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DRUGS FOR ANGINA

Beta Blockers

• Most common examples: MAN

o metoprolol

o atenolol

o nadolol

▪ non-specific beta blocker

▪ longer duration of action/don’t have to take as frequently as propranolol

• Mechanism of Action

o Reduces cardiac workload by decreasing sympathetic flow

o Decrease oxygen demand

o Lower HR and contractility of heart

• Indications: Stable angina, CAD, HTN

o These drugs can cause heart failure

o Alternatives to nitrates since not everyone can tolerate these

Calcium Channel Blockers (CCB)

• Typical Examples: Are Very Nice Drugs

o amiodipine

▪ vessel selective ( HTN

o verapamil

▪ non-selective

▪ used for chest pain, angina, cardiac arrythmias

o nifedipine

▪ vessel selective ( HTN

o diltiazem

▪ non-selective

▪ used for chest pain, angina, cardiac arrythmias

• Mechanism of action

o Interfere with calcium influx of heart and blood vessels

▪ Heart and skeletal muscles controlled by movement of calcium and influenced by intracellular concentrations

▪ When calcium moves into cells ( contract

• Hypocalcemia lowers action potential making muscles more reactive to calcium in tetany

▪ When calcium is blocked from moving in ( relax

o Reduce cardiac workload

o Decrease peripheral vascular resistance

o Decrease HR, BP, and preload

o Vessel Selective vs Non-selective

▪ Non-selective decrease contractility which decreases the workload of the heart

• Indication

o HTN and Angina

• Adverse effects

o Hypotension & postural

▪ Because they cause vasodilation

▪ This can result in headache

o Bradycardia

o Heart failure

▪ Want to decrease workload so we don’t have chest pain, but don’t want to decrease so much that this happens

o Don’t have bronchoconstriction problem, like beta blockers though

▪ Would be a good choice for pulmonary problem pts like those w/ COPD or asthma

• Nursing Implications

o Assess vital signs (BP and P)

▪ Hold if hypotensive esp. if symptomatic

▪ Hold if HR ................
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