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    Unit 4b Drugs Affecting CVS, Antianginal Drugs

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    The document discusses different types of drugs used to treat angina pectoris including organic nitrates, beta-blockers, and calcium channel blockers. These drugs work to reduce myocardial oxygen demand and increase blood supply to the heart. Complications of angina are also reviewed as well as risk factors, symptoms, causes and other treatments including angioplasty, stenting, and coronary artery bypass surgery.

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    Unit 4b Drugs Affecting CVS, Antianginal Drugs

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    The document discusses different types of drugs used to treat angina pectoris including organic nitrates, beta-blockers, and calcium channel blockers. These drugs work to reduce myocardial oxygen demand and increase blood supply to the heart. Complications of angina are also reviewed as well as risk factors, symptoms, causes and other treatments including angioplasty, stenting, and coronary artery bypass surgery.

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    The document discusses different types of drugs used to treat angina pectoris including organic nitrates, beta-blockers, and calcium channel blockers. These drugs work to reduce myocardial oxygen demand and increase blood supply to the heart. Complications of angina are also reviewed as well as risk factors, symptoms, causes and other treatments including angioplasty, stenting, and coronary artery bypass surgery.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    38 views17 pages

    Unit 4b Drugs Affecting CVS, Antianginal Drugs

    Uploaded by

    الدتادتغدتعد
    The document discusses different types of drugs used to treat angina pectoris including organic nitrates, beta-blockers, and calcium channel blockers. These drugs work to reduce myocardial oxygen demand and increase blood supply to the heart. Complications of angina are also reviewed as well as risk factors, symptoms, causes and other treatments including angioplasty, stenting, and coronary artery bypass surgery.

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    © All Rights Reserved
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    of 17

    Unit 4b

    ANTIANGINAL DRUGS
    Dr. Muhammad Almoyad
    Overview
     Angina pectoris (Myocardial Ischemia) is a
    characteristic sudden, severe, pressing chest
    pain radiating to the neck, jaw, back, and arms.
     Atherosclerotic lesions in the coronary arteries
    cause obstruction to the blood flow, leading to
    an imbalance in the myocardial oxygen demand
    and supply.
     Antianginal agents lower the oxygen demand of
    the heart by affecting blood pressure, venous
    return, heart rate, and contractility.
    Myocardial ischemia (MI)
    Myocardial infraction
    Symptoms
     Some people have “silent ischemia”
    (Not associated with any symptoms)
     MI with sign & symptoms include:
    1. Chest pain (left side)
    2. Neck or jaw pain
    3. Shoulder or arm pain
    4. Nausea &vomiting
    5. Diaphoresis
    6. Indigestion
    Causes
    1. Coronary artery diseases
    2. Blood clot
    3. Coronary spasm
    4. Sever illness
    Risk factors
    1. Tobacco
    2. Diabetes
    3. High B.P
    4. High blood cholesterol or triglyceride levels
    5. Lack of physical activity
    6. Obesity
    7. Family history

    Complications
     Irregular heart rhythms (arrhythmia)
     Heart attack (myocardial infarction)
    Types of Angina

    1. Stable or typical angina (Effort induced, classic)

    2. Unstable angina
    3. Prinzmetal's or variant angina (Vasoplastic, rest)
    Classification
    ORGANIC NITRATES Ca2+ CHANNEL BLOCKERS
    -Isosorbide dinitrate -Amlodipine

    -Isosorbide mononitrate -Diltiazem

    -Nitroglycerin -Felodipine
    -Nicardipine
    β-BLOCKERS
    -Verapamil
    -Acebutolol
    SODIUM CHANNEL BLOCKER
    -Atenolol -Ranolazine
    -Metoprolol
    -Propanolol
    Other treatments
    1. Angioplasty
    2. Stenting
    3. Coronary artery bypass surgery

    Stenting Angioplasty
    ORGANIC NITRATES
     These compounds cause a rapid reduction in
    myocardial oxygen demand, followed by rapid
    relief of symptoms.
     They relax the vascular smooth muscles and
    dilate the coronary blood vessels, thus
    increasing the blood supply.
     They are effective in stable and unstable angina
    as well as in variant angina pectoris.
     Isosorbide dinitrate and isosorbide mononitrate,
    nitroglycerin, amyl nitrite
    ORGANIC NITRATES
    Adverse effects

     Headache

     Postural hypotension
     Facial flushing
     Tachycardia
    β-BLOCKERS
     Acebutolol, Atenolol, Metoprolol, Propanolol

     Decrease the oxygen demands of the myocardium by


    lowering both the rate and the force of contraction of the
    heart.
     They suppress the activation of the heart by blocking β-
    receptors, and reduce the work of the heart by decreasing
    heart rate, contractility, cardiac output, and blood pressure.
     The demand for oxygen by the myocardium is reduced both
    during exertion and at rest.
    β-BLOCKERS
    Therapeutic uses
     Treatment of patients with myocardial
    infarction and have been shown to prolong
    survival.
     Can be used with nitrates to increase exercise
    duration and tolerance.
     Contraindicated in patients with asthma,
    diabetes, severe bradycardia, peripheral
    vascular disease, or chronic obstructive
    pulmonary disease.
    Ca2+ CHANNEL BLOCKERS
     Amlodipine, Diltiazem, Felodipine, Nicardipine,
    Verapamil.
     Calcium influx is increased in ischemia because of
    the membrane depolarization.
     Protect the tissue by inhibiting the entrance of
    calcium into cardiac and smooth muscle cells of
    the coronary and systemic arterial beds.
     Acts as arteriolar vasodilators that cause a
    decrease in smooth muscle tone and vascular
    resistance.
    Treatment of angina in patients with
    concomitant diseases
    References
    Books:
    1. Karen W, Richard F, Thomas AP. Lippincott
    illustrated reviews: Pharmacology (6th Edition).
    U.S.A: Wolters Kluwer Health/Lippincott Williams
    and Wilkins; 2015. PAGE NUMBERS: 281-287.

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