This presentation is based on the fundamentals of angina pectoris, and the basics of antianginal drugs.Here all the fundamental mechanism of antianginal drugs and their ADR, contraindications are described.

1. JITU HALDER,,
BPHARM,
NSHM KNOWLEDGE CAMPUS KOLKATA

2. INTRODUCTION
What is angina pectoris?
It is a pain syndrome due to induction of an adverse oxygen
supply or demand in a portion of the myocardium.
 Antianginal drugs may relieve attacks of acute myocardial
ischemia by increasing myocardial oxygen supply or by
decreasing myocardial oxygen demand.

3. TYPES

4. TREATMENT PLAN
A. Decrease the risk factor like atherosclerosis,
hypertension,
B. Increase oxygen supply
C. Decrease oxygen demand

5.  AGENTS WHICH O2 DEMAND AND O2 SUPPLY
A. NITRATES
B. CALCIUM CHANNEL BLOCKERS
 AGENTS WHICH O2 DEMAND
C. BETA BLOCKERS

7. MECHANISM OF ACTION

8. NITRATES
 Coronary artery dilation Decrease coronary bed resistance
Increase coronary blood flow Increase oxygen supply
 Reduction on peripheral resistance Decrease blood pressure
Decrease after load Decrease workload
Decrease oxygen consumption
 Peripheral pooling of blood Reduced venous return
Decrease preload
Decrease workload Decrease oxygen consumption

9. ADVERSE EFFECTS
 Fullness in head, throbbing headache, tolerance
develops on continued use.
 Flushing, weakness, sweating, palpitation, dizziness,
and fainting
 Methemoglobinemia; not signifiant. severe anaemia
reduce o2 carrying capacity of blood.
INTERACTIONS
 Sildenafil cause dangerous potentiation of nitrates
action.

11. MECHANISM OF ACTION
Intracellular Ca conc
Block L type voltage gated calcium channel
Act on vascular smooth muscle, reduce contraction of
the arteries and arterial diameter
Act on cardiac muscles, reduce force of contruction
Slowering the conduction

12. Ca2+ Channel blockers
coronary artery dilation Reduction on peripheral
resistance
coronary bed resistance
Blood pressure
coronary blood flow
Afterload
O2 supply
workload
O2 consumption

13. Most Commonly Used Ca Channel Blockers
 Nifedipine , Verapamil, Diltiazem
UNWANTED EFFECT
Nausea and vomiting
Dizziness
Flushing of the face
Tachycardia
Decrease insulin release
CONTRAINDICATIONS
Should not given with other cardiac
depressant

14. β - BLOCKERS

15. MECHANISM OF ACTION

16. Beta blockers
 Decrease heart rate and contractility
Increase duration of diastole
workload
Coronary blood flow
O2 consumption
Increase O2 supply

17. ADVERSE EFFECT
 Congestive heart failure
 Asthma
 Complete heart block
INTERACTION
 Aditive depression with digitalis and verapamil-cardiac
arrest can occur.
 Indomethacin and other NSAIDs attenuate the
antihypertensive action of β blockers
COMMONLY USED β BLOCKERS
Propanolol,

18. REFERENCES
KD TRIPATHI Essentials of medical pharmacology
7th Edition , p-539 to 557
Finkel, Richard; Clark, Michelle A,; Cubedde, Luigi x.
Lippincott's Illustrated Reviews: Pharmacology, 4th
Edition , p334 to 340

19. THANK YOU