Marie Garcia, age 67, reports that her chronic angina has been recurring even though she has been taking nitroglycerin sublingual tablets as prescribed. She tells the nurse that she used to store the tablets on a table by the window, and when she started to use a new batch of tablets, the problem subsided. What I would explain the ineffectiveness of the tablets?

Explanation:

A. Beta blockers are used to manage blood pressure and heart rate but are a different class.

B. Isosorbide is a nitrate, which is used primarily to treat and prevent episodes of angina by relaxing and widening blood vessels.

C. Calcium channel blockers also manage blood pressure and chest pain but act through a different mechanism.

D. Glycoprotein IIb/IIIa receptor antagonists are used to prevent platelet aggregation and are typically used in acute coronary syndrome, not as a long-term treatment for angina.

A. ACE inhibitors may be started later to manage heart failure or hypertension after a heart attack but are not typically given acutely during a myocardial infarction.

B. Thrombolytics, such as alteplase, are given as soon as possible after a heart attack to dissolve the blood clot causing the blockage in the coronary artery.

C. Aspirin is commonly administered during a heart attack to help prevent further clot formation and reduce the risk of complications.

D. Potassium-sparing diuretics are not typically given during a myocardial infarction but may be used later in the management of heart failure.

E. Beta blockers are commonly given during and after a heart attack to reduce the heart's workload, decrease oxygen demand, and improve survival rates.