SlideShare a Scribd company logo
Anti-anginal drugs
Prepared By – UndhadTushar C.
Masters Of Pharmacy Sem – 1 (Pharmacology)
CONTENTS
• 1.Introduction
• 2.Type of angina
• 3.Risk factors
• 4.Pharmacology of antianginal drugs
• 5.Reference
Tushar Undhad antianginal drugs 2
1.Introduction
Angina pectoris is the chief
symptom of ischemic heart disease
(IHD) characterized by sudden,
severe, pain which may radiate to
the left shoulder and surface of the
left arm.
Tushar Undhad antianginal drugs 3
1.Introduction
• Myocardial oxygen
consumption depends
on preload afterload
and heart rate.
• When the oxygen
supply to the
myocardium is
insufficient for its
needs, myocardial
ischemia develops.
Tushar Undhad antianginal drugs 4
2.Type of angina
• 1.stable angina
• 2.unstable angina
• 3.variant angina
Tushar Undhad antianginal drugs 5
2.Type of angina
1. Classical angina
(stable angina):
• Pain is induced by
exercise or emotion,
both of which increase
myocardial oxygen
demand.
Tushar Undhad antianginal drugs 6
2.Type of angina
• In such patients there is
narrowing of the coronary
arteries due to atherosclerosis
and therefore the coronaries
cannot dilate to increase the
blood supply during exercise.
• Hence there is an imbalance
between oxygen supply and
demand.
Tushar Undhad antianginal drugs 7
2.Type of angina
2.Unstable angina:
• Unstable angina is classified between stable
angina and Myocardial infraction.
• What cause unstable angina- this atheroma
plague rapture and blood clot may form and
decrease blood flow in the artery.
Tushar Undhad antianginal drugs
8
2.Type of angina
• 3.Variant angina
• angina that occurs at rest
and is due to coronary
artery spasm.
• Symptoms are caused by
decreased blood flow to
the heart muscle from the
spasm of the coronary
artery.
Tushar Undhad antianginal drugs 9
3.Risk factors
• Hyperlipidaemia
• Hypertension
• Diabetes
• Smoking
Tushar Undhad antianginal drugs 10
4.Classification of antianginals drugs
Class of drugs Name of drugs
1. Nitrates Nitroglycerine, isosorbide
dinitrate, isosorbide mononitrate,
2. Calcium channel
blockers
Verapamil, diltiazem, amlodipine,
nifedipine, Nicardipin,
3.β-blockers Propranolol, atenolol, metoprolol,
4. Potassium channel
openers
Nicorandil, minoxidil, diazoxide,
5.Other antianginal Dipyridamole, aspirin,
trimetazidine
Tushar Undhad antianginal drugs 11
1. Nitrates
• Ex - Nitroglycerine, Isosorbide Dinitrate, Isosorbide
Mononitrate
• MOA:- Nitrates are vasodilators.
Tushar Undhad antianginal drugs 12
1. Nitrates
• They are converted to
nitric oxide.
• Activates vascular guanylyl
cyclase which increases
the synthesis of cGMP.
• This cGMP catalases the
phosphorylation of protein
kinases causing relaxation
of the smooth muscles.
Tushar Undhad antianginal drugs 13
1. Nitrates
• Pharmacokinetics :-
• Organic nitrates are lipid-soluble: well absorbed
from buccal mucosa. Action occur 5-7 min.
• Half life 2-5 hr.
Tushar Undhad antianginal drugs 14
1. Nitrates
• ADR:-
• Palpitation
• Fatigue, dizziness
• Postural hypotension
Tushar Undhad antianginal drugs 15
1. Nitrates
• USE:
• Angina pectoris
• Cardiac failure
• Myocardial infarction (Ml)
Tushar Undhad antianginal drugs 16
2.Calcium channel blockers
• Ex - Verapamil, Diltiazem, Amlodipine,
Nifedipine, Nicardipin.
