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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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