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Antianginal drugs - Coggle Diagram
Antianginal drugs
Nitrates
Therapeutic action
Drop in systemic blood
Compatates by increasing blood flow to arteries and veins
Indications
Children
Cardiac surgery
Congenital heart
Adult
Old adult
Sublingual nitroglycerin is most effective for recurrent variant angina
Continuous infusion or transdermal patch for untable angina
Contraindications
Allergy to nitrates - prevent hypersensitivity reactions
Severe anaemia -decrease cardiac output caused by nitrates is dangerous for blood with low-oxygen binding capacity
Head trauma and cerebral hemorrhage -relaxation of cerebral Cassels leads to intercranial bleeding
Pregnancy and lactation -harm to fetus
Hepatic and renal disease -alteration in drug metabolism and excretion
Conditions that can limit CO
Adverse effect
CNS -throbbing headache, dizziness, weakness
GI -nause, vomiting,incontince.
EET-pallor, flushing sweating.
CV -hypotention,reflex tachycardia, syncope.
Large doses leads to methemoglobinemia and cynosis
Nursing consideration
Nursing assessment
•presence of mentioned contraindications and cautions
•skin color and integrity
•pain and activity level
•neurological status(level of consciousness)
•cardiopulmonary status(BP,take HR in a full minutes)
Nursing diagnosis
•decreased cardiac output related to vasodilation and hypotensive
•Risk for injury related to adverse effect on neurological and cardiovascular status
•ineffective tissue perfusion related to low oxygen supply to myocardial cells
Implementation with rationale
•ask for burning sensation to ensure drug potency
•protect drug from sunlight to maintain drug potency
•instruct patient not to swallow sublingual preparation to ensure therapeutic effect
•Rotate injection sites and provide skin care as appropriate to prevent skin abrasion.
Evaluation
•monitor patients'responce to therapy
•monitor for presence of mentioned adverse effect
•monitor for effective of comfort measures
•monitor laboratory tests
Calcium -channel blockers - blocks heart construction by inhibiting movement of calcium ions
Therapeutic action
•Relieves vasospasm in variant angina by Increasing blood flow to the heart
•can block atherosclerotic process in endothelial cells
•Treatmentbof variant angina, chronic angina and effort associated angina
Contraindications and cautions
•Allergy to the drug
•heart block and sick sinus syndrome -conduction problems in these disease may be exacerbated by slow conduction effectsbof drugs
•Renal and hepatic dysfunction -alteration with metabolism and excretion
•heart failure-worsened by decreased CO effort of the drug
Adverse effect
CNS - dizziness, ligtheadness, fatigue, and headache
•GI- nausea, hepatotoxicity effect of the drug
• CV -hypotention, bradycardia peripheral edema
EET-flushing,rash
Nursing management
Nursing assessment
•
Nursing assessment
•presence of mentioned contraindications and cautions
•skin color and integrity
•pain and activity level
•neurological status(level of consciousness)
•cardiopulmonary status(BP,take HR in a full minutes)
Nursing diagnosis
• decreased cardiac output related to hypotension and vasodilation effect of the drug
•Risk for injury related to cardiovascular and CNS adverse drug effect
Implementation and rationale
•monitor blood pressure and heart rate and rhythm to detect possible development of adverse effect
•provide comfort measures for patient tolerant side effect
•educate a client on measures to avoid angina attack
•emphasize to the client the important of strict adherence to drug therapy to ensure maximum therapeutic effect
Evaluation
•monitor response of the patient to therapy
•monitor for present of mentioned adverse effect
•monitor for effective of comfort measures
•monitor for compliance to drug therapy regimen
•monitor laboratory tests
Beta- adrenergic blockers
Drugs that block or lyse the effect sympathetic stimulation.also called sympatholitics
Therapeutic action
Decrease blood pressure
•contractility
Decrease heart rate by blocking the beta receptors in the heart and juxtaglomerular apparatus
Indications
•Nodalol-for management of chronic angina
•prepranolol -for treatment of angina and it is the only drug that cross blood brain barrier
•Nebivelol-newest one
Contraindications and cautions
•bradycardia ,, heart shock and cardiogenic shock-blocking effect of drugs excerbates these conditions
•pregnacy and lactation -harmful effect to the fetus
•Diabetes ,COPD , thyrotoxicosis, and peripheral vascular disease
Adverse effect
• CNS-emotional depression, dizziness, fatigue, sleep disturbances
•GI-gastric pain ,nausea, vomiting,cotilis,diarrhoea,
•CV-heart failure, reduced cardiac output, arrhythmia