• MOA:
• The intracellular concentration of calcium
plays an important role in maintaining the
tone of smooth muscle and in the
contraction of the myocardium.
Tushar Undhad antianginal drugs 17
2.Calcium channel blockers
• Calcium enters muscle cells through special
voltage sensitive calcium channels.
• This triggers release of calcium from the
sarcoplasmic reticulum and mitochondria, which
further increases the cytosolic level of calcium.
Tushar Undhad antianginal drugs 18
2.Calcium channel blockers
• Calcium channel blocker block L-type calcium
channels in the heart and in smooth muscle of
the coronary and peripheral arteriolar.
• This causes vascular smooth muscle to relax,
dilating mainly arterioles
Tushar Undhad antianginal drugs 19
2.Calcium channel blockers
• Pharmacokinetic action :
• Most of these agents have short half-lives (3 to 8
hours)
• Metabolized in liver
• Excreted in urine
Tushar Undhad antianginal drugs 20
2.Calcium channel blockers
• ADR:
• Dizziness, headache, and a feeling of fatigue
caused by a decrease in blood pressure
• Peripheral edema is another commonly reported
side effect of this class.
Tushar Undhad antianginal drugs 21
2.Calcium channel blockers
• Therapeutic uses:
• Hypertension
• Treatment of angina
• Arrhythmias
Tushar Undhad antianginal drugs 22
3.β-blockers
• Ex- Propranolol, Atenolol, Metoprolol.
• MOA:
• Blockade of cardiac β1 receptors results in
decreased myocardial contractility and cardiac
output.
• They reduce the BP due to a fall in the cardiac
output.
• They also lower plasma renin activity and have
an additional central antihypertensive action.
Tushar Undhad antianginal drugs 23
3.β-blockers
Tushar Undhad antianginal drugs 24
Mechanism of action:
3.β-blockers
• Pharmacokinetic action :
• β-blockers are orally active
• Metabolised in the liver
• t½ is 3-7 hrs.
Tushar Undhad antianginal drugs 25
3.β-blockers
• ADR:
• Bradycardia
• Fatigue
• Insomnia
• Sexual dysfunction
• Hypotension
Tushar Undhad antianginal drugs 26
3.β-blockers
• Therapeutic uses:
• Previous myocardial infarction,
• Angina pectoris
• Chronic heart failure
• Hypertension
Tushar Undhad antianginal drugs 27
4. Potassium channel openers
• MOA:
• Opening these channels
hyperpolarizes the smooth
muscle, which closes voltage-
gated calcium channels and
decreases intracellular calcium.
• This leads to relaxation and
vasodilation.
Tushar Undhad antianginal drugs 28
Ex - Nicorandil, Minoxidil, Minoxidil, Diazoxide
4. Potassium channel openers
Tushar Undhad antianginal drugs 29
4. Potassium channel openers
• ADR:
• Headaches, flushing
• Reflex tachycardia
• Fluid and salt retention
Tushar Undhad antianginal drugs 30
4. Potassium channel openers
• Therapeutic uses:
• Hypertension
• Smooth muscle relaxing activity
• Vasodilator to treat angina
Tushar Undhad antianginal drugs 31
5.References:
• Essentials Of Medical Pharmacology 8th Edition
2018 By KDTripathi
• Lippincott's pharmacology
• Padmaja Uday Kumar Professor and Head
Department of Pharmacology Fr. Muller Medical
College, Mangalore Karnataka India
• Goodman and Gilman’s The Pharmacological Basis of
Therapeutics, 11th -Edition 2006
• Rang & Dale’s Pharmacology, Eighth edition
Tushar Undhad antianginal drugs 32
Tushar Undhad antianginal drugs 33

