Classification of Antianginal Drugs

Classification of Antianginal Drugs

Antianginal drugs are a diverse group of medications used to treat angina pectoris, a condition characterized by chest pain due to reduced blood flow to the heart. These drugs can be classified into several categories based on their mechanisms of action and therapeutic effects. Here's a comprehensive classification of antianginal drugs with examples:

Nitrates:

a) Short-acting: Nitroglycerin (sublingual tablets, spray)

b) Long-acting: Isosorbide dinitrate, Isosorbide mononitrate

Beta-blockers:

a) Cardioselective: Metoprolol, Atenolol, Bisoprolol

b) Non-cardioselective: Propranolol, Nadolol

Calcium Channel Blockers:

a) Dihydropyridines: Amlodipine, Nifedipine

b) Non-dihydropyridines: Diltiazem, Verapamil

Potassium Channel Openers:

Nicorandil

Late Sodium Current Inhibitors:

Ranolazine

If Channel Inhibitors:

Ivabradine

Metabolic Modulators:

Trimetazidine

Each class of antianginal drugs works through different mechanisms to either increase oxygen supply to the heart or reduce its oxygen demand. Nitrates act as vasodilators, improving blood flow to the heart. Beta-blockers reduce heart rate and contractility, decreasing oxygen demand. Calcium channel blockers relax blood vessels and reduce heart workload. Potassium channel openers like nicorandil combine the effects of nitrates and potassium channel activation. Ranolazine inhibits the late sodium current in cardiac cells, while ivabradine specifically reduces heart rate by inhibiting the If channel in the sinoatrial node.

The choice of antianginal drug depends on various factors, including the patient's specific condition, comorbidities, and potential side effects. Often, a combination of these drugs is used to achieve optimal symptom control and improve the patient's quality of life. It's important to note that while these medications effectively manage angina symptoms, they should be used in conjunction with lifestyle modifications and treatments addressing the underlying coronary artery disease for comprehensive management.