Durana, Ma. Clarisa C.

BSN 2A

WHAT IS ANTIANGINAL NITRATE?

Antianginal medication is used to treat angina pectoris. Angina is chest pain caused by inadequate blood flow, resulting in
hypoxia of the cardiac tissue. Angina can be chronic pain caused by atherosclerosis in coronary artery disease or acute pain
caused by a myocardial infarction.

DRUG NAME ACTION INDICATION

BRAND NAME: NITROSTAT
GENERIC NAME: NITROGLYCERIN
DOSE:
Adults—2.5 to 6.5 milligrams (mg)
Adults—1 or 2 packets (form powder)
Adults—1 or 2 sprays (form spray)
Adults—1 tablet (form tablets)
It works by relaxing the blood vessels and NITROSTAT is indicated for the acute relief
increasing the supply of blood and oxygen to of an attack or acute prophylaxis of angina
the heart while reducing its work load. When pectoris due to coronary artery disease.
used regularly on a long-term basis, or just
before exercise or a stressful event, this helps
prevent angina attacks from occurring.

THERAPEUTIC CLASS: ANTIANGINALS

FREQUENCY:
3 to 4 times a day.
q15 minutes

ROUTE: ORAL, SUBLINGUAL

 Durana, Ma. Clarisa C. BSN 2A

CONTRAINDICATION ADVERSE EFFECT NURSING CONSIDERATION

● NITROSTAT is contraindicated in Headache, dizziness, lightheadedness, ➢ Nitroglycerine should not be used in

patients with severe anemia (large nausea, and flushing may occur as your body patients who have severe anemia or
doses of nitroglycerin may cause adjusts to this medication. increased intracranial pressure.
oxidation of hemoglobin to ➢ Monitor the hemodynamics of your
methemoglobin and could patient as well as their chest pain.
exacerbate anemia). ➢ Teach your patient to not use
● NITROSTAT is contraindicated in nitroglycerine are using any erectile
patients who are allergic to dysfunction medications, and also
nitroglycerin, other nitrates or nitrites or they should limit their alcohol use.
any excipient.
● NITROSTAT is contraindicated in
patients with acute circulatory failure
or shock.

DRUG INTERACTION

➔ Oral administration of nitroglycerin

markedly decreases the first-pass
metabolism of dihydroergotamine and
subsequently increases its oral
bioavailability. Ergotamine is known to
precipitate angina pectoris. Therefore,
patients receiving sublingual
 Durana, Ma. Clarisa C. BSN 2A

nitroglycerin should avoid ergotamine

and related drugs or be monitored for
symptoms of ergotism if this is not
possible.

DRUG NAME ACTION INDICATION

BRAND NAME: ISORDIL
GENERIC NAME: ISOSORBIDE DINITRATE
DOSE:
5mg, 10mg, 20mg, 30mg, 40mg
(capsule/tablet)
2.5mg & 5mg (sublingual)
THERAPEUTIC CLASS: ANTIANGINALS
Produce vasodilation (venous greater than Acute treatment of anginal attacks (sublingual
arterial). Decrease left ventricular end- only). Prophylactic management of angina
diastolic pressure and left ventricular end- pectoris. Treatment of chronic CHF
diastolic volume (preload). Net effect is (unlabeled).
reduced myocardial oxygen consumption.
Increase coronary blood flow by dilating
coronary arteries and improving collateral flow
to ischemic regions.

FREQUENCY:
2 to 3 times a day

ROUTE: ORAL, SUBLINGUAL

CONTRAINDICATION ADVERSE EFFECT NURSING CONSIDERATION

 Durana, Ma. Clarisa C. BSN 2A

CNS: dizziness, headache. ➢ If used to treat acute angina, make sure

● Isosorbide dinitrate tablets are
CV: hypotension, tachycardia, paradoxic patient brings isosorbide sublingual
contraindicated in patients who are
bradycardia, syncope. tablets to all physical therapy
allergic to isosorbide dinitrate or any of
GI: nausea, vomiting. appointments, and that this drug is
its ingredients.
Misc: flushing, tolerance. readily available during exercise and
● Do not use isosorbide dinitrate in
other interventions.
patients who are taking certain drugs
➢ Avoid physical therapy interventions
for erectile dysfunction
that cause systemic vasodilation (large
(phosphodiesterase inhibitors), such as
whirlpool, Hubbard tank). Additive
sildenafil, tadalafil, or vardenafil.
effects of this drug and these
Concomitant use can cause severe
interventions may cause a dangerous
hypotension, syncope, or myocardial
fall in blood pressure.
ischemia.
➢ Because of an increased risk of angina
● Do not use isosorbide dinitrate in
and arrhythmias, or in conditions such
patients who are taking the soluble
as CHF, use caution during aerobic
guanylate cyclase stimulator riociguat.
exercise and endurance conditioning.
Concomitant use can cause
Terminate exercise if patient exhibits
hypotension.
untoward symptoms (chest pain,
shortness of breath, etc.) or displays
other criteria for exercise termination
➢ Design and implement aerobic exercise
and endurance training programs to
improve coronary perfusion, reduce
 Durana, Ma. Clarisa C. BSN 2A

angina, and improve myocardial

pumping ability.
➢ To minimize orthostatic hypotension,
patient should move slowly when
assuming a more upright position.

DRUG INTERACTION

➔ Do not take riociguat (Adempas),

sildenafil (Viagra), tadalafil (Cialis), or
vardenafil (Levitra) while you are using
this medicine. Using these medicines
together may lower your blood
pressure and cause blurred vision,
dizziness, lightheadedness, or fainting.
➔ The metabolism of Aminophylline can
be decreased when combined with
Isosorbide dinitrate.
➔ Isosorbide dinitrate may increase the
hypotensive activities of Ambrisentan.