ANTIANGINAL AGENTS

CHAPTER 46
PREPARED BY: JEWEL S. SANTOS, BSN 2B
 CORONARY ARTERY DISEASE (CAD)
• ATHEROMA
• PLAQUE IN THE ENDOTHELIAL LINING OF ARTERIES; CONTAINS FATS, BLOOD
CELLS, LIPIDS, INFLAMMATORY AGENTS, AND PLATELETS

• ATHEROSCLEROSIS
• NARROWING OF THE ARTERIES CAUSED BY BUILDUP OF ATHEROMAS

• ANGINA PECTORIS
• “SUFFOCATION OF THE CHEST”

• MYOCARDIAL INFARCTION
• CELLS IN THE MYOCARDIUM BECOME NECROTIC AND DIE
 TYPES OF ANGINA

• STABLE ANGINA
• PAIN DUE TO THE IMBALANCE OF MYOCARDIAL OXYGEN SUPPLY AND
DEMAND THAT IS RELIEVED BY REST OR STOPPAGE OF ACTIVITY

• UNSTABLE ANGINA
• EPISODE OF MYOCARDIAL ISCHEMIA WITH PAIN DUE TO THE
IMBALANCE OF MYOCARDIAL OXYGEN SUPPLY AND DEMAND WHEN
THE PERSON IS AT REST

• PRINZMETAL’S ANGINA
• DROP IN BLOOD FLOW THROUGH THE CORONARY ARTERIES CAUSED BY
A VASOSPASM IN THE ARTERY
 ANTIANGINAL DRUGS ACTION
• IMPROVE BLOOD DELIVERY TO THE HEART
MUSCLE BY DILATING BLOOD VESSELS
• INCREASING THE SUPPLY OF OXYGEN
• IMPROVE BLOOD DELIVERY TO THE HEART
MUSCLE BY DECREASING THE WORK OF HEART
• DECREASING THE DEMAND FOR OXYGEN
 TYPES OF ANTIANGINAL DRUGS

• NITRATES
• BETA – ADRENERGIC
BLOCKERS
• CALCIUM CHANNEL BLOCKERS
 NITRATES

• ACTIONS
• ACT DIRECTLY ON SMOOTH MUSCLE TO CAUSE RELAXATION AND
TO DEPRESS MUSCLE TONE
• INDICATIONS
• PREVENTION AND TREATMENT OF ATTACKS OF ANGINA PECTORIS
• PHARMACOKINETICS
• VERY RAPIDLY ABSORBED
• METABOLIZED IN THE LIVER
• EXCRETED IN THE URINE
 NITRATES
• CONTRAINDICATIONS
• ALLERGY
• SEVERE ANEMIA
• HEAD TRAUMA OR CEREBRAL HEMORRHAGE
• PREGNANCY AND LACTATION
• CAUTION
• HEPATIC OR RENAL DISEASE
• HYPOTENSION, HYPOVOLEMIA, AND OTHER CONDITIONS THAT
LIMIT CARDIAC OUTPUT
 NITRATES
• ADVERSE EFFECTS
• RELATED TO VASODILATION AND THE DECREASE IN BLOOD FLOW
• CNS – HEADACHE. DIZZINESS, AND WEAKNESS
• GI – NAUSEA, VOMITING, INCONTINENCE
• CV – HYPOTENSION
• SKIN RELATED – FLUSHING, PALLOR, AND INCREASED PERSPIRATION

• DRUG-TO-DRUG INTERACTIONS
• ERGOT DERIVATIVES
• HEPARIN
 BETA BLOCKERS
• ACTIONS
• TO BLOCK THE STIMULATORY EFFECTS OF THE SYMPATHETIC
NERVOUS SYSTEM
• INDICATIONS
• TREATS STABLE ANGINA PECTORIS AND HYPERTENSION,
PREVENTS REINFARCTION IN MI PATIENTS; TREAT STABLE CHF
• PHARMACOKINETICS
• ABSORBED IN GI TRACT, UNDERGOES HEPATIC METABOLISM,
EXCRETED IN THE URINE
 BETA BLOCKERS
• CONTRAINDICATIONS
• BRADYCARDIA
• HEART BLOCK
• CARDIOGENIC SHOCK
• ASTHMA OR COPD
• PREGNANCY AND LACTATION
• CAUTION
• DM
• PERIPHERAL VASCULAR DISEASE
• THYROTOXICOSIS
 BETA BLOCKERS
• ADVERSE EFFECTS
• ASSOCIATED WITH THE BLOCKAGE OF THE SYMPATHETIC
NERVOUS SYSTEM
• CNS – DIZZINESS, FATIGUE, EMOTIONAL DEPRESSION
• GI – NAUSEA, VOMITING, COLITIS
• RESPIRATORY – BRONCHOSPASM, DYSPNEA, AND COUGH
• DRUG-TO-DRUG INTERACTIONS
• CLONIDINE
 CALCIUM CHANNEL BLOCKERS
• ACTIONS
• BLOCKERS INHIBIT THE MOVEMENT OF CALCIUM IONS ACROSS THE
MEMBRANES OF MYOCARDIAL AND ARTERIAL MUSCLE CELLS,
ALTERING THE ACTION POTENTIAL AND BLOCKING MUSCLE CELL
CONTRACTION

• INDICATIONS
• PRINZMENTAL’S ANGINA

• PHARMACOKINETICS
• WELL ABSORBED
• METABOLIZED IN THE LIVER
• EXCRETED IN THE URINE
 CALCIUM CHANNEL BLOCKERS

• CONTRAINDICATIONS
• ALLERGY
• HEART BLOCK OR SICK SINUS SYNDROME
• RENAL OR HEPATIC DYSFUNCTION
• PREGNANCY OR LACTATION
 CALCIUM CHANNEL BLOCKERS
• ADVERSE EFFECTS
• HYPOTENSION
• CARDIAC ARRHYTHMIAS
• GI UPSET
• SKIN REACTIONS
• HEADACHE
• DRUG-TO-DRUG INTERACTIONS
• VARY WITH EACH DRUG