Common Antianginal Drugs

Common Antianginal Drugs

Antianginal drugs are medications used to prevent or treat angina pectoris, a symptom of coronary artery disease characterized by chest pain or discomfort. Here's a list of common antianginal drugs, organized by their classes:

Nitrates

a. Short-acting:

Nitroglycerin (sublingual tablets or spray)

b. Long-acting:

Isosorbide mononitrate

Isosorbide dinitrate

Transdermal nitroglycerin patches

Beta-Blockers

Metoprolol

Atenolol

Propranolol

Bisoprolol

Carvedilol

Calcium Channel Blockers

a. Dihydropyridines:

Amlodipine

Nifedipine

b. Non-dihydropyridines:

Diltiazem

Verapamil

Ranolazine

Ranolazine (Ranexa)

Ivabradine

Ivabradine (Corlanor)

These medications work through various mechanisms to reduce the heart's workload, improve blood flow, or optimize cardiac energy utilization. Here's a brief overview of each class:

Nitrates: These drugs work by dilating blood vessels, reducing the workload on the heart and improving blood flow. Nitroglycerin is commonly used for acute angina attacks, while long-acting nitrates are used for prevention.

Beta-Blockers: These medications reduce heart rate and blood pressure, decreasing the heart's oxygen demand. They are effective for both acute and chronic angina management.

Calcium Channel Blockers: These drugs relax blood vessels and, in some cases, reduce heart rate and contractility. They are particularly useful in vasospastic angina and in patients who cannot tolerate beta-blockers.

Ranolazine: This medication works by inhibiting the late sodium current in cardiac cells, reducing calcium overload and improving myocardial relaxation. It's often used as add-on therapy for chronic stable angina.

Ivabradine: This drug selectively reduces heart rate by inhibiting the If current in the sinoatrial node. It's used in patients who cannot tolerate beta-blockers or as an add-on therapy.

When prescribing antianginal drugs, healthcare providers consider factors such as:

The type and severity of angina

Patient's age and overall health

Presence of other medical conditions

Potential drug interactions

Side effect profiles

Often, a combination of these drugs is used to achieve optimal angina control. Treatment plans are individualized based on patient response and tolerability. It's important to note that antianginal therapy is typically part of a comprehensive approach to managing coronary artery disease, which may also include lifestyle modifications, risk factor management, and in some cases, revascularization procedures.