More Related Content

What's hot

Vasodilators - Medicinal chemistry for B.Pharm.
Vasodilators - Medicinal chemistry for B.Pharm.Vasodilators - Medicinal chemistry for B.Pharm.
Vasodilators - Medicinal chemistry for B.Pharm.
Purna Nagasree K
 
Antihyperlipidemic drug
Antihyperlipidemic drugAntihyperlipidemic drug
Antihyperlipidemic drug
Ashwani Dhingra
 
Sympatholytics.pptx
Sympatholytics.pptxSympatholytics.pptx
Sympatholytics.pptx
A M O L D E O R E
 
5.adrenergics and antiadrenergics
5.adrenergics and antiadrenergics 5.adrenergics and antiadrenergics
5.adrenergics and antiadrenergics
Dr.Manish Kumar
 
Anti anginal drugs naser
Anti anginal drugs naserAnti anginal drugs naser
Anti anginal drugs naser
Naser Tadvi
 
Calcium channel blockers word file
Calcium channel blockers word fileCalcium channel blockers word file
Calcium channel blockers word file
Nikhil Vaishnav
 
Antianginal drugs and drugs used in ischaemia - drdhriti
Antianginal drugs and drugs used in ischaemia - drdhritiAntianginal drugs and drugs used in ischaemia - drdhriti
Antianginal drugs and drugs used in ischaemia - drdhriti
http://neigrihms.gov.in/
 
Antihyperlipidemic agents
Antihyperlipidemic agentsAntihyperlipidemic agents
Antihyperlipidemic agents
kencha swathi
 
Nitrates in angina pectoris
Nitrates in angina pectorisNitrates in angina pectoris
Nitrates in angina pectoris
Jimmy Potter
 
Drugs used for CHF
Drugs used for CHFDrugs used for CHF
Drugs used for CHF
Dr Manish Pal Singh
 
Calcium channel blockers nikku
Calcium channel blockers nikkuCalcium channel blockers nikku
Calcium channel blockers nikku
Nikhil Vaishnav
 
Drugs for heart failure
Drugs for heart failureDrugs for heart failure
Drugs for heart failure
Karun Kumar
 
Pharmacology of Diuretics
Pharmacology of DiureticsPharmacology of Diuretics
Pharmacology of Diuretics
Koppala RVS Chaitanya
 
Antianginals - pharmacology
Antianginals - pharmacologyAntianginals - pharmacology
Antianginals - pharmacology
pavithra vinayak
 
antianginal drugs
antianginal drugs antianginal drugs
antianginal drugs
jaynandanprasadsah2
 
Drugs used in congestive heart failure-1
Drugs used in congestive heart failure-1Drugs used in congestive heart failure-1
Drugs used in congestive heart failure-1
Goutam Mallik
 
Anti anginal drugs
Anti anginal drugsAnti anginal drugs
Anti anginal drugs
Dr Pralhad Patki
 
5-Hydroxytrptamine & it's Antagonist
5-Hydroxytrptamine & it's Antagonist5-Hydroxytrptamine & it's Antagonist
5-Hydroxytrptamine & it's Antagonist
Shubham Patil
 
Cardiovascular pharmacology
Cardiovascular pharmacologyCardiovascular pharmacology
Cardiovascular pharmacology
Reza Heidari
 

What's hot (20)

Vasodilators - Medicinal chemistry for B.Pharm.
Vasodilators - Medicinal chemistry for B.Pharm.Vasodilators - Medicinal chemistry for B.Pharm.
Vasodilators - Medicinal chemistry for B.Pharm.
 
Antihyperlipidemic drug
Antihyperlipidemic drugAntihyperlipidemic drug
Antihyperlipidemic drug
 
Sympatholytics.pptx
Sympatholytics.pptxSympatholytics.pptx
Sympatholytics.pptx
 
5.adrenergics and antiadrenergics
5.adrenergics and antiadrenergics 5.adrenergics and antiadrenergics
5.adrenergics and antiadrenergics
 
Anti anginal drugs naser
Anti anginal drugs naserAnti anginal drugs naser
Anti anginal drugs naser
 
Calcium channel blockers word file
Calcium channel blockers word fileCalcium channel blockers word file
Calcium channel blockers word file
 
Antianginal drugs and drugs used in ischaemia - drdhriti
Antianginal drugs and drugs used in ischaemia - drdhritiAntianginal drugs and drugs used in ischaemia - drdhriti
Antianginal drugs and drugs used in ischaemia - drdhriti
 
Antihyperlipidemic agents
Antihyperlipidemic agentsAntihyperlipidemic agents
Antihyperlipidemic agents
 
