A case of chest pain in the emergency department always go for the protocol of angina and/or MI. The MI protocol primarily focuses on relief of pain with antianginal medications.
What are Antianginal Medications?
Those medicines which reduce the oxygen demand of the myocardium or increases the oxygen supply to the heart are known as The Antianginal Drugs.
Examples
- Nitrates
- Calcium Channel BlockersAll About Antihypertensive series 3 – Calcium channel blockers, CCBs
- β BlockersAll About Antihypertensive Series 5 beta-adrenergic blocking agents (beta blockers)
Here I will discuss the details of Nitrates
NITRATES
Classification
Indications of NITRATES
- Acute Angina – Prophylaxis and Treatment
- Chronic Angina treatment
- Hypertension associated with MI or CHF
- Raynaud’s disease (NTG ointment)
Mechanism of Action
Antianginals mainly work either by decreasing the Oxygen demand or by increasing oxygen supply.
PHARMACOKINETICS
- ONSET – 2min (S/L); 3min (PO); 30min (Topical)
- HALF LIFE – 5-7min
- METABOLISM – In Liver
Contraindications
- Sensitivity to Nitrates
- Severe Anemia
- Hepatic or Renal dysfunction
- Hypotension
- Head Trauma
- Cerebral Haemorrhage
Side Effects
- Dizziness (especially at the beginning of the treatment)
- Orthostatic Hypotension
- Topical application may lead to dermatitis
- A throbbing Headache
- Flushing of face
- Reflex tachycardia
Drug Interaction
Additive hypotension with other ANTIHYPERTENSIVES
SILDENAFIL (Viagra) can cause additive hypotension
Intake of ALCOHOL along with NTG also cause hypotension
NURSING CONSIDERATIONS WHILE ADMINISTERING NITRATES
About the nurse’s responsibility, there is a lot to discusses. So I am dealing with it as a separate post. You can read it NURSING CONSIDERATIONS WHILE ADMINISTERING NITRATES
