Term
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Definition
MOA
- venous and arteriolar dilators
- Converted to nitric oxide (NO): helps w/ vasodilation, - relax vascular smooth muscle
- Reduce O2 demand by ↓ preload and afterload: effective in acute attacks, help diolate blood vessels (supply O2 to heart) -> SL nitroglycerin (fast and effective w/in min)
- ↑ blood flow to myocardial muscle |
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Term
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Definition
ADRs
- Flushing
- venous pooling
- HA: complain w/ min, due to SL which causes dilation of blood vessels in brain, resolves w/in min. to hrs)
- hypotension and orthostatic hypotension: make sure pt. sits down after taking med
All related to vasodilation |
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Term
Nitrate formulations
Drugs
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Definition
- Nitro SL (Nitrostat®) - treat acute attacks
- Nitroglycerin ointment
- Nitroglycerin SR caps
- Isoosorbide dinitrate tabs
- Isosorbide mononitrate tabs
Taken daily to PREVENT attacks! (all but SL)
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Term
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Definition
-tablets and spray
-DOC for acute attack
-treat acute attacks
-work w/in 1-2 min. |
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Term
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Definition
-Dissolves in skin
-Dosed in inches
-applied every 6-8 hrs.
-Quick onset of action (15-30 min)
-Can be removed quickly if SE occur (hospital setting) |
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Term
| Nitroglycerin transdermal patch (Nitro-Dur®, Minitran®) |
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Definition
- NOT effective for acute attacks
- used prophylactically: reduce freq. of exertional or variant attacks
- steady constant release over 24 hrs
- Used once daily
- Don't apply w/ heat, electrical modalities or cover w/ plastic
-Apply to hairless area |
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Term
| Nitroglycerin SR caps (Nitro-Bid®) |
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Definition
- NOT effective for acute attacks
- used prophylactically
- used on a daily basis |
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Term
Isosorbide dinitrate tabs (Isordil®)
Isosorbide mononitrate tabs (Ismo®, Monoket®) |
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Definition
- NOT effective for acute attacks
- used prophylactically
- Taken daily (works w/ both types of angina) |
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Term
Digoxin (Lanoxin®) - HF
MOA |
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Definition
- Positive inotropic effects: block inhibit Na+/K+ pump, increases intracelluar Na+ levels facilitating Ca+ influx w/in the cell -> Na+ blocks exit of Ca+-> stronger muscle (LV) contraction
- Beneficial neurohormonal effects: reduces SNS activation and ↑ PNS activity -> ↓ HR and ↑ diastolic filling |
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Term
Digoxin (Lanoxin®)
Therapeutic Uses |
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Definition
Therapeutic Uses
-Treat systolic HF:
-Improves symptoms
-Improves QOL
-Improves LVEF
-Improves exercise tolerance
-Does NOT improve survival (M/M)
-Treat atrial fibrillation
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Term
Digoxin (Lanoxin®)
Drug Interactions |
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Definition
DI
-AV heart block: used w/ β-blockers, diltazem or verapamil
-Cytochrome p450
-Antacids: may reduce oral absorption
-Many more
Does reduce HR: can be problematic w/ other drugs that lower HR |
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