ANTI – ANGINA DRUGS

Angina is chest pain produced when insufficient oxygen reaches the heart muscle. This is usually cause by a narrowing of the blood vessels ( coronary arteries ) the carry blood and oxygen to the muscle. In the most common type of angina ( classic angina ),pain usually occurs during physical exertion or emotional stress. In variant angina, pain may also occurs at rest. in classic angina, the narrowing of the coronary arteries results from deposits of fat called atheroma – on the walls of the arteries. in the variant type,however,angina is caused by contraction (spasm) of the muscle fibres in the artery walls.
Atheroma deposits built up more rapidly in the arteries of smokers and people who eat a high-fat diet. this is why, as a basic component of angina treatment,doctors recommend tha smoking should be given up and the diet changed.Overweight people are also adviced to lose weight in order to reduce the demands placed on the heart.
While such changes in lifestyle often produce an improvement in symptoms,drug treatment to relieve angina also frequently necessary.
The drugs used to treat angina include beta blockers,nitrates,calcium channel blockers and potassium channel openers.

Why they used?
Frequent episodes of angina can be disabling and, if left untreated,can lead to increased risk of a heart attack.
Drugs can be used both to relieve angina attacks and to reduce their frequency.
People who suffer from only occasional episodes are usually prescribed a rapid acting drug to take at the first signs of an attack,or before an activity tha is known to bring on an attack.A rapid acting nitrate-glyceryl trinitrate-is usually prescribed for this purpose.

If attacks become more frequent or more severe.regular preventative treatment may be adviced. Betablockers,long acting nitrates,and calcium channel blockers are used as regular medication to prevent attacks.The introduction of adhesive pathes to administer nitrates through the patient’s skin has extenden the duration of action of glyceryl trinitrate ,making treatment easier.
Drugs can often control angina for many years,but they cannot cure the disorder.When severe angina cannot be controlled by drugs,then surgery to increase the blood flowto the heart may be recommended.

How they work?
Nitrates and calcium channel blockers dilate blood vessel walls.blood is more easily pumped through the dilated vessels,reducing the strain on the heart.
Betablockers reduce heart muscle stimulation during exercise or stress by interrupting signal transmission in the heart.Decreased heart muscle stimulation means less oxygen is required,reducing the risk of angina attacks.

How they effect you ?
Treatment with one or more of these medicines usually effectively controls angina.Drugs to prevent attacks allow sufferers to undertake more strenuous activities without provoking pain,and if an attack does occur,nitrates usually provide effective relief.

These drugs do not usually cause serious adverse effedt,but they can produce a variety of minor symptoms.By dilating blood vessels throughout the body,the nitrates and calcium channel blockers can cause dizziness (especially when standing)and can cause fainting. Other possible side effects are headaches at the start of treatment,flusing of the skin(especially at face),and ankle swelling.Beta blockers often cause cold hands and feet,and sometimes they may produce tiredness and a feeling of heaviness in the legs.

COMMOM DRUGS

• Beta blockers Cardioselective

• Betaxolol
• Bisoprolol
• Celiprolol
• Metoprol
Atenolol

• Beta blockers Non-cardioselective

• Acebutolol
• Carvedilol
• Labetalol
• Nadolol
• Pindolol
• Propanolol
• Sotalol
• Timolol

• Calcium channel blockers

• Amiodipine
• Ditiazem
• Nicardipine
• Nifedifine

• Nitrates

• Glyceryl trinitrate
• Isosorbide dinitrate/mononitrate
Potassium channel blocker opener
• Nicorandil

• Other drugs

• Aspirin
• Simvastatin
• Heparin