Antianginal Drugs
TERMS
□ nifedipine (Procardia)
□ nitroglycerin (Nitro-bid, Nitrostat, others)
□ propranolol (Inderal)
QUICK LOOK AT THE CHAPTER AHEAD
The nitrates, beta-blockers, and calcium channel blockers are the three main classes of drugs used to treat angina pectoris. The goal of treatment is to decrease pain, minimize frequency of attacks, prevent or delay myocardial infarction by reducing oxygen demand, and maintaining oxygen supply.1
The nitrates are the most frequently used antianginal drugs. Nitroglycerin has been used for treatment of angina since 1879.1
Table 41-1 Antianginal Drugs | ||||||||||||
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ANTIANGINAL DRUGS CLIENT TEACHINGNitrates
Change positions gradually to avoid orthostatic hypotension.
Nitroglycerin can lose potency if exposed to light, moisture, or heat.
Replace tablets 6 months after opening, as nitrates lose potency over time.
Avoid alcohol, hot baths, saunas, and whirlpools, as they can cause vasodilatation and lead to hypotension and fainting.
Teach side effects and adverse effects of nitrates, which include headaches (that can last up to 20 minutes), dizziness, facial flushing, increased heart rate, and lightheadedness.
Report to health care provider if dry mouth, severe headaches, or blurred vision occur.
An analgesic can be given to treat headache.
Discard cotton packing after opening bottle, as the packing may absorb the drug and lead to decreased potency.
Encourage client to discontinue tobacco use, as tobacco causes vasoconstriction.
Avoid OTC and herbal remedies without first consulting health care provider.
Keep a journal documenting number and characteristics of anginal attacks, contributing factors and number of tablets taken, and adverse effects.
Change positions gradually to avoid orthostatic hypotension.
Nitroglycerin can lose potency if exposed to light, moisture, or heat.
Avoid alcohol, hot baths, saunas, and whirlpools, as they can cause vasodilatation and lead to hypotension and fainting.Sublingual Tablets
If client has an acute anginal attack, teach client to lie down and take SL tablet as soon as possible; up to 3 nitroglycerin tablets every 5 minutes for 15 minutes may be taken; if no relief, emergency services should be notified for transport to the emergency room.
Do not chew SL tablets. Place under tongue to dissolve. Do not swallow tablet.
Tablet should burn slightly under the tongue, if not replace supply of tablets.4
Do not eat food or smoke until tablet dissolves.
If client has an acute anginal attack, teach client to lie down and take SL tablet as soon as possible; up to 3 nitroglycerin tablets every 5 minutes for 15 minutes may be taken; if no relief, emergency services should be notified for transport to the emergency room.Buccal
Place tablet between upper lip and gum to dissolve.
Chew thoroughly and hold in mouth 2 minutes before swallowing.Chewable Tablets
Chew thoroughly and hold in mouth 2 minutes before swallowing.
Oral Sustained-Release Tablets or Capsules
Take with a full glass of water on an empty stomach, swallowing whole medication.
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