ANGINA PECTORIS MEDICATIONS

Medications Used for Treatment of Angina Pectoris Nitroglycerin (NTG)

Potential side effects:
Clinical effect: Vasodilators Cardiac depressants HA, hypotension, increased heart
rate (remember 3 H’s).
Class
Calcium channel Anti-angina Storing NTG: All forms store at room
of medication: Nitrates Beta blockers
blockers Anti-ischemic temp away from light. SL tablets
Nitroglycerin Verapamil Propranolol store in original glass container.
Ranolazine¹
Examples: Nifedipine Metoprolol Tolerance: Can develop rapidly,
Isosorbid
use lowest effective dose. NTG
mononitrate Diltiazem patches, remain patch free 8–12
1
Ranolazine: Not to be used as a single, primary medication. Ranolazine is used in hrs/day usually while sleeping. Do
conjunction with a β-blocker or calcium channel blocker. Can be used with nitrates. not abruptly stop use. Long-acting
Mechanism of action is unknown. nitrates increase risk of tolerance.
Call for help: If pain is not improved
Type Cause
Goal of treatment Medications after 3 doses of NTG, client should
of angina of problem call emergency responders. Do not
Demand ↑ Cardiac oxygen Nitrates, calcium channel drive self to hospital.
Stable
issue ↓ Cardiac demand blockers, β-blockers
CLINICAL TIPS:
Nitrates, β-blocker
• Short-acting nitrates are used for
ACE inhibitor or ARB acute angina attacks. Long-acting
Maintain cardiac oxygen
Supply Antiplatelet (ASA), nitrates are used to prevent chest
Unstable ↓ Oxygen demand
issue pain.
anticoagulant (LMW heparin),
Prevent infarction • Antiplatelet drugs
possible use of thrombolytics
and anticoagulants increase risk
after diagnostics
for bleeding.
Variant Supply Nitrates, calcium channel • β-blockers are not used in variant
↑ Cardiac oxygen angina. They can increase risk
Prinzmetal issue blockers
of coronary artery spasm.

Route Acute angina Long-term prophylactic Abort ongoing attack & Emergency
of administration treatment treatment of angina anticipation of exertion Management Steps
Sublingual tablets X X for Chest Pain:
Translingual spray X X M Morphine
If O2 SAT
Patches X
O Oxygen < 90% or
Ointment X in respiratory
N Nitrates
distress
Sustained release
X
oral capsules A Aspirin

NOTES

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