This document discusses different types of drugs used to treat angina pectoris, including nitrates, beta-blockers, calcium channel blockers, and ranolazine. Nitrates work by dilating blood vessels to reduce oxygen demand on the heart. Beta-blockers lower heart rate and contractility. Calcium channel blockers inhibit calcium influx to protect heart tissue. Ranolazine inhibits sodium channels to improve the balance of oxygen supply and demand in the heart. These drugs are commonly used alone or in combination to manage stable angina by reducing factors that can trigger chest pain.
Anti anginal drugs, uses, mechanism of action, adverse effectsKarun Kumar
A presentation outlining the causes of angina, mechanism of action of various anti-anginal drugs, their uses and side effects alongwith contraindications
Anti anginal drugs, uses, mechanism of action, adverse effectsKarun Kumar
A presentation outlining the causes of angina, mechanism of action of various anti-anginal drugs, their uses and side effects alongwith contraindications
5-Hydroxytryptamine & it’s Antagonist is a Topic in Pharmacology which will defiantly Help You in pharmacy field All information is related to pharmacology drug acting and it's effect on body. it is collage project given by our department i would like to share with you.
It is a anti- hypertensive drug. It is non-selective beta blocker drug. Hence it is beta blocker drug so it has many side effect.Not only Propranolol but also Timolol,Atenolol are beta blocker drugs.
5-Hydroxytryptamine & it’s Antagonist is a Topic in Pharmacology which will defiantly Help You in pharmacy field All information is related to pharmacology drug acting and it's effect on body. it is collage project given by our department i would like to share with you.
It is a anti- hypertensive drug. It is non-selective beta blocker drug. Hence it is beta blocker drug so it has many side effect.Not only Propranolol but also Timolol,Atenolol are beta blocker drugs.
principle action of drugs,types of angina classification of drugs ,nitrates,calcium channel blockers pharmacological actions ,combination therapy and its sid effects
An interesting ppt on antianginal drugs and drug therapy of myocardial infarction with illustrations for better understanding of concepts and grasping facts...
PH1.28 Describe the mechanisms of action, types, doses, side effects, indicat...Dr Pankaj Kumar Gupta
PH1.28 Describe the mechanisms of action, types, doses, side effects, indications and contraindications of the drugs used in ischemic heart disease (stable, unstable angina and myocardial infarction), peripheral vascular disease
Observation of Io’s Resurfacing via Plume Deposition Using Ground-based Adapt...Sérgio Sacani
Since volcanic activity was first discovered on Io from Voyager images in 1979, changes
on Io’s surface have been monitored from both spacecraft and ground-based telescopes.
Here, we present the highest spatial resolution images of Io ever obtained from a groundbased telescope. These images, acquired by the SHARK-VIS instrument on the Large
Binocular Telescope, show evidence of a major resurfacing event on Io’s trailing hemisphere. When compared to the most recent spacecraft images, the SHARK-VIS images
show that a plume deposit from a powerful eruption at Pillan Patera has covered part
of the long-lived Pele plume deposit. Although this type of resurfacing event may be common on Io, few have been detected due to the rarity of spacecraft visits and the previously low spatial resolution available from Earth-based telescopes. The SHARK-VIS instrument ushers in a new era of high resolution imaging of Io’s surface using adaptive
optics at visible wavelengths.
This pdf is about the Schizophrenia.
For more details visit on YouTube; @SELF-EXPLANATORY;
https://www.youtube.com/channel/UCAiarMZDNhe1A3Rnpr_WkzA/videos
Thanks...!
Comparing Evolved Extractive Text Summary Scores of Bidirectional Encoder Rep...University of Maribor
Slides from:
11th International Conference on Electrical, Electronics and Computer Engineering (IcETRAN), Niš, 3-6 June 2024
Track: Artificial Intelligence
https://www.etran.rs/2024/en/home-english/
What is greenhouse gasses and how many gasses are there to affect the Earth.moosaasad1975
What are greenhouse gasses how they affect the earth and its environment what is the future of the environment and earth how the weather and the climate effects.
