Antianginal drugs || Classification-Mnemonics || ONI
What is the definition of anti anginal drugs

The word anti anginal is a mixing of two word , one is anti that means effective against and second is angina that means a disease that characterized by chest pain due to coronary artery disease. 

So anti anginal drugs means a drugs that is effective against angina pectoris. 

Or
Anti anginal is defined as the drug that is used in the treatment of angina pectoris to prevent attacks of angina pectoris. 


    What is angina pectoris

    Angina pectoris is chief singal of ischemic heart disease characterized by sudden, severe, substernal discomfort or pain which may radiate to the left shoulder, jaw, arm. 

    The most common and main symptoms of angina pectoris is chest pain caused by reduce blood flow to the heart due to coronary artery disease. 

    Angina pectoris is also known as stenocardia. 


    What are the 3 types of angina pectoris

    The three types of angina pectoris are... 
    • Stable angina
    • Prinzmental angina
    • Unstable angina

    Stable angina :- In stable angina pain is induced by exercise or emotion, both of which increase myocardial oxygen demand. 

    It releases by rest and NTG. 

    Prizmental angina :- It occurs at rest and caused by spasm of coronary artery. 

    Unstable angina :- It combination of factor like increase oxygen demand, coronary vasospasm and platlets aggregation may result in angina called unstable angina. 


    Classification/list of anti-anginal drugs


    Mnemonics (Trick) :- Nilli short lona and his brother has low calsium and potassium channel level


    1.Nitrates (M - Nilli) :-

    (A) Short acting (M - short) 
    • Glycery trinitrate  nitroglycerine (GTN) 

    (B) long acting (M - lona) 
    • Isosorbide dinitrate 
    • Isosorbide mononitrate 
    • Erythrityl tetranitrate 
    • Pentacrythritol tetranitrate 

    Mnemonics (Trick) :- I so pale

    (C) Beta blocker (M - brother) 
    • Metaprolol 
    • Atenolol 
    • Propranolol

    Mnemonics (Trick) :- MAP

    (D) Calcium channel blocker (M- calcium) 
    • Nifedipine
    • Felodipine
    • Amlodipine
    • Nitrondipine
    • Lacidipine
    • Verpamil

    Mnemonics (Trick) :- NO FULL AND OF LV (LOVE) 

    (E) Potassium channel blocker(M-potassium ) 
    • Nicorandil 
    • Pinacidil
    (D) Other drugs (M- low) 
    • Dipyrida mole
    • Trimethazidine
    • Ranolazine
    • Oxyphendrine

    Mnemonics (Trick) :- Dipika consume Tri-Rono-Oxy medicine

    (A) Nitrates :-

    The nitrates are the class of anti-anginal drugs which release nitric oxide in body for the treatment and prevention of angina and myocardial infraction. 

    Nitroglycerin


    Nitroglycerin also known as....... 
    • Trinnitroglycerin
    • Nitro
    • Glyceryltrinitrate
    • 1,2,3-trinitroxy propane

    It is a medication use for heart failure, high blood pressure and to treat and prevent chest pain. 

    Mechanism of action
    Same as nitrates (see below) 

    Pharmacokinetic

    It act with in 1 to 2 minute because of directly absorb the into systemic circulation. 

    Plasma half life is 2 minute

    Use of nitroglycerin

    • Angina
    • Acute myocardial infraction
    • Sever hypertension
    • Acute coronary spasm

    Side effect of nitroglycerin
    • Weakness
    • Headache
    • Palpitation
    • Flushing
    • Methemoglobinemia

    Nursing care of NTG

    1. To keep tablets in air tight glass container 
    2. To advise the patient to take tablets sublingually not to swallow, tablet may gusted under teeth. 
    3. To advise patient to take rest for 15 minute after dose has been taken. 
    4. Maximum number of dose and between 5 minutes gap with blood pressure monitering. 
    5. To advise the patient to rise slowly form lying or sitting position, postural hypertension may occurs (hypotension) 

    (B) Beta blocker :-

    Beta blocker are used to manage abnormal heart rhythm. It is contraindicated in prizmental angina. 

