Angina Pectoris

Clinical Syndrome

Episodes of Chest Pain

Deficit in Myocardial Oxygen

Most often caused by atherosclerotic plaques

Antianginal Agents

Nitrates

Beta blockers:

previously discussed

Calcium channel blockers: previously discussed

Antianginal Agents

Decrease Myocardial Demand for Oxygen

Increase Blood Supply to Myocardium

Antianginal Agents:
Therapeutic Effects
Refer to Lilley pg. 337 Box 22-1

Nitrates:
Mechanism of Action

Dilate all blood vessels, primarily venous circulation, but slight arterial vasodilatation

Venodilation is a result of relaxation of smooth muscle surrounding veins

Potent dilating effect directly on coronary arteries!!!!!!

Nitrates:
Therapeutic Uses

Prototype Drug: Nitroglycerine (Nitrostat SL)
(Brand name in parentheses)

(Refer to Prototype List in syllabus
Also listed in Lilley, pg. 339)

Sublingual

Action 1-3 minutes

Duration 30-60 minutes

 

How to Administer Nitroglycerine?

Under tongue

Take at first sign of symptoms

If no relief in 5 minutes take a second SL tablet

If no relief in 5 minutes take a third SL tablet

If no relief after 3^rd tablet, activate EMS

Nursing Actions

Check Blood Pressure and Heart Rate BEFORE each dose

Observe for relief of chest pain

Observe for hypotension, dizziness, tachycardia, headache

 

Client Teaching

Keep in original dark container

Replace every 6 months

Headache and dizziness may occur

Avoid OTC meds

Avoid Alcohol (ETOH)

Prophylactic use

THE END