Anti Anginal Drug Introduction

Question 1

What are type of angina pectoris

Answer 1

Stable angina(classical angina)
Episode of chest pain associated c exertion

Unstable angina- angina at rest or ↑freq. And duration of anginal attack
Due to- rupture of atheromatous plaque
- platelet deposition in coronary artery —– thrombosis

Prinzmetal angina-( variant angina)
Angina at rest and due to spasm of coronary artery

Question 2

Pathophysiology of angina and aim of tx

Answer 2

↓o2 supply
Coronary atherosclerosis
Coronary vasospasm
Coronary thrombosis

↑o2 demand
↑ heart rate
Ventricular hypertrophy
↑ ventricular contractility
↑ ventricular wall tension

Aim of tx
↑ O2 supply.
1. Restore blood flow
–Pre cutaneous intervention (PCT) including stenting
– coronary artery bypass graft

2.relive vasospasm- CCB / Nitrate
3.break thrombi - streptokinase / urokinase
4.prevent tgrombis formation - antiplatete

↓O2 demand
↓preload - nitrate
↓afterload- CCB , k+ channel opener
↓HR and contractility - beta #

Question 3

Classify antianginal drug

Answer 3

5 classes
1.Nitrate - nitroglycerin,isosorbide dinitrate
2.beta# - propranolol,metoprolol,timolol
3.CCB- Verapamil,diltiazem,nifedipine,
Amlodipine
4.K+ channel opener- nicorandil
5.others- STAIR
S- statin
T- trimetazidine
A- Antiplatelet
I- ivabradine
R- ranolazine