Nitrates in angina pectoris
Nitrates in angina pectorisNitrates in angina pectoris
Nitrates in angina pectoris
 
Drugs used for CHF
Drugs used for CHFDrugs used for CHF
Drugs used for CHF
 
Calcium channel blockers nikku
Calcium channel blockers nikkuCalcium channel blockers nikku
Calcium channel blockers nikku
 
Drugs for heart failure
Drugs for heart failureDrugs for heart failure
Drugs for heart failure
 
Pharmacology of Diuretics
Pharmacology of DiureticsPharmacology of Diuretics
Pharmacology of Diuretics
 
Antianginals - pharmacology
Antianginals - pharmacologyAntianginals - pharmacology
Antianginals - pharmacology
 
antianginal drugs
antianginal drugs antianginal drugs
antianginal drugs
 
Drugs used in congestive heart failure-1
Drugs used in congestive heart failure-1Drugs used in congestive heart failure-1
Drugs used in congestive heart failure-1
 
Anti anginal drugs
Anti anginal drugsAnti anginal drugs
Anti anginal drugs
 
5-Hydroxytrptamine & it's Antagonist
5-Hydroxytrptamine & it's Antagonist5-Hydroxytrptamine & it's Antagonist
5-Hydroxytrptamine & it's Antagonist
 
Adrenergic antagonists
Adrenergic antagonistsAdrenergic antagonists
Adrenergic antagonists
 
Cardiovascular pharmacology
Cardiovascular pharmacologyCardiovascular pharmacology
Cardiovascular pharmacology
 

Similar to Antianginal drugs.pptx

Directly acting Arteriolar Dilators
Directly acting Arteriolar DilatorsDirectly acting Arteriolar Dilators
Directly acting Arteriolar Dilators
CCSU
 
ANTI ANGINAL DRUGS.pptx
ANTI ANGINAL DRUGS.pptxANTI ANGINAL DRUGS.pptx
ANTI ANGINAL DRUGS.pptx
HaseebAliHaseebAli
 
Anti Hypertensive Drugs
Anti Hypertensive DrugsAnti Hypertensive Drugs
Anti Hypertensive DrugsShams Patel
 
Ant ihypertensive
Ant ihypertensiveAnt ihypertensive
Ant ihypertensive
Monika Devi NR
 
hypertension.pptx
hypertension.pptxhypertension.pptx
hypertension.pptx
Ahad Ali
 
13. VASODIL_ISCHEMIC HEART DISEASE_095100 (1).pptx
13. VASODIL_ISCHEMIC HEART DISEASE_095100 (1).pptx13. VASODIL_ISCHEMIC HEART DISEASE_095100 (1).pptx
13. VASODIL_ISCHEMIC HEART DISEASE_095100 (1).pptx
bwalyakangwa582
 
UNIT X CARDIAC DRUGS
UNIT X CARDIAC DRUGSUNIT X CARDIAC DRUGS
UNIT X CARDIAC DRUGS
A Y
 
PH1.28 Describe the mechanisms of action, types, doses, side effects, indicat...
PH1.28 Describe the mechanisms of action, types, doses, side effects, indicat...PH1.28 Describe the mechanisms of action, types, doses, side effects, indicat...
PH1.28 Describe the mechanisms of action, types, doses, side effects, indicat...
Dr Pankaj Kumar Gupta
 
Angina pectoris
Angina pectorisAngina pectoris
Angina pectoris
mzabihi
 
Antihypertensives
AntihypertensivesAntihypertensives
Antihypertensives
Dr. Marya Ahsan
 
7.ANTI-ANGINAL DRUGS.ppt
7.ANTI-ANGINAL DRUGS.ppt7.ANTI-ANGINAL DRUGS.ppt
7.ANTI-ANGINAL DRUGS.ppt
Fridahchungu
 
Drugs used for the treatment of myocardial ischemia
Drugs used for the treatment of myocardial ischemiaDrugs used for the treatment of myocardial ischemia
Drugs used for the treatment of myocardial ischemiask-yasmeen
 
