Which of the following medicine is administered sublingually for the managing angina pectoris?

RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Pharmacology

Easy

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Explanation

Nitroglycerine is the drug of choice for treating an acute attack of angina pectoris.
Its primary mechanism is vasodilation, mainly of the veins, which reduces cardiac preload and myocardial oxygen demand, thereby relieving ischemic pain.
The sublingual route provides rapid absorption directly into the bloodstream, bypassing liver metabolism, which allows for an onset of action within 1-3 minutes.
It is specifically indicated for terminating an ongoing anginal attack or for prophylaxis immediately before an activity known to cause angina.

Option A: Aspirin is an antiplatelet agent, not a vasodilator. Its role is to prevent clot formation, not to provide immediate relief from chest pain.
Option B: Betalol (a beta-blocker) is used for long-term prophylaxis of angina, not for acute relief. It works by reducing heart rate and contractility, which takes time and is not suitable for an emergency.
Option D: Warfarin is an anticoagulant that prevents the formation of blood clots by interfering with vitamin K-dependent clotting factors. It has no role in the treatment of angina.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacological management of acute angina pectoris as background academic context rather than a clinical decision trigger.
A key nursing responsibility is to assess the patient's blood pressure before administering nitroglycerine, as it can cause severe hypotension. Do not administer if systolic BP is less than 90 mmHg.
Patient education is critical. The patient must know how to take the medication correctly (under the tongue, do not swallow), the dosing protocol (up to 3 doses, 5 minutes apart), and proper storage to maintain potency.
What if? If a patient's chest pain is not relieved after three doses of sublingual nitroglycerine, the nurse must assume the patient is having a myocardial infarction (MI) and activate emergency medical services immediately.

How to Approach the Question

First, identify the key clinical concepts in the question: 'angina pectoris' (the condition) and 'administered sublingually' (the route).
The question asks for a medication used for managing an acute episode, which implies a need for rapid action.
Recall the first-line, rapid-acting medications for acute angina. The sublingual route is specifically chosen for its fast absorption.
Evaluate the options based on their primary use and route. Aspirin is antiplatelet, Beta-blockers are for prevention, and Warfarin is an anticoagulant.
Nitroglycerine is the classic rapid-acting vasodilator administered sublingually for acute angina, making it the correct choice.

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