Anti-anginal drug

SUMMARY DRUG TABLE ANTI ANGINAL DRUGS (Cbnf/ m/ed)... 

Is the patient taking any medications/supplements that may exacerbate angina or interact with anti-anginal drug therapy ... 

Ikorel is a proprietary preparation of nicorandil (an anti-anginal drug). 

Van Zwieten PA. Clinical pharmacology of calcium antagonists as antihypertensive and anti-anginal drugs. J Hypertens 1996 14(Suppl 3) S3-9. 

Flammang D, Waynberger M, Jansen FH, PaiUet R, Coumel P. Electrophysiological profile of bepridil, a new anti-anginal drug with calcium blocking properties. Eur Heart J 1983 4(9) 647-54. 

Slow Calcium Channel Blockers (SCCBs), which are also referred to as calcium entry blockers and even, erroneously, as calcium antagonists, are a number of marketed drugs, several of which have no chemical relationship to the others. They will be discussed in some detail with the anti-anginal drugs (see later). At this point, suffice it to state that their antihypertensive effect is due to their ability to modulate the influx of Ca2+ across the cell membrane of the arterial smooth muscle. This will reduce Ca2+-promoted activation of the cells contractile proteins, leading to vasodilation. 

Verstraete M, Vermy len J, Claeys H. Dissimilar effect of two anti-anginal drugs belonging to the benzofuran group on the action of coumarin derivatives. Arch Int Pharmacodyn Ther (1968) 176,33-41. 

The controversy over the actions of nitroglycerin and propranolol continues and, therefore, the relative importance of selective dilatation of collateral coronary arteries compared to reduction in myocardial oxygen needs per se has not been established. While propranolol appears effective in the prophylactic therapy of angina pectoris, concern has been raised over the apparent "rebound" increase in anginal attacks after cessation of therapy. Therefore, further investigation is needed before propranolol is accepted as the sine qua non of anti-anginal drugs. 

Sodium tanshinone II-A sulfonate (a water soluble sulfonate of the parent diterpenoid) is used to treat angina pectoris and myocardial infarction. It exhibits a strong membrane-stabilizing effect on red blood corpuscles and may act similarly to the drug verapamil. Intravenously, a S. miltiorrhizalDalbergia odorifera TCM mixture may have potential as an anti-anginal drug (31). 

We describe below the use of halloysite nanotubules for entrapment and the subsequent release of three drugs Nifedipine (anti-anginal), Furosemide (anti-hypertension and diuretic), and Dexamethasone (synthetic corticosteroid). To increase the loading of these poorly soluble drugs in the tubules, we loaded them into a water-alcohol co-solvent solution (0, 10, and 50% ethanol). 

Heparin and antiplatelet drugs are therefore used in various forms of angina to help prevent infarction. When administered with the traditional anti-anginal medications, these anticoagulants can help decrease morbidity and mortality in people with ischemic heart disease. For more details on the effects of anticoagulant medications, please refer to Chapter 25. 

Orally administered isosorbide dinitrate shows clear hemodynamic and anti-anginal effects, but it undergoes a rapid hepatic first-pass metabolism, with a plasma half-life of ca. 40 min. Its major metabolites are isosorbide-2-mononitrate and isosorbide-5-mononitrate, with half-lives of 2 and 4 h, respectively [16]. A transdermal spray of isosorbide dinitrate can be administered in order to avoid the first-pass effect, and the unchanged drug penetrates through the skin within 20 min so that it is slowly released into the capillaries in therapeutically effective amounts [24]. A very recent study showed intravenously infused isosorbide dinitrate to be ideal anti-anginal agent, especially in acute conditions [25]. 

The measurement of the heart dimensions allows to localize the effect of a drag on the activity of the heart. An ultrasonic technique is used for continuous measurement of left ventricular dimensions. Compounds are tested with potential anti-anginal activity due to the reduction of left ventricular diameter. The test is used to evaluate the influence of drugs on left ventricular external and internal diameter in anesthetized dogs. 

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