Multi-source connectivity as the driver of solar wind variability in the heli...Sérgio Sacani
The ambient solar wind that flls the heliosphere originates from multiple
sources in the solar corona and is highly structured. It is often described
as high-speed, relatively homogeneous, plasma streams from coronal
holes and slow-speed, highly variable, streams whose source regions are
under debate. A key goal of ESA/NASA’s Solar Orbiter mission is to identify
solar wind sources and understand what drives the complexity seen in the
heliosphere. By combining magnetic feld modelling and spectroscopic
techniques with high-resolution observations and measurements, we show
that the solar wind variability detected in situ by Solar Orbiter in March
2022 is driven by spatio-temporal changes in the magnetic connectivity to
multiple sources in the solar atmosphere. The magnetic feld footpoints
connected to the spacecraft moved from the boundaries of a coronal hole
to one active region (12961) and then across to another region (12957). This
is refected in the in situ measurements, which show the transition from fast
to highly Alfvénic then to slow solar wind that is disrupted by the arrival of
a coronal mass ejection. Our results describe solar wind variability at 0.5 au
but are applicable to near-Earth observatories.
3. ATHEROSCLEROSIS
Atherosclerotic lesions in coronary arteries can obstruct blood
flow.
leading to an imbalance in myocardial oxygen supply and
demand that presents as stable angina or an acute coronary
syndrome (myocardial infarction [MI] or unstable angina).
Spasms of vascular smooth muscle may also inhibit cardiac blood
flow, reducing perfusion and causing ischemia and anginal pain.
4. ANGINA PECTORIS
Typical angina pectoris is a characteristic:
Sudden, severe, crushing chest pain that may radiate to the neck,
jaw, back, and arms.
Patients may also present with dyspnea or
Atypical symptoms such as indigestion, nausea, vomiting, or
diaphoresis.
Angina different types caused by varying combinations of increased
myocardial demand and decreased myocardial perfusion.
5. TREATMENT STRATEGIES
Four types of drugs, used either alone or in combination, are
commonly used to manage patients with stable angina:
β-blockers.
Calcium Channel Blockers.
Organic Nitrates.
The sodium channel–blocking drug, ranolazine.
These agents help to balance the cardiac oxygen supply and
demand equation by affecting blood pressure, venous return, heart
rate, and contractility.
6.
7. ORGANIC NITRATES
These compounds cause a reduction in myocardial oxygen demand,
followed by relief of symptoms.
Main Mechanism of action:
Organic nitrates relax vascular smooth muscle by their intracellular
conversion to nitrite ions and then to nitric oxide, which activates
guanylate cyclase and increases the cells’ cyclic guanosine
monophosphate (cGMP).
Elevated cGMP ultimately leads to dephosphorylation of the myosin
light chain, resulting in vascular smooth muscle relaxation
Nitrates such as nitroglycerin cause dilation of the large veins, which
reduces preload (venous return to the heart) and, therefore, reduces
8. MECHANISM OF ACTION OF
NITRATES
Nitrates also dilate the coronary vasculature,
providing an increased blood supply to the heart
muscle.
9. PHARMACOKINETICS
Nitratesdiffer in their onset of action and rate of elimination.
For prompt relief of an angina attack precipitatedby exercise or
emotional stress,sublingual (or spray form) nitroglycerinis the
drug of choice.
All patientssufferingfrom angina should have nitroglycerinon
hand to treat acute angina attacks.
Significantfirst-passmetabolismof nitroglycerinoccurs in the
liver.
Sublingual or transdermalroute (patch or ointment), avoiding the
hepatic first-passeffect.
10. Isosorbide Mononitrate its
improved bioavailability and
long duration of action to its
stability against hepatic
breakdown.
Oral isosorbide dinitrate
undergoes denitration to two
mononitrates, both of which
possess antianginal activity.
11. ADVERSE EFFECTS
Headache is the most common adverse effect of nitrates.
High doses …..postural hypotension, facial flushing, and tachycardia.
Phosphodiesterase type 5 inhibitors as sildenafil potentiate the action of the
nitrates Dangerous hypotension ………. combination is contraindicated.
