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
- 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
- To keep tablets in air tight glass container
- To advise the patient to take tablets sublingually not to swallow, tablet may gusted under teeth.
- To advise patient to take rest for 15 minute after dose has been taken.
- Maximum number of dose and between 5 minutes gap with blood pressure monitering.
- 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
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