Antianginal – Pharmacology for Nurses: Practical Applications

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Chapter 23: Anti-Anginal Drugs Test, Antianginal Therapy, Patient, Nitroglycerin

The key terms in this Pharmacology course include Anti-anginal drugs test, Patient, Nitroglycerin, Erectile Dysfunction Drugs, Calcium Channel Blockers, Nurse, Myocardial Oxygen Demand, Afterload, Sublingual Nitroglycerin Tablets, Adverse Effects, Medication, Prescription, Beta Blocker, Type 2 Diabetes Mellitus, Hyperthyroidism , Antianginal Antianginal Therapy.


It is most important for the nurse to instruct a patient prescribed nitroglycerin to avoid which substance?

Potassium-sparing diuretics

Antacids

Erectile dysfunction drugs

Grapefruit juice

Concurrent administration of nitrate drugs and erectile dysfunction drugs such as sildenafil citrate, tadalafil, and vardenafil can cause an additive hypotensive effect.


Calcium channel blockers reduce myocardial oxygen demand by decreasing afterload. How would the nurse explain afterload to the patient?

It is the force against which the heart must pump.

It is the pressure within the four chambers of the heart.

It is the total volume of blood in the heart.

It is the contractility of the heart muscle.

Afterload is the force (systemic vascular resistance) against which the heart must exert itself when delivering blood to the body.


The patient asks the nurse, “What is the best way to store sublingual nitroglycerin when I travel?” What is the appropriate response by the nurse?

“You can protect it from heat by placing the bottle in an ice chest.”

“You can put a few tablets in a resealable bag and carry it in your pocket.”

“Keep it in the glove compartment of your car to prevent exposure to heat.”

“It’s best to keep it in its original container away from heat and light.”

Although sublingual nitroglycerin needs to be kept in a cool, dry place, it should not be placed in an ice chest, where it could freeze. It should not be kept in the glove compartment of a car and needs to be kept away from heat, not in a clear plastic bag.


The nurse understands that a patient receiving nitroglycerin would be monitored for which common adverse effects associated with this medication? (Select all that apply.)

Headache

Blurred vision

Hypotension

Flushing

Dizziness

The common adverse effects of nitroglycerin include flushing of the face, dizziness, fainting, headache, and hypotension.


A patient has been diagnosed with angina and will be given a prescription for sublingual nitroglycerin tablets. When teaching the patient how to use sublingual nitroglycerin, the nurse will include which instruction?

Take up to 5 doses at 15-minute intervals for an angina attack.

If the tablet does not dissolve quickly, chew the tablet for maximal effect.

Wait 1 minute between doses of sublingual tablets, up to 3 doses.

If the chest pain is not relieved after one tablet, call 911 immediately.

According to current guidelines, if the chest pain or discomfort is not relieved in 5 minutes, after 1 dose, the patient (or family member) must call 911 immediately. The patient may take one more tablet while awaiting emergency care and may take a third tablet 5 minutes later, but no more than a total of three tablets. The sublingual dose is placed under the tongue, and the patient needs to avoid swallowing until the tablet has dissolved.


A patient has been taking a beta blocker for 4 weeks as part of his antianginal therapy. He also has type 2 diabetes mellitus and hyperthyroidism. When discussing possible adverse effects, the nurse will include which information?

“Monitor your blood glucose levels for possible hypoglycemia or hyperglycemia.”

“Monitor your pulse for increased heart rate.”

“Use the hot tub and sauna at the gym as long as time is limited to 15 minutes.”

“Watch for unusual weight loss.”

Beta blockers can cause both hypoglycemia and hyperglycemia. They may also cause weight gain if heart failure is developing, and decreased pulse rate. The use of hot tubs and saunas is not recommended because of the possibility of hypotensive episodes.