Dental Pharmacology - Ans
Dental Pharmacology - AnsDental Pharmacology - Ans
Dental Pharmacology - Ans
Taha Hussein Kadi
 
Antihypertensive.pptx
Antihypertensive.pptxAntihypertensive.pptx
Antihypertensive.pptx
ADOLEYBEATRICE
 
Anti-Angina & Anti arryhthias Drugs .ppt
Anti-Angina & Anti arryhthias Drugs .pptAnti-Angina & Anti arryhthias Drugs .ppt
Anti-Angina & Anti arryhthias Drugs .ppt
ssuser504dda
 
Cardiovascular Drugs
Cardiovascular DrugsCardiovascular Drugs
Cardiovascular Drugs
HannaShibu
 
Unit 10 cardivascular drugs
Unit 10 cardivascular drugsUnit 10 cardivascular drugs
Unit 10 cardivascular drugs
Mr. Dipti sorte
 
Antianginal drugs
Antianginal drugsAntianginal drugs
Antianginal drugs
ajaykumarbp
 

Similar to Antianginal drugs.pptx (20)

Directly acting Arteriolar Dilators
Directly acting Arteriolar DilatorsDirectly acting Arteriolar Dilators
Directly acting Arteriolar Dilators
 
ANTI ANGINAL DRUGS.pptx
ANTI ANGINAL DRUGS.pptxANTI ANGINAL DRUGS.pptx
ANTI ANGINAL DRUGS.pptx
 
Anti Hypertensive Drugs
Anti Hypertensive DrugsAnti Hypertensive Drugs
Anti Hypertensive Drugs
 
Ant ihypertensive
Ant ihypertensiveAnt ihypertensive
Ant ihypertensive
 
hypertension.pptx
hypertension.pptxhypertension.pptx
hypertension.pptx
 
13. VASODIL_ISCHEMIC HEART DISEASE_095100 (1).pptx
13. VASODIL_ISCHEMIC HEART DISEASE_095100 (1).pptx13. VASODIL_ISCHEMIC HEART DISEASE_095100 (1).pptx
13. VASODIL_ISCHEMIC HEART DISEASE_095100 (1).pptx
 
UNIT X CARDIAC DRUGS
UNIT X CARDIAC DRUGSUNIT X CARDIAC DRUGS
UNIT X CARDIAC DRUGS
 
PH1.28 Describe the mechanisms of action, types, doses, side effects, indicat...
PH1.28 Describe the mechanisms of action, types, doses, side effects, indicat...PH1.28 Describe the mechanisms of action, types, doses, side effects, indicat...
PH1.28 Describe the mechanisms of action, types, doses, side effects, indicat...
 
Angina pectoris
Angina pectorisAngina pectoris
Angina pectoris
 
Antihypertensives
AntihypertensivesAntihypertensives
Antihypertensives
 
7.ANTI-ANGINAL DRUGS.ppt
7.ANTI-ANGINAL DRUGS.ppt7.ANTI-ANGINAL DRUGS.ppt
7.ANTI-ANGINAL DRUGS.ppt
 
CHF.pptx
CHF.pptxCHF.pptx
CHF.pptx
 
Antianginals +Calcium channel blockers AHS gowtham sap
Antianginals +Calcium channel blockers AHS gowtham sapAntianginals +Calcium channel blockers AHS gowtham sap
Antianginals +Calcium channel blockers AHS gowtham sap
 
Drugs used for the treatment of myocardial ischemia
Drugs used for the treatment of myocardial ischemiaDrugs used for the treatment of myocardial ischemia
Drugs used for the treatment of myocardial ischemia
 
Dental Pharmacology - Ans
Dental Pharmacology - AnsDental Pharmacology - Ans
Dental Pharmacology - Ans
 
Antihypertensive.pptx
Antihypertensive.pptxAntihypertensive.pptx
Antihypertensive.pptx
 
Anti-Angina & Anti arryhthias Drugs .ppt
Anti-Angina & Anti arryhthias Drugs .pptAnti-Angina & Anti arryhthias Drugs .ppt
Anti-Angina & Anti arryhthias Drugs .ppt
 