Tolerance to the actions of nitrates develops rapidly as the blood vessels become
desensitized to vasodilation.
Tolerance can be overcome by providing a daily “nitrate-free interval” to restore
sensitivity to the drug. This interval of 10 to 12 hours is usually taken at night
because demand on the heart is decreased at that time.
Nitroglycerin patches are worn for 12 hours and then removed for 12 hours.
Nitrate-free interval in these patients should occur in the late afternoon.
12. Β-ADRENERGIC BLOCKERS
The β-adrenergic blockers decrease the oxygen demands of the
myocardium by blocking β1 receptors, resulting in decreased heart
rate, contractility, cardiac output, and blood pressure.
These agents reduce myocardial oxygen demand during exertion
and at rest.
Can reduce both the frequency and severity of angina attacks.
β-Blockers can be used to increase exercise duration and
tolerance in patients with effort-induced angina.
β-Blockers are recommended as initial antianginal therapy in all
patients unless contraindicated.
β-Blockers reduce the risk of death and MI in patients who have
had a prior MI and also improve mortality in patients with
hypertension and heart failure with reduced ejection fraction.
13. Propranolol is the prototype for this class of compounds,
but it is not cardioselective
Metoprolol and Atenolol, are preferred.
All β-blockers are nonselective at high doses and can
inhibit β2 receptors.
o β-Blockers should be avoided in patients with severe
bradycardia.
o Nonselective β-blockers should be avoided in patients
with asthma.
o It is important not to discontinue β-blocker therapy
abruptly.
o The dose should be gradually tapered off over 2 to 3
weeks to avoid rebound angina, MI, and hypertension.
15. CALICUM CHANNEL BLOCKERS
Calcium is essential for muscular contraction.
Calcium influx is increased in ischemia because of the
membrane depolarization that hypoxia produces.
This promotes the activity of several ATP-consuming
enzymes, thereby depleting energy stores and worsening
the ischemia.
The calcium channel blockers protect the tissue by
inhibiting the entrance of calcium into cardiac and smooth
muscle cells of the coronary and systemic arterial beds.
16. CALCIUM CHANNEL BLOCKERS
These agents primarily affect the resistance of peripheral and coronary
arteriolar smooth muscle.
In the treatment of effort-induced angina, calcium channel blockers reduce
myocardial oxygen consumption by decreasing vascular resistance, thereby
decreasing afterload.
All calcium channel blockers lower blood pressure.
17. DIHYDROPYRIDINE CALCIUM
CHANNEL BLOCKERS
Amlodipine an oral dihydropyridine, functions mainly
as an arteriolar vasodilator.
This drug has minimal effect on cardiac conduction.
The vasodilatory effect of amlodipine is useful in the
treatment of variant angina caused by spontaneous
coronary spasm.
Nifedipine is another agent in this class; it is usually
administered as an extended-release oral formulation.
18. NONDIHYDROPYRIDINE CALCIUM
CHANNEL BLOCKERS
Verapamil slows atrioventricular (AV) conduction directly and decreases heart
rate, contractility, blood pressure, and oxygen demand.
Verapamil has greater negative inotropic effects than amlodipine, but it is a
weaker vasodilator.
Verapamil is contraindicated in patients with preexisting depressed cardiac
function or AV conduction abnormalities.
Diltiazem also slows AV conduction, decreases the rate of firing of the sinus
node pacemaker, and is also a coronary artery vasodilator.
Nondihydropyridine calcium channel blockers can worsen heart failure due to
their negative inotropic effect, and their use should be avoided in this
population.
19. SODIUM CHANNEL BLOCKERS
Ranolazine inhibits the late phase of the sodium current (late INa).
Improving the oxygen supply and demand equation.
Inhibition of late INa reduces intracellular sodium and calcium
overload, thereby improving diastolic function.
Ranolazine has antianginal as well as antiarrhythmic properties.
It is indicated for the treatment of chronic angina and may be used
alone or in combination with other traditional therapies.
It is most often used in patients who have failed other antianginal
therapies.
Ranolazine is extensively metabolized in the liver.
Ranolazine is subject to numerous drug interactions.