Classic Anginal Pain:

Beta-Adrenergic Blockers: Atenolol (Tenormin)

 Substernal chest pain (constricting,
 Action: decrease workload by slowing the heart
squeezing, suffocating); may radiate to
rate, decreasing blood pressure, and reducing
the jaw, neck, shoulder, both arms, back;
contractibility
may be mistaken for arthritis, indigestion
 Adverse effects: heart failure, bradycardia,
 Other symptoms: N/V, dizziness,
hypotension, bronchospasms in COPD clients
diaphoresis, SOB, or fear of impending
 NI: monitor ECG, BP & HR; assess apical pulse for 1
doom may be associated
full min. prior to administering; hold if HR <60 or
 Gender differences exist in symptom
SBP <90; assess pain
quality
 Patient Edu: educate masks signs of hypoglycemia
Adjunctive Antianginal Drugs:
Nonpharmacologic Management of CAD:
 Aspirin: Antiplatelet effects
 Risk factor modification
 Antilipidemics: reduce serum
 Lifestyle changes, medications: obesity, stop
smoking, elevated triglycerides, cholesterol,
Angina Pectoris: cholesterol
 Clinical syndrome characterized by  antihypertensives
elevated blood pressure, fasting glucose
episodes of chest pain occurs with
 Patient education
myocardial O2 deficit, produces
 Revascularization, interventional procedures
myocardial ischemia
 Most often caused by atherosclerotic
Antianginal Drugs: plaque in coronary arteries: coronary
 Goals of therapy: relieve acute angina pain, artery disease (CAD), development,
reduce number & severity of acute angina progression of atherosclerotic plaque,
attacks, improve exercise tolerance & life continuum progresses from angina to
quality, delay progression of CAD, & prevent MI
MI & sudden cardiac death

Nitrates: Nitroglycerin (IV, SL, Transdermal, PO)
 Use: the management & prevention of acute chest
pain caused by myocardial ischemia
 Action: nitrates are converted to nitric oxide, a potent
vasodilator, which relaxes smooth muscle in blood
vessel walls. Causes: venous, coronary artery &
arteriole dilation
 Adverse effects: severe h/a, dizziness, bradycardiam
hypotension, syncope, orthostatic hypotension
 NI: monitor BP, HR & ECG, assess chest pain, teach
administration of various routes, proper storage &
disposal
Calcium Channel Blockers: Nifedipine (Procardia)
 Action: inhibits the influx of calcium entering through slow channels, producing
vasodilation of the peripheral blood vessels & coronary arteries; minimal effect
on SA & AV node-does not effect HR
 Adverse effects: hypotension, flushing, h/a, dizziness, lower limb edema,
constipation, nausea, gingival hyperplasia
 NI: hold for SBP <90, assess chest pain
 Patient Edu: do not take with grapefruit juice, take without regard to food