1. Antianginal Drugs Ischemic Heart Disease Angina pectoris
Section 3, Lecture 5
Antianginal Drugs
Ischemic Heart Disease
Angina pectoris
Chronic condition, episodic chest discomfort
Occurs during transient coronary ischemia
Myocardial infarction
Acute and complete occlusion of a coronary artery
Due to coronary thrombosis

2. Angina- episodic chest pains as a result of transient coronary ischemia (as opposed to myocardial infarction which is acute and complete occlusion of a coronary artery .
angina (heavy weight or pressure or pain in the chest) occurs when blood (oxygen, nutrient) supply to the heart is limited as a result of :
disruption of coronary blood flow because of vasospasm or platelet aggregation
increased demand for oxygen evoked by physical exertions
a combination of both

3. Vasospasm at rest or during sleep
If the frequency and severity increases- forerunner to a MI
If symptoms remains the same and angina occurs under similar circumstances

4. Drugs employed: Typical Variant MI Stable Unstable
Organic nitrite and nitrates
Ca2+-channel blockers to
- adrenergic Antagonists
Aspirin
Fibrinolytic drugs
Antianginal drugs :
-O2 increase supply and/or lower demand
Myocardial O2 supply: Coronary blood flow, regional flow distribution
Myocarial O2 –demand: amount of energy required to support the work of the heart
Cardiac work influenced by: heart rate, heart contractility, myocardial wall tension

5. Vasodilators- organic compounds containing ONO or ONO2 (prodrugs) all release NO upon interacting with serum components.