Cardiovascular Drugs
Cardiovascular DrugsCardiovascular Drugs
Cardiovascular Drugs
 
Unit 10 cardivascular drugs
Unit 10 cardivascular drugsUnit 10 cardivascular drugs
Unit 10 cardivascular drugs
 
Antianginal drugs
Antianginal drugsAntianginal drugs
Antianginal drugs
 

Recently uploaded

Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 UpakalpaniyaadhyayaCharaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Dr KHALID B.M
 
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.GawadHemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
NephroTube - Dr.Gawad
 
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdfBENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
DR SETH JOTHAM
 
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptxPharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Dr. Rabia Inam Gandapore
 
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptxMaxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Dr. Rabia Inam Gandapore
 
micro teaching on communication m.sc nursing.pdf
micro teaching on communication m.sc nursing.pdfmicro teaching on communication m.sc nursing.pdf
micro teaching on communication m.sc nursing.pdf
Anurag Sharma
 
The Normal Electrocardiogram - Part I of II
The Normal Electrocardiogram - Part I of IIThe Normal Electrocardiogram - Part I of II
The Normal Electrocardiogram - Part I of II
MedicoseAcademics
 
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
GL Anaacs
 
263778731218 Abortion Clinic /Pills In Harare ,
263778731218 Abortion Clinic /Pills In Harare ,263778731218 Abortion Clinic /Pills In Harare ,
263778731218 Abortion Clinic /Pills In Harare ,
sisternakatoto
 
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness JourneyTom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
greendigital
 
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #GirlsFor Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
Savita Shen $i11
 
Knee anatomy and clinical tests 2024.pdf
Knee anatomy and clinical tests 2024.pdfKnee anatomy and clinical tests 2024.pdf
Knee anatomy and clinical tests 2024.pdf
vimalpl1234
 
POST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its managementPOST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its management
touseefaziz1
 
Ocular injury ppt Upendra pal optometrist upums saifai etawah
Ocular injury  ppt  Upendra pal  optometrist upums saifai etawahOcular injury  ppt  Upendra pal  optometrist upums saifai etawah
Ocular injury ppt Upendra pal optometrist upums saifai etawah
pal078100
 
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptxHow STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
FFragrant
 
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
i3 Health
 
How to Give Better Lectures: Some Tips for Doctors
How to Give Better Lectures: Some Tips for DoctorsHow to Give Better Lectures: Some Tips for Doctors
How to Give Better Lectures: Some Tips for Doctors
LanceCatedral
 
KDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologistsKDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologists
د.محمود نجيب
 
Physiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdfPhysiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdf
MedicoseAcademics
 
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdfAlcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Dr Jeenal Mistry
 

Recently uploaded (20)

Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 UpakalpaniyaadhyayaCharaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
 
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.GawadHemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
 
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdfBENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
 
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptxPharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
 
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptxMaxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
 
micro teaching on communication m.sc nursing.pdf
micro teaching on communication m.sc nursing.pdfmicro teaching on communication m.sc nursing.pdf
micro teaching on communication m.sc nursing.pdf
 
The Normal Electrocardiogram - Part I of II
The Normal Electrocardiogram - Part I of IIThe Normal Electrocardiogram - Part I of II
The Normal Electrocardiogram - Part I of II
 
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
 
263778731218 Abortion Clinic /Pills In Harare ,
263778731218 Abortion Clinic /Pills In Harare ,263778731218 Abortion Clinic /Pills In Harare ,
263778731218 Abortion Clinic /Pills In Harare ,
 
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness JourneyTom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
 
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #GirlsFor Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
 
Knee anatomy and clinical tests 2024.pdf
Knee anatomy and clinical tests 2024.pdfKnee anatomy and clinical tests 2024.pdf
Knee anatomy and clinical tests 2024.pdf
 
POST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its managementPOST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its management
 
