Medicinal Chemistry II ALL ANTIANGINAL AGENT CLASSIFICATION , VASODILATOR, CALCIUM CHANNEKL BLOCKER, USES OF ANTIANGINAL AGENT, USES OF VASODILATOR, USES OF CA CAHANNEL BLOCKER, USES SAR.

1. Antianginal agent
MEDICINAL CHEMISTRY
By
Miss. Wagh hrutuja
ASSISTANT PROFESSOR

3. Angina pectoris
• Angina is a type of chest pain caused by reduced blood flow to the
heart. Angina is a symptom of coronary artery
• disease.
• - In theory, the imbalance between oxygen delivery and myocardial
oxygen demand
• - Angina is usually due to obstruction or spasm of the coronary arteries.
• - Other causes include anemia, abnormal heart rhythms and heart
failure.
• - The main mechanism of coronary artery obstruction is an
atherosclerosis as part of coronary artery disease.
• - Angina, also known as Angina Pectoris The term derives from the
Latin angere ("to strangle") and pectus ("chest").

4. Types or Classification
Class I Angina only during strenuous or
prolonged physical activity
Class II
Slight limitation, with angina only during
vigorous physical activity
Class III
Symptoms with everyday living activities,
ie, moderate limitation
Class
IV
Inability to perform any activity without
angina or angina at rest, ie, severe
limitation
variant angina
(Prinzmetal's angina)
- Usually happens during resting
- Is often severe
- May be relieved by angina
medication
unstable angina (a
medical emergency)
- Occurs even at rest
- Is a change in your usual
pattern of angina
stable angina - Develops when your heart
works harder, such as when you
exercise or climb stairs
- It usually happens when you
exert yourself and goes away
with rest.

5. Classification OF ANTIANGINAL DRUG
Nitrites and Nitrates
Nitrates
Nitroglycerine; pentaerythrityl tetranitrate; Isosorbide dinitrate
Nitrites: Amyl nitrite; Sodium nitrite; Nitroprusside sodium,
Calcium channel blockers
1,4-Dihydro Pyridines derivatives
Nifedipine 1ST GENERATION
Amlodipine,Felodipine , Nimodipine Nicardipines, Nisoldipine
Diphenyl alkylamines derivatives Verapamil
Benzothiazepine derivatives Diltiazem
Diamino propanol ethers Bepridil
Micellaneous dipyridamole

6. Nitrites and Nitrates
vasodilator

7. STRUCTURES

10. Use of Nitrates
Acute Use:
• - NTG is the mainstay of therapy for the IMMEDIATE RELIEF of angina the most
common route of
• administration is sublingual (tablets are placed under the tongue) which produces a
rapid onset of effect, and
• avoids liver metabolism (no first pass effect) prior to reaching the systemic
circulation duration of action is
• typically 10-30 minutes after a single dose
Prophylactic Use:
• - Dermal patches or slow release formulations of NTG and other similar nitrates are
used for prolonged
• prophylaxis to reduce the incidence of angina.

11. Nitrate Side Effects
• - Headache (due to meningeal vasodilation)
• - Dizziness
• - Reflex Tachycardia (baroreceptor mediated due to a fall in
arterial BP produced by higher doses of NTG)
• - Orthostatic hypotension (less common)
• - Tolerance

12. SYNTHESIS

13. SYNTHESIS

14. CA + CHANNEL BLOCKERS

16. CA + CHANNEL MODE OF ACTION

18. CA + CHANNEL BLOCKERS MOA
• The three main subclasses of CCB drugs are based on their
chemical structure and activity:
• Dihydropyridines work mostly on the arteries.
• Benzothiazepines work on the heart muscle and arteries.
• Phenylalkylamines work mostly on the heart muscle.

19. 1,4 DIHYDROPYRIDINES

23. SAR 1, 4-Dihydro pyridine
• 1, 4-Dihydro pyridine ring is essential for activity. Substitution at N or
oxidation or reduction of the ring reduces or abolishes the activity.
• A phenyl substitution at the 4th position is optimum for the activity.
Substitution at para or unsubstituted phenyl ring reduces the activity.
• The 3rd and 5th position ester group optimizes activity. Placement of
electron withdrawing substitution results in agonistic activity.
• When the ester at C3 and C5 are nonidentical, the C4 become chiral and
stereo selectivity is observed. S-enantiomers found to be more effective.

25. USES
• High blood pressure (hypertension).
• Arrhythmias (irregular heartbeat rhythms).
• Chest pain (angina).
• Coronary artery spasm.
• Hypertrophic cardiomyopathy (enlarged heart).
• Pulmonary hypertension.
• Subarachnoid hemorrhage (bleeding into the space between
the brain and the skull).

26. side effects
Dihydropyridines
• Feeling lightheaded or dizzy.
• Feeling flushed.
• Headaches.
• Swelling in your limbs.
Non-dihydropyridines
• Constipation.
• Slow heartbeat (bradycardia).
• Reduction in your heart’s blood pumping ability.
Many calcium channel blockers can cause gingival hyperplasia, which is when
your gums grow too much around your teeth. They may also cause an
increase in symptoms of gastroesophageal reflux disease (GERD) orheartburn.