Anti anginal drugs - cardiovascular drugs (chapter 3/7)

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Angina Pectoris=Sudden, severe pressing chest pain radiating to the Neck, Jaw, Back,Arms

Due to decrease Coronory blood flow, insufficient O2 to meet the demands of Myocardium, leading to ISCHEMIA.

Cardiovascular drugs and interview preparation test screening process


Types of Angina

1) Effort-Induced Angina ,Classic/Stable Angina/Typical/Atherosclerotic Angina Short-lasting, heavy or Squeezing feeling in the chest…due to reduction of coronary perfusion due to obstruction of Coronory Artery by Atherosclerosis..

Nitroglycerin used 

Developed during work i.e Exercise, physical activity, emotional excitement 

2) Unstable Angina 

Chest pain occur with increased frequency, duration, intensity by less effort… lasts for 20 minutes…

3) Prinzmetal/Variant/Vasospastic/Rest Angina 

Due to coronary artery spasm

4) Mixed form Angina 

5) Acute Coronory Syndrome


Organic Nitrates

Nitroglycerine & Nitrites= Isosorbide Mononitrate & dinitrate are solid at room temp…

Nitroglycerine volatile at room temp….Amylnitrate extremely Volatile

MOA=relax veins...Venodilation...decrease Preload...decrease Myocardial O2 consumption…

Organic nitrate (Nitroglycerine) convert into Nitrites...then NO...activate cGMP...increase cGMP...dephosphorylation of Myosin light chain…Vascular smooth muscle relaxtion

S.E= Headche, Facial flushing, Tachycardia, postural Hypotension

Tolerance ; blood vessels become desensitized…to avoid it interval 10-12hr b/w dose 

Adrenergic Blocker

Decrease O2 demand by decreasing Rate & Force of contraction of heart by blocking β1 receptor…DOC in Effort-Induced Angina

Calcium Channel Blocker 

Ca++ cause contraction...activate ATP...depleting energy store….worsen Ischemia

MOA=Block Ca++ channel by binding with L-type Ca++ channels in the heart & smooth muscle.. vascular muscle of coronary & peripheral arteries relax..dilating arterioles..

do not dilate veins 

Nifedipine=Dihydropyridine derivative…Arteriolar Vasodilator..max effects on smooth muscles of vessels…useful in Variant Angina…cause Constipation,Reflax tachycardia.. 

Nifedipine cause GINGIVAL enlargement 

Verapamil= DiphenylAlkylAmines derivative...

max effects on Heart…slow AV 

conduction Contraindicated in AV conduction failure & Depressed Cardiac Functions…weak vasodilator……Cause constipation, 

Diltiazim=similar action to Verapamil…do not casue Constipation

Sodium Channel Blocker 

Ranolazine= inhibit Na+ channel …improve O2 supply & deαmand…used for Chronic Angina.



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