Ocular injury ppt Upendra pal optometrist upums saifai etawah
Ocular injury  ppt  Upendra pal  optometrist upums saifai etawahOcular injury  ppt  Upendra pal  optometrist upums saifai etawah
Ocular injury ppt Upendra pal optometrist upums saifai etawah
 
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptxHow STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
 
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
 
How to Give Better Lectures: Some Tips for Doctors
How to Give Better Lectures: Some Tips for DoctorsHow to Give Better Lectures: Some Tips for Doctors
How to Give Better Lectures: Some Tips for Doctors
 
KDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologistsKDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologists
 
Physiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdfPhysiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdf
 
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdfAlcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
 

Antianginal drugs.pptx

  • 1. Anti-anginal drugs Prepared By – UndhadTushar C. Masters Of Pharmacy Sem – 1 (Pharmacology)
  • 2. CONTENTS • 1.Introduction • 2.Type of angina • 3.Risk factors • 4.Pharmacology of antianginal drugs • 5.Reference Tushar Undhad antianginal drugs 2
  • 3. 1.Introduction Angina pectoris is the chief symptom of ischemic heart disease (IHD) characterized by sudden, severe, pain which may radiate to the left shoulder and surface of the left arm. Tushar Undhad antianginal drugs 3
  • 4. 1.Introduction • Myocardial oxygen consumption depends on preload afterload and heart rate. • When the oxygen supply to the myocardium is insufficient for its needs, myocardial ischemia develops. Tushar Undhad antianginal drugs 4
  • 5. 2.Type of angina • 1.stable angina • 2.unstable angina • 3.variant angina Tushar Undhad antianginal drugs 5
  • 6. 2.Type of angina 1. Classical angina (stable angina): • Pain is induced by exercise or emotion, both of which increase myocardial oxygen demand. Tushar Undhad antianginal drugs 6
  • 7. 2.Type of angina • In such patients there is narrowing of the coronary arteries due to atherosclerosis and therefore the coronaries cannot dilate to increase the blood supply during exercise. • Hence there is an imbalance between oxygen supply and demand. Tushar Undhad antianginal drugs 7
  • 8. 2.Type of angina 2.Unstable angina: • Unstable angina is classified between stable angina and Myocardial infraction. • What cause unstable angina- this atheroma plague rapture and blood clot may form and decrease blood flow in the artery. Tushar Undhad antianginal drugs 8
  • 9. 2.Type of angina • 3.Variant angina • angina that occurs at rest and is due to coronary artery spasm. • Symptoms are caused by decreased blood flow to the heart muscle from the spasm of the coronary artery. Tushar Undhad antianginal drugs 9
  • 10. 3.Risk factors • Hyperlipidaemia • Hypertension • Diabetes • Smoking Tushar Undhad antianginal drugs 10
  • 11. 4.Classification of antianginals drugs Class of drugs Name of drugs 1. Nitrates Nitroglycerine, isosorbide dinitrate, isosorbide mononitrate, 2. Calcium channel blockers Verapamil, diltiazem, amlodipine, nifedipine, Nicardipin, 3.β-blockers Propranolol, atenolol, metoprolol, 4. Potassium channel openers Nicorandil, minoxidil, diazoxide, 5.Other antianginal Dipyridamole, aspirin, trimetazidine Tushar Undhad antianginal drugs 11
  • 12. 1. Nitrates • Ex - Nitroglycerine, Isosorbide Dinitrate, Isosorbide Mononitrate • MOA:- Nitrates are vasodilators. Tushar Undhad antianginal drugs 12
  • 13. 1. Nitrates • They are converted to nitric oxide. • Activates vascular guanylyl cyclase which increases the synthesis of cGMP. • This cGMP catalases the phosphorylation of protein kinases causing relaxation of the smooth muscles. Tushar Undhad antianginal drugs 13