    (C) Calcium channel blocker :-

    Calcium channel blocker is most effective in prizmental angina and it act by blocking the entry of calcium. 

    (D) Potassium channel blocker :-

    These class of anti-anginal drugs act by blocking potassium channel for the treatment of angina by arterial and venous dilation. 


    Mechanism of action of anti-anginal drugs

    (A) Mechanism of action of Nitrates :-

    Nitrates
    Converts
    Nitric acid
    Nitric acid stimulate guanylyl cyclase (GC) enzyme
    Produce cyclic guanosine monophosphate (CGMP) 
    Activates
    Cyclic nucleotide
    Decrease intracellular calcium level
    Vasodilation
    Increase blood flow 

    (B) Mechanism of action of Beta blocker :-


    Beta blocker
    Blocks
    Hormone of adrenaline (epinephrine)
     ⇊
    Dilation of arteries and veins
    Increase blood flow

    (C) Mechanism of action of calcium channel blocker :-


    Calcium channel blocker
    Blocks
    Entry of calsium in muscle cell
    Relaxation of muscle cell
    Dilation of arteries and veins
    Increase blood flow

    (D) Mechanism of action of potassium channel blocker :-


    Potassium channel blocker
    Blocks
    Entry of potassium in muscle cell
    Relaxation of muscle cell
    Dilation of arteries and veins
    Increase blood flow

    Notes :- It also act as nitric acid like nitrates. 


    What is the uses of anti anginal drugs

    (A) Uses of Nitrates :-

    • Angina
    • Cardiac failure
    • Myocardial infraction
    • Cyanide poisoning

    (B) Uses of Beta blocker :-

    • Hypertension
    • Angina
    • Myocardial infraction
    • Tachycardia
    • Anxiety
    • Migrane

    (C) Uses of calcium channel blocker :-

    • Headache
    • Angina
    • Flushing 
    • Hypertension
    • Edema

    (D) Uses of potassium channel blocker :-

    • Angina
    • Hypertension
    • Congestive heart failure
    • Asthma


    What is the  side effect of anti anginal drugs

    (A) Side effect of Nitrates :-

    • Flushing
    • Headache 
    • Hypotension
    • Nausea 
    • If you take for long time than it leads to cancer

    (B) Side effect of Beta blocker :-

    • Bradycardia
    • Slow heart rate
    • Cold fingers and toes
    • Dizziness
    • Drowsiness
    • Congestive heart failure
    • Fatigue

    (C) Side effect of Calcium channel blocker :-

    • Headache
    • Fast heart beat
    • Constipation
    • Dry mouth
    • Dizziness
    • Flushing
    • Edema

    (D) Side effect of Potassium channel blocker

    • Hyperglycemia
    • Insomnia
    • Hepatic dysfunction
    • Diarrhoea
    • Hemolytic anemia

    What is the first line of treatment for angina

    Beta blocker, calcium channel blocker, short acting nitrates are the first line drugs for the treatment of angina. It helps in relaxation of smooth muscle lead to increase blood flow and increase supply of oxygen to the heart result in releive from symptoms of angina pectoris. 

    What is the second line of treatment for angina

    In second line drugs long acting nitrates, potassium channel blocker are use to treat angina pectoris and prevent attack of angina. It helps to increase blood flow by blocking the entry of potassium in smooth muscle cell. 

    Is aspirin is anti anginal drugs

    Yes aspirin is anti anginal drugs and useful in the treatment of angina pectoris related to the clot formation because it prevents the aggregation of platlets that form blood clot in arteries result in improving blood flow to the heart.

    See Also



    Anti anginal drugs PDF download



    I hope you like this article on Anti anginal drugs.if you have any query about Anti anginal drugs topic please comment on comment box because online nursing Institute is ready to always helping their students