Chapter 28 -- Drug Therapy for Coronary Heart Disease

Atherosclerosis begins with accumulation of lipid-filled __________ on the inner lining of the coronary arteries.

macrophages

Isosorbide dinitrate is used to reduce the frequency and severity of acute _______ episodes.

anginal

Intravenous (IV) ___________ is used to manage angina that is unresponsive to organic nitrates via other routes or beta-adrenergic blocking agents.

Nitroglycerin

When coronary atherosclerosis develops and lifestyle changes are not enough to reduce blood lipid levels, ___________ are useful in the management of the disorder.

dyslipidemic drugs

_______, formed from the inhalation of carbon monoxide in smoke, decreases delivery of blood and oxygen to the heart

Carboxyhemoglobin

What condition indicates the need to administer nitroglycerin? Headache Dizziness Chest pain Palpitations

Chest pain Chest pain is an indication that there is a lack of oxygen in the coronary arteries. Nitroglycerin is administered to dilate the vessels to promote better blood flow. It is not indicated for headache, dizziness, or palpitations.

Which finding is not an adverse effect of nitroglycerin? Hypotension Constipation Headache Weakness

Constipation Constipation is not a known adverse effect of nitroglycerin. However, hypotension, headache, and weakness are all adverse effects associated with it.

True or False: An impaired liver produces more drug-binding proteins such as albumin

False

True or False: Beta-adrenergic blockers are generally used to treat angina.

False

True or False: Calcium channel blockers only act on contractile tissues of the heart and on vascular smooth muscle.

False

How does nitroglycerin work? It vasoconstricts veins, arteries, and capillaries. It increases myocardial contractility. It vasodilates veins, arteries, and capillaries. It increases metabolic demand.

It vasodilates veins, arteries, and capillaries. Nitroglycerin is a potent vasodilator that improves blood flow within the heart. It does not constrict blood vessels or increase contractility and metabolic demand.

A patient is receiving nitroglycerin sublingually. How should the nurse instruct the patient to take this medication? Swallow the pill whole. Chew the pill quickly. Mix the pill in juice. Let the pill dissolve under the tongue.

Let the pill dissolve under the tongue. Medications given sublingually should be dissolved under the tongue for best absorption. Swallowing and chewing the pill or mixing it in juice could interfere with absorption.

A nurse is administering nitroglycerin to a patient. What is the priority intervention? Stay with the patient. Monitor vital signs every 15 minutes. Send the patient to the cardiac catheterization lab. Encourage incentive spirometry.

Stay with the patient. It is important to stay with the patient to frequently monitor their vital signs and ensure safety. Monitoring vital signs every 15 minutes is too infrequent. There is no indication to send the patient to the cardiac catheterization lab, and incentive spirometry is not a priority for this patient.

True or False: Both nicotine and carbon monoxide increase platelet adhesiveness and aggregation.

True

True or False: Propranolol is used to reduce the frequency and severity of acute attacks of angina.

True