  • 14. 1. Nitrates • Pharmacokinetics :- • Organic nitrates are lipid-soluble: well absorbed from buccal mucosa. Action occur 5-7 min. • Half life 2-5 hr. Tushar Undhad antianginal drugs 14
  • 15. 1. Nitrates • ADR:- • Palpitation • Fatigue, dizziness • Postural hypotension Tushar Undhad antianginal drugs 15
  • 16. 1. Nitrates • USE: • Angina pectoris • Cardiac failure • Myocardial infarction (Ml) Tushar Undhad antianginal drugs 16
  • 17. 2.Calcium channel blockers • Ex - Verapamil, Diltiazem, Amlodipine, Nifedipine, Nicardipin. • MOA: • The intracellular concentration of calcium plays an important role in maintaining the tone of smooth muscle and in the contraction of the myocardium. Tushar Undhad antianginal drugs 17
  • 18. 2.Calcium channel blockers • Calcium enters muscle cells through special voltage sensitive calcium channels. • This triggers release of calcium from the sarcoplasmic reticulum and mitochondria, which further increases the cytosolic level of calcium. Tushar Undhad antianginal drugs 18
  • 19. 2.Calcium channel blockers • Calcium channel blocker block L-type calcium channels in the heart and in smooth muscle of the coronary and peripheral arteriolar. • This causes vascular smooth muscle to relax, dilating mainly arterioles Tushar Undhad antianginal drugs 19
  • 20. 2.Calcium channel blockers • Pharmacokinetic action : • Most of these agents have short half-lives (3 to 8 hours) • Metabolized in liver • Excreted in urine Tushar Undhad antianginal drugs 20
  • 21. 2.Calcium channel blockers • ADR: • Dizziness, headache, and a feeling of fatigue caused by a decrease in blood pressure • Peripheral edema is another commonly reported side effect of this class. Tushar Undhad antianginal drugs 21
  • 22. 2.Calcium channel blockers • Therapeutic uses: • Hypertension • Treatment of angina • Arrhythmias Tushar Undhad antianginal drugs 22
  • 23. 3.β-blockers • Ex- Propranolol, Atenolol, Metoprolol. • MOA: • Blockade of cardiac β1 receptors results in decreased myocardial contractility and cardiac output. • They reduce the BP due to a fall in the cardiac output. • They also lower plasma renin activity and have an additional central antihypertensive action. Tushar Undhad antianginal drugs 23
  • 24. 3.β-blockers Tushar Undhad antianginal drugs 24 Mechanism of action:
  • 25. 3.β-blockers • Pharmacokinetic action : • β-blockers are orally active • Metabolised in the liver • t½ is 3-7 hrs. Tushar Undhad antianginal drugs 25
  • 26. 3.β-blockers • ADR: • Bradycardia • Fatigue • Insomnia • Sexual dysfunction • Hypotension Tushar Undhad antianginal drugs 26
  • 27. 3.β-blockers • Therapeutic uses: • Previous myocardial infarction, • Angina pectoris • Chronic heart failure • Hypertension Tushar Undhad antianginal drugs 27
  • 28. 4. Potassium channel openers • MOA: • Opening these channels hyperpolarizes the smooth muscle, which closes voltage- gated calcium channels and decreases intracellular calcium. • This leads to relaxation and vasodilation. Tushar Undhad antianginal drugs 28 Ex - Nicorandil, Minoxidil, Minoxidil, Diazoxide
  • 29. 4. Potassium channel openers Tushar Undhad antianginal drugs 29
  • 30. 4. Potassium channel openers • ADR: • Headaches, flushing • Reflex tachycardia • Fluid and salt retention Tushar Undhad antianginal drugs 30
  • 31. 4. Potassium channel openers • Therapeutic uses: • Hypertension • Smooth muscle relaxing activity • Vasodilator to treat angina Tushar Undhad antianginal drugs 31
  • 32. 5.References: • Essentials Of Medical Pharmacology 8th Edition 2018 By KDTripathi • Lippincott's pharmacology • Padmaja Uday Kumar Professor and Head Department of Pharmacology Fr. Muller Medical College, Mangalore Karnataka India • Goodman and Gilman’s The Pharmacological Basis of Therapeutics, 11th -Edition 2006 • Rang & Dale’s Pharmacology, Eighth edition Tushar Undhad antianginal drugs 32