The nurse is caring for a client who has chronic angina. Treatment for the condition has been unsuccessful. Which medication does the nurse anticipate will be prescribed?
1. Atenolol (Tenormin)
2. Nitroglycerin (Nitrostat)
3. Sildenafil (Viagra)
4. Ranolazine (Ranexa)
Correct Answer: 4
Rationale 1: Atenolol (Tenormin) is incorrect because this is a cardioselective beta1 blocker; it reduces the rate and force of cardiac contractions, and is used for angina, MI, and hypertension.
Rationale 2: Nitroglycerin (Nitrostat) is incorrect. It is an organic nitrate, the oldest and most widely used of the organic nitrates, and can be delivered by a number of different routes, including sublingual, lingual spray, oral, IV, transmucosal, transdermal, topical, and extended-release forms. It is normally taken while an acute anginal episode is in progress or just prior to physical activity.
Rationale 3: Sildenafil (Viagra) is used to treat erectile dysfunction.
Rationale 4: Ranolazine is believed to act by shifting the metabolism of cardiac muscle cells so that they utilize glucose rather than fatty acids as the primary energy source. The drug is only approved for chronic angina that has not responded to other agents.
Global Rationale: Ranolazine is believed to act by shifting the metabolism of cardiac muscle cells so that they utilize glucose rather than fatty acids as the primary energy source. The drug is only approved for chronic angina that has not responded to other agents. Atenolol (Tenormin) is incorrect because this is a cardioselective beta1 blocker; it reduces the rate and force of cardiac contractions, and is used for angina, MI, and hypertension. Nitroglycerin (Nitrostat) is incorrect. It is an organic nitrate, the oldest and most widely used of the organic nitrates, and can be delivered by a number of different routes, including sublingual, lingual spray, oral, IV, transmucosal, transdermal, topical, and extended-release forms. It is normally taken while an acute anginal episode is in progress or just prior to physical activity. Sildenafil (Viagra) is used to treat erectile dysfunction.
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