd MI ECG NC severe AI TAL SA Chewable exceptcontraindication to always rphi.ie if pain blocker not to break clot sarin prevent father clof ating art job to give oxygen supply demand ngena Supply channel calcium blocker