Types of Antianginal Drugs_ A Comprehensive Overview

Types of Antianginal Drugs: A Comprehensive Overview

Antianginal drugs are a diverse group of medications used to treat and prevent angina pectoris. These drugs work through various mechanisms to improve the balance between myocardial oxygen supply and demand. The main types of antianginal drugs include:

Nitrates:

Short-acting: Nitroglycerin (sublingual tablets, spray)

Long-acting: Isosorbide dinitrate, Isosorbide mononitrate

Mechanism: Vasodilation of coronary arteries and systemic veins

Beta-Blockers:

Metoprolol, Atenolol, Propranolol, Bisoprolol

Mechanism: Reduce heart rate and myocardial contractility

Calcium Channel Blockers (CCBs):

a) Dihydropyridines:

Amlodipine, Nifedipine, Felodipine

Mechanism: Primarily cause peripheral vasodilation

b) Non-dihydropyridines:

Verapamil, Diltiazem

Mechanism: Reduce heart rate and contractility, and cause vasodilation

Ranolazine:

Mechanism: Inhibits late sodium current in cardiac cells

Ivabradine:

Mechanism: Selectively inhibits If current in the sinoatrial node, reducing heart rate

Trimetazidine:

Mechanism: Metabolic modulator, shifts cardiac metabolism from fatty acid to glucose oxidation

Nicorandil:

Mechanism: Potassium channel activator with nitrate-like effects

Molsidomine:

Mechanism: Nitric oxide donor, similar to organic nitrates

Each type of antianginal drug has its unique properties, indications, and side effect profile. The choice of medication depends on the patient's specific condition, comorbidities, and response to treatment. Often, a combination of these drugs is used to achieve optimal symptom control and improve the patient's quality of life.