Antianginal Drugs Mnemonic: BORN to Relieve Angina
Here's a helpful mnemonic to remember the main classes of antianginal drugs:
B - Beta-blockers
O - Other (Ranolazine)
R - Revascularization (not a drug, but an important treatment option)
N - Nitrates and Calcium channel blockers
This mnemonic, ”BORN to Relieve Angina,” provides a quick and easy way to recall the primary categories of antianginal treatments. Let's break down each component and expand on the drugs within these categories:
B - Beta-blockers:
Beta-blockers are a crucial class of antianginal drugs. They work by blocking the effects of adrenaline on the heart, reducing heart rate, blood pressure, and myocardial oxygen demand. Examples include:
Metoprolol
Atenolol
Propranolol
Carvedilol
O - Other (Ranolazine):
Ranolazine is a newer antianginal drug with a unique mechanism of action. It inhibits the late sodium current in cardiac cells, improving diastolic function and reducing myocardial oxygen demand. It's often used when other antianginal drugs are not effective or tolerated.
R - Revascularization:
While not a drug, revascularization procedures are essential treatment options for severe angina. These include:
Percutaneous Coronary Intervention (PCI) with stenting
Coronary Artery Bypass Grafting (CABG)
N - Nitrates and Calcium channel blockers:
This category includes two major classes of antianginal drugs:
Nitrates:
These drugs cause vasodilation, reducing preload and afterload. Examples include:
Nitroglycerin (short-acting)
Isosorbide mononitrate (long-acting)
Isosorbide dinitrate
Calcium Channel Blockers (CCBs):
CCBs reduce calcium influx into vascular smooth muscle and cardiac cells, causing vasodilation and reducing heart rate and contractility. They are divided into two main types:
Dihydropyridines (primarily affect blood vessels):
Amlodipine
Nifedipine
Felodipine
Non-dihydropyridines (affect both heart and blood vessels):
Verapamil
Diltiazem
This mnemonic not only helps in remembering the main categories of antianginal treatments but also emphasizes the importance of considering revascularization in severe cases. It's worth noting that while the mnemonic groups nitrates and calcium channel blockers together, they are distinct classes of drugs with different mechanisms of action.
In clinical practice, these drugs are often used in combination to provide optimal angina management. The choice of drug or combination depends on the patient's specific condition, comorbidities, and response to treatment. Regular assessment and adjustment of the treatment plan are essential for effective angina management.
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