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What are the 3 main groups to treat angina
Beta Blockers, Calcium Channel Blockers, Nitrates
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What is the drug of choice for Prinzmetal Angina?
Calcium Channel Blockers
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How do Nitrates help with angina?
- dilate coronary arteries, arterioles, veins (vasodilation)
- decrease the preload
- reduces resisitance and afterload
- no help in CO
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Treatment of choice for pt having acute angina attack?
SL nitroglycerin or nitrates
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Drug choice of nitrates for chronic recurrent angina?
topical route, or oral (oral is not nitroglycerin)
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How to reduce tolerance build up to Nitrates?
- use smallest dose possible
- remove patch 8-10hrs during the night
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Most common adverse effect of nitroglycerin?
Headache, BP/HR drop, *syncope, palpitations
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Special accommodations for nitroglycerin storage?
- glass bottle/ special IV tubing
- toss after 3mo
- avoid light, heat or humidity exposure
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What should the nurse teach the pt about nitroglycerin?
- repeat SL nitroglycerin 3x with 5 min break in between for relief
- pt should call EMS if they are taking their 3rd tablet
- *should feel tingling under tongue
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What should the nurse watch for after administering NTG?
- Headache, reflex tachycardia *
- do not let NTG get on your skin, wear gloves, will cause HA, wash hands
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What is the oral Antianginal agent?
- Isosorbide (Isordil)
- treats and prevents angina orally
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Isosorbide MOA
long acting prototype, only NTG that does NOT treat HTN, SL or orally
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Adjunct therapy for angina
- MONA
- Morphine, Oxygen, NTG, Aspirin
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