Author Question: A patient with asthma and depression develops stable angina. In addition to organic nitrites, which ... (Read 54 times)

joe · **on:** Jul 23, 2018

A patient with asthma and depression develops stable angina. In addition to organic nitrites, which other medications will be used to treat this condition? (Select all that apply.)

a. ACE inhibitors
b. Antiplatelet drugs
c. Beta blockers
d. Calcium channel blockers
e. Cholesterol-lowering drugs

Question 2

A patient with angina who is taking ranolazine (Ranexa) has developed a respiratory infection and a dysrhythmia.

The provider has ordered azithromycin (Zithromax) for the infection and amlodipine for the dysrhythmia. A nursing student caring for this patient tells the nurse that the patient's heart rate is 70 beats per minute, and the blood pressure is 128/80 mm Hg. The nurse asks the student to discuss the plan for this patient's care. Which action is correct?
a. Observe the patient closely for signs of respiratory toxicity.
b. Question the order for azithromycin (Zithromax).
c. Report the patient's increase in blood pressure to the provider.
d. Request an order for a different calcium channel blocker.

Leostella20 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: A, B, D, E
ACE inhibitors have shown benefit in reducing the incidence of adverse outcomes in patients with coronary artery disease (CAD) and are recommended as part of therapy. Antiplatelet drugs are recommended to reduce the risk of thrombus formation. CCBs are used as adjuncts to nitroglycerin and are safe in patients with asthma and depression. Cholesterol-lowering drugs are recommended to help slow the progression of CAD. Beta blockers are not recommended in patients with asthma or depression.

Answer to Question 2

ANS: B
Agents that inhibit CYP3A4 can increase levels of ranolazine and also the risk of torsades de pointes. Macrolide antibiotics, such as azithromycin, are CYP3A4 inhibitors. Respiratory toxicity is not an expected effect with this patient. The patient's blood pressure is not elevated enough to notify the provider. Amlodipine is the only CCB that should be